Matt’s story: Australian vasectomy experience

The decision

I spent a lot of time making the decision that vasectomy was the way to go. I’d thought for a few years that it was the easiest and best long-term contraceptive option, and when our youngest was 3, I started thinking seriously. I always like to read up on anything I’m planning to do, so I searched the web, found sites for a few local clinics, found a few articles, and found the alt.support.vasectomy newsgroup.

Nothing I read worried me too much. There were suggestions of things like links to prostate cancer, but the weight of evidence seemed against any real risk. There are also horror stories of things going wrong – infections, reversals, terrible pain, loss of sex drive, etc. These are worrying, but after doing the reading I felt I could weigh up the risks & benefits, and I was willing to make the choice and take responsibility for accepting the risks.

I started off wondering about sperm banking. This seemed sensible insurance: keep my options open in case all my kids were killed in a car crash the day after the operation. I asked a question about it in the newsgroup; no-one knew much about it but a couple of replies gently suggested that if I was thinking about this then perhaps I hadn’t quite made up my mind. That’s not the case for everyone but, in the end, I decided I probably wasn’t quite ready. Anyway I did a bit of digging on the web about sperm banking, and it’s fiddly (probably need to make about 6 deposits, over a week apart, and refrain from sex for 3 days before each) and expensive (in the order of several hundred dollars for the deposits, and an annual fee of a couple of hundred more). Ultimately I knew I could never be certain how I’d feel if my kids died, but for the benefit of condom-free sex, I was now prepared to wear the risk.

At the same time, I was discussing it with my wife who was supportive but probably not yet 100% certain that we’d finished the family. So I put the idea on the back burner for a few months but kept an eye on the newsgroup. This was really helpful as, when we finally made the decision, I felt that I’d heard & thought about almost everything that might come up.

The options

In Australia, some local doctors will do the job, or else refer you to a specialist (urologist or surgeon), or there are specialized vasectomy clinics. I searched for clinics on the web; for some reason, I didn’t like the look of the one closest to me, and the others were a bit far from where I live. The most common procedure in Australia seems to be 2 incisions, cut the vas, and tie off both ends, and this is what I ended up having. NSV doesn’t seem very common here. Some doctors don’t tie the testicle end of the vas (I asked my doctor about this; he said he saw little point leaving it open as it would close up with scar tissue anyway); others seal the tubes with titanium clips (when I mentioned this on the newsgroup, people wondered whether they’d trigger the metal detector at the airport!)

Making the arrangements

Eventually while opening a condom packet one night my wife & I both decided we’d made up our minds, so I went to see the local doctor. He didn’t do it but had two local specialists he’d refer me to, a urologist or a surgeon. The urologist would only operate under general anesthetic, which I didn’t really want, so he referred me to the surgeon.

General anesthetic seems more common in Australia than the US or UK. It’s probably a good option if you want to remove yourself from the procedure, but I don’t like the idea of being knocked out of control, and whenever I’ve seen anyone come out of a general they’ve always looked pretty miserable. I thought I’d find a general more unpleasant than having someone tinker with my genitals while I was awake (and as all went well, this did end up a good decision).

I also had to choose between private treatment or public. Private (which, of course, is only available if you’ve paid for insurance) lets you choose your own doctor, and is usually quicker. It also costs more since the insurance only covers part of the cost and leaves you a couple of hundred dollars out of pocket. The public is free, and typically just as good, but can be a long wait. I wanted to get it done quickly, mainly because I was having a rare quiet patch at work and wanted to schedule a couple of days off while I could, so went private. Also, I thought it would give me a bit more flexibility in case I didn’t like the surgeon and wanted to change.

Ten days after seeing the doctor I had the appointment with the surgeon; he ran me clearly through the procedure and explained the main risks (all of which I’d heard before from the newsgroup), did a quick examination (I suppose to check that the tubes were in the usual place) and booked me in for the operation ten days later. Having my genitals touched by another bloke, even a doctor, was a bit odd, and I’d thought up a gambit to deal with this: as soon as he started I asked him the question about whether to tie both cut ends of the vas, so I could concentrate on the answer rather than the examination.

I wasn’t totally happy with the amount of sedation and anesthetic the surgeon wanted to use – I thought it was more than necessary, didn’t want to be too knocked out, and thought a quick shot of local anesthetic should be quite enough. All the drugs he proposed (described in detail below) didn’t appeal to my minimalist view that this was a common and straightforward operation that shouldn’t involve too much fuss – but as things turned out I ended up very happy.

