Vasectomy Specialist in Concord, North Carolina

Vasectomies are one of the most common procedures performed by urologists in the US, with over 500,000 done each year. It is a low-cost, low-risk procedure that can be done in an office setting and leads to permanent sterilization for men.

The decision to have a vasectomy should be made only after an open discussion with your partner. Although reversal procedures can be done, these are expensive and highly specialized procedures that may be unsuccessful.

Studies have shown that although the delivery of sperm is halted, there are no major long term effects on the testicles themselves. After recovery from the procedure, a man and his partner should notice no difference during sex. An uncomplicated vasectomy does not cause erection problems. Ejaculation and orgasm should feel the same.

Urologist Dr. Richard Natale
Urologist Dr. Richard Natale

Vasectomy: What to Expect

The vasectomy is typically performed using one small incision made in the center of the scrotum. The vas deferens is a small tube that carries the sperm from the testicle to the ejaculatory ducts. Ordinarily, there is one tube connected to each testicle. Part of each tube is removed and the open ends are clipped to interrupt the flow of sperm.

The procedure is typically performed using mild sedation with Valium. However, the procedure can be done under deeper sedation to provide a pain-free experience. Sedation is administered by a board-certified anesthesiologist at a small additional charge in the office setting.

Risks of Vasectomy

Although not very common, you should be aware of the potential risks associated with surgery, which includes (but is not necessarily limited to):

  1. Infection
  2. Bleeding
  3. Sperm granuloma / scarring
  4. Failure: This is a rare occurrence that happens when the ends of the tubes reconnect. One study in the mid-2000s stated that there is a 1 in 2000 risk of paternity in men who’ve had successful vasectomies (as demonstrated by the absence of sperm on follow up specimens). The risk can be reduced by modifying the technique of the procedure slightly, which includes the use of two clips and the cauterization of the internal surface of the tubule. Nevertheless, the overall risk is still very low (<1%).
  5. Chronic pain: There are some men that will develop intermittent chronic discomfort in one or both testicles following this procedure (thought to be due to ‘congestion’). Recent research showed that this post-vasectomy pain syndrome may happen in up to 18% of people BUT less than 2% of them actually said it truly bothered them. It isn’t uncommon to hear about mild discomfort that may come and go several months after the procedure.

Pre-operative instructions:

  • Shave the hair on the upper part of your scrotum and around the base of the penis the morning of your appointment. Use electrical clippers if possible or a razor with warm soap and water. Make sure to thoroughly wash the area to remove all loose hairs.
  • Bring ‘scrotal support’ of some kind (e.g. jockey shorts, jockey-briefs, or jock-strap) and wear loose-fitting, comfortable pants.
  • Take the prescribed sedative about 30 minutes prior to your appointment. YOU WILL NEED TO BE ACCOMPANIED BY A DRIVER.
  • Do not take Aspirin, ibuprofen, naproxen, or any “NSAID” medications one week prior to your vasectomy as these may increase the likelihood for bleeding. Tylenol is OK.

Post-operative instructions:

  • You are NOT immediately protected from getting a woman pregnant until two consecutive semen tests demonstrate no active sperm.
  • Minimal activity for the first 48 – 72 hours after the procedure (i.e. this is a great excuse for watching the games on the couch). Avoid strenuous activity (e.g. working out) for the first 7 days after the procedure.
  • Avoid sexual activity / ejaculating for the first 7 days after the procedure.
  • You can shower the next day after the procedure but it is advisable to not soak the area for the first 72 hours.
  • Wear scrotal support for at least the first week after the procedure (or as long as you think is necessary).
  • Ice packs help soothe the pain. Frozen peas/corn are the best because they conform to the shape of your scrotum more easily than a bag of ice.
  • Pain control: You can take extra-strength Tylenol, Ibuprofen, or Aleve for most pain. You may also be prescribed some narcotic pain medication that you can use in case of significant pain.

Bruising may occur after the procedure; it is usually slight and occurs around the incision. Significant swelling and discoloration of the entire scrotum is uncommon and can be avoided by refraining from using aspirin or related products, making sure to wear supportive underwear, and avoiding strenuous activities for the first 48 to 72 hours after the procedure. If this swelling does develop, often times the treatment is simply bed rest, elevation of the scrotum, ice packs, and pain medications.

Report any fevers more than 100.5, pain not controlled by medication, significant redness, drainage, or soreness around the incisions, significant swelling of the scrotum, or any concerning change in your general state of health.

Post-Vasectomy Follow up Semen Analysis

  • You will need to have a minimum of two semen analyses that demonstrate no sperm in order to be declared sterilized.
  • It’s best to wait at least 6 weeks after the procedure to submit your first specimen. The second should be submitted about three to four weeks afterwards.
  • Alere home testing is a more convenient and more sensitive means of detecting sperm than the previously used method. Please speak to nursing staff on the day of your vasectomy to be signed up.
  • If there are persistent motile (moving) sperm in your specimen by three months after the procedure, it may likely need to be repeated.

When you are ready to have a vasectomy, look to Dr. Richard Natale and the experts at Carolina Urology Partners. Dr. Natale will answer all of your questions and ease your concerns about the procedure.

Request an appointment online or call (704) 786-5131.

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