Bskulli’s experience: Written 21 years after his vasectomy

The Road to My Vasectomy – Leading Up to The Decision

My wife and I had been married for 6 years without children when we decided that it was time to do something about our hassles with contraception (we were 29 years of age at the time). We had tried just about every possible contraceptive method over the years. She had used the pill, but the side effects were difficult for her, and I was concerned about the health effects of hormones over the long term. The advantage of the pill was undoubtedly the spontaneous sex we could enjoy without stopping to insert foam, diaphragms, and put on a condom. We explored her getting an IUD which would have been a great method has her uterus not been “tilted’ which made insertion by our physician apparently impossible. Later there were the problems with the Dalcon shield and IUDs essentially disappeared from the market anyway.

For the remaining years, we had religiously used the combination method of a diaphragm and condom or foam and condom. This was the best method for us after searching for a contraceptive method that was appropriate for our needs. However, we really disliked the loss of spontaneity and if we wanted to have oral sex the spermicides were a real turn off in that they generally tasted bad and would somewhat numb my tongue! So we tended to have to “plan” our course of action in the bedroom. We did well using the diaphragm and condom method. Sex wasn’t too bad if one used a skin rather than a latex condom, the sensitivity was acceptable, but there was always the stopping action and donning out equipment before continuing and concern that something was slipping off during the action.

Wishing for something better we discussed the possibility of a vasectomy since we already knew it was the least difficult of the sterilization methods available. However, we were still not sure about the permanence, even though we were fairly sure we didn’t want any kids. I did a lot of research on the subject over the next few years, looked up a variety of articles about the methods available at the time (this was the early 70’s), the complications, and possible future methods and techniques. At that time there was some information about the open-ended technique which made sense especially in terms of future reversibility and reduced complications. I was also intrigued by a variety of research looking at valves and plugs. About this time a friend of ours mentioned that there was a urologist in the area that had designed a reversible vas valve. We went to his office and saw the schematic for the device hoping that maybe in a few years it would become available for general use. However, as a couple of years went by I was resigned to the fact that such new technology would not become available anytime soon.

The Scare and Decision

A few years later the “inevitable” happened and my wife became pregnant. We agonized over the situation and what we really wanted to do when she spontaneously aborted just a few weeks into the pregnancy. We were both somewhat relieved, but we were left with the contraception question again and the possibility of another accident in our future contraceptive practices. Obviously, the current method led to failure (after 8 years mind you). We were ready for and wanted something more assured and foolproof. Another couple we were good friends with mentioned to us that they were going into the Planned Parenthood clinic to set up an appointment for him to get a vasectomy. We were very interested, to say the least since they also were childless. We discussed our situation and decided to go and sign up for the program and see what was involved.

There was a councilor that we met twice about getting the procedure done through the Planned Parenthood clinic. We discussed our motivations and of course acknowledged that we understood that this was considered a permanent operation, etc. We next met with the clinic physician and after filling out paperwork and stuff we were put on a waiting list for the operation which would be one month later. Time enough to review one’s decision.

The Operation

The appointed came. The night before had prepared according to the instructions and I had shaved my scrotum and at the base of my penis. At the clinic, my wife and I were led to a examine room by the nurse (who seemed rather bored by the whole deal even if I was a little nervous), and I was instructed to strip off my pants and undies and given some betadine solution to swab over the appropriate area. The doctor can in with the intern he was training to do the procedure. The intern discussed with me again the permanence of the procedure, that we had no kids and that he felt we were a little young for this. Though the intern went through a routine of hesitating and saying he really wasn’t sure that he wanted to do the vasectomy, we held our ground. Just when I thought we might be heading home without the operation the intern agreed to go ahead with the procedure.

The vasectomy was the generally used technique of two small incisions, cut and remove a segment, and tying off the end. The doctor placed a drape with a hole over my genitals and isolated my vas on one side and then attached a clamp to hold it in place, he then injected the anesthetic into the skin and then deeper into the vas. I could feel the needle into the skin at first as just a slight prick, going into the vas was a little more of a dull pain which quickly went away as the anesthetic took hold.

Once I was numbed he preceded to make the smallest of cuts over the first vas of no more than maybe 1/4-1/2 inch in length. I watched with interest as he then pulled the vas and its’ sheath out through the incision. He then proceeded to make a small cut through the covering sheath and there was the very white-colored vas. Using a looped hook he pulled the vas out from the sheath into a loop which he then grabbed with two hemostats at the base of the legs of the loop. During this, I could feel the pulling and tugging that was going on and at one point had a little bit of pain which they gave me another shot of anesthetic for. He then cut about a centimeter of vas out and tied off the ends with a suture. There was no cautery or clips used. He then removed the hemostats and let the vas ends slip back through the incision and repeated the process for the other side. He placed a small wad of gauze over each incision and taped them down. I then put on the suspensory I had brought along as instructed. We were done in about 40 minutes. It was curiously interesting and maybe a relief seeing those two half-inch pieces of vas sitting on the surgical tray. Now we were in anticipation of finally being free of condoms, diaphragms, and spermicide. I really couldn’t feel much pain at this point as we went home and I took up residence on our couch.

Post Vasectomy

Not much was mentioned about using ice after the procedure, but in retrospect, I would highly recommend that to anyone having a vasectomy for as long as you can the first 24-48 hours. Why take a chance with undue swelling and pain? I was doing ok for the first 48 hours and then I had a significant ache start in my nuts particularly on one side to start. It felt like the pain you feel after getting knocked in the nuts or having them forcefully and constantly squeezed! This went on for several days and I finally saw the doctor for some pain pills which helped a little bit. The best thing was ice for dulling the pain. The pain problem went on for 10-14 days before subsiding enough that I could go back to work! I could tell that my epididymis had become swollen and very tight and painful to the touch. Over the next several months the pain subsided somewhat, but when I manipulate my nuts there is still residual soreness there to this day (21 years later), though this hasn’t stopped me from doing what I would like. However, I often wonder what it would feel like to not have that small amount of chronic soreness there! If I massage the epididymides I can make the soreness/tenderness go away temporarily and things feel ok. The epididymides are not as firm and hard as within a year after the vasectomy, so I assume that there have been some of the ruptured areas occurring to relieve the pressure buildup of the retained sperm.

Conclusion

Would I get a vasectomy again? If there were some reversible techniques I would probably try that first. It would be interesting if there were valves or removable plugs developed. Otherwise, I would do a vasectomy again yes, but with a physician that does the open-ended procedure, regardless if it were done with the No-Scalpel method or not. I am convinced that the tying off of the vas on the testicular side probably causes more problems than it really prevents in terms of potential recanalization or reduced sperm antibody development. With an open-ended technique, one might develop a granuloma due to the sperm leakage, but this would be at one defined site. I think this is preferable to having pressure-induced ruptures at sites like the epididymis, where I believe there are more sensitive and debilitatingly sensitive nerve endings, leading to testicular pains as I have had. With that in mind, I am tempted to maybe have my vasectomy “converted” to the open-end type. It is just that after so many years I feel a little sheepish going in for another vasectomy for pain that is generally tolerable and which I have had for so long that I wonder if it is really related to the vasectomy or maybe just normal sensitivity. I also wonder that if the damage has been done to the epididymis opening the ends would just be worthless. Hard to say.

With there being more information about vasectomy one should shop for the procedure that he thinks is best. If I had the choice for open-ended vasectomy over traditional I would do open-ended without a second of hesitation. The vasectomy has allowed for freedom in our sexual relations that was lacking before (much more fun). It is certainly a relief to not have to worry about bringing all the stuff like diaphragm, foam, jelly, condoms, etc along when you travel. Plus you can be as certain as you possibly be that there will be no “mistakes”! It is a wonderful relief and freedom to have.

Submitted by Bskulli