Shaving

The night before, I had to shave. This was one area when I’d found the newsgroup a lot of help in giving specific information. The surgeon just said “shave the scrotum”; that didn’t really give me enough detail about how to go about it, though maybe he would have given more if I’d asked. First I trimmed the hair back with scissors, then shaved in the shower with a disposable safety razor, using a new one so it would be as sharp as possible. I imagined a ring encircling the penis and scrotum, marking off where they join the rest of the body and shaved everything inside the ring. So I shaved the whole of the scrotum, and the shaft of the penis (I was surprised how much hair I actually had grown on the base of the shaft), but not any of the hair on the pubic bone above the penis, or anything on the inside of my legs. I’m not very hairy generally and didn’t think my balls were particularly hairy, but I was surprised at how much went down the plughole. I invited my wife to watch but she declined!

There have been some comments in the newsgroup that shaving made your balls look bigger, but this wasn’t my experience. I didn’t like the shaved look at all, and the hair was very slow to grow back. Even after 6 weeks it still wasn’t back to normal. I certainly won’t be repeating the experience for cosmetic reasons!

The operation

I had it done at a small private hospital near where I live. My other recent hospital experiences have been taking the kids to the emergency department of a nearby public hospital, for those broken arms & other childhood accidents that always seem to happen on public holidays when the doctor’s not around – the emergency department is overcrowded with car accidents & drug overdoses, stressful and frightening, and the private hospital, by comparison, was pleasantly quiet and comfortable.

After the usual form-filling and waiting, I changed into hospital gowns (“we believe in dignity here” so they give you two – one that does up at the back, leaving your backside exposed, but then you put another over the top like a dressing gown).

They put me on a bed and gave me the first part of the sedative/anesthetic cocktail – a shot of Omnopon at the bottom. This is mainly morphine and codeine and left me feeling very pleasantly relaxed & comfortable. Could have dosed off, but I wanted to stay awake. It’s a drug you could certainly get attached to! I lay back on the bed, all my muscles relaxed and feeling as though I could just sink into the mattress, and watched the tennis on TV for an hour.

Next, I was wheeled into the theatre. “You’re very wide awake”, they said; “that’s because I want to be”. I was still covered with a blanket, which they lifted aside to swab my genitals with betadine (antiseptic), and then replaced. A nurse inserted a cannula into the back of my hand – she said I had thick skin and had to have a couple of goes before getting it right, so this minor needle prick ended up being the most painful part of the procedure. They also gave me some oxygen through a mask. The surgeon then said he’d insert a shot of something like valium into the cannula, give me a local on one side of the scrotum, cut and tie on that side, then repeat for the other side. Blankets & things were skilfully arranged over my chest so I couldn’t see anything (other than a very blurry reflection in the overhead theatre lights), the nurses lifted back the lower part of the blanket and he went to work.

The effect of the omnopon plus valium (or whatever) was that I didn’t even feel the local anesthetic to the scrotum. I was awake but very relaxed and unworried. The drugs relaxed my muscles so that my balls hung down & there were no problems finding the vas, and my penis was exposed but I don’t think I could have had an erection (at least not without a great deal of work!), nor did I feel worried that excessive shrinkage would make me an object of ridicule! All I felt was that my balls were being touched, without being able to work out the details of what was happening. Nothing hurt at all.

They put on a firm bandage that encircled the penis and testicles, then wheeled me into a recovery area to doze for a while. Again, I could have slept but didn’t want to; I read a book. Then they removed the bandage and I got dressed (putting on 2 pairs of underpants with a gauze pad in case of any slight bleeding), had a cup of tea and something to eat, and my wife picked me up and took me home. All up, about 4 and a half hours since I’d arrived at the hospital, but a lot of that was just sitting around.

Afterward

Ice – can’t recommend it enough. It reduces bruising and swelling, and the cold keeps your balls high which minimizes the uncomfortable dragging feeling. I bought 3 packets of frozen peas and kept alternating them, after the op and for most of the following day. My doctor hadn’t said anything about this – another great idea picked up from the newsgroup.

The doctor simply recommended wearing 2 pairs of jockey-type underpants for 5 days. After trying this I didn’t think it was enough to support, so (belatedly following the advice from the newsgroup) went and bought a jockstrap.

For the rest of the day of the op, I lay around watching TV, reading, and playing with the computer. I still felt a bit knocked out from the drugs, and after sitting at the computer for 15 minutes I’d feel as though I needed another lie-down. I felt great, as long as I kept the ice up there was no pain and not even anything I’d describe as discomfort, just a general awareness that I’d want to keep my balls protected. All the careful anesthesia and sedation seemed well worth it at this point. The nurse had suggested taking pain killers every 4 hours, but I didn’t need any.

Driven by excessive competitiveness with another contributor to the newsgroup, I persuaded my wife that sex the night of the op was an essential part of the treatment (“I need to check if everything’s still in working order”). This probably wasn’t the greatest idea (though I’m still glad I did) – with the lingering effect of the drugs (and perhaps guilt over my motives!) it took rather too long, and I started to worry that in fact, everything wasn’t in working order, which only made the problem worse, but got there in the end. It was sweet of my wife to go along with all this! I did a solo follow-up a couple of days later just to check, without pressure, that everything was still operating at normal speed (it was).

Day 2

Stayed home, did a bit of work from home, & kept up the ice in the morning. Still no pain, though perhaps a bit more discomfort (a sort of heavy-balled dragging feeling), which the icepack took care of. In the afternoon I left the ice off, felt a bit less comfortable so got it out again for an hour or so, then put it away for good.

Day 3

Back to work and no problems. Feeling a bit tender, and happier sitting down than standing (fortunately my job is mostly sitting down), but everything was quite bearable. Told a few people why I’d been away from work, watched them cross their legs and wince (great fun). No-one wanted to talk about it. Walking home from the train station after work I was wishing I’d taken the advice of the newsgroup and bought a jockstrap. I pulled on a fairly tight pair of bathers over my two pairs of underpants, felt better, and went out for dinner.

Days 4-5

The weekend. Finally bought the jockstrap, and wished I’d done it earlier. I don’t think they’re used much in Australia and it wasn’t easy to find. Department stores are no use – try Rebel Sport or a pharmacy. Starting to feel flabby from lack of exercise so I tried a few stomach crunches but felt a bit of a strain in the balls and around the stitches, so quit. By the end of the weekend I felt comfortable with some brisk walking (with the jockstrap) and playing some relaxed family cricket, but no running.

End of day 7

Decided I’d had enough of the jockstrap. Without it, my balls hung down a bit heavy but this felt OK and better than the constraint of the jockstrap. The stitches occasionally felt like lumps of barbed wire in my underpants but this was bearable. I did a few stomach crunches & pushups and go for a brisk walk (all without the jockstrap) and feel great.

Week 2

The remaining ache disappeared overnight between days 8 and 9, and on day 9 I felt fine to go to the gym. Stitches softened and fell out during the week. Hair still very slow to grow back.

Checkup with the surgeon after 3 weeks. This was very brisk – just a quick check that everything had healed properly, and a slip to take to the pathology lab when I was ready to provide the sample.

The sample

I’d misunderstood the surgeon, and thought I’d be providing the sample on the premises at the pathology center. So I rang up, to say “I’ve, um, recently had a vasectomy and, um, need a semen analysis; do I just turn up or do I need to make an appointment?” (I didn’t really feel as embarrassed as this sounds, I just thought it would be better to sound embarrassed than over-enthusiastic.) Anyway “Cheryl”, who answered the phone, obviously thought I sounded like a real weirdo and got rid of me as briskly as possible. “You just come here, collect the instructions and jar, then you can go away and collect the sample at your leisure. Thank you. Goodbye.”

So I went in on a Saturday morning to collect the specimen jar & instructions. Both the women there (not Cheryl this time) told me their husbands had had the snip but hadn’t bothered to have the test afterward. Sounds dangerous to me! It turned out the courier would be picking up samples to take to the central laboratory at about 11 am, so it would be best if my “leisure” time could coincide with getting back shortly before 10.50.

Back home to do the job. Just before I was about to settle down to it, the neighbor dropped in – seems my wife had agreed, unknown to me, that we’d be minding his 2 kids that morning while he was out. I hadn’t counted on doing it while dodging 5 kids (3 of my own and 2 neighbors) around the house. Fortunately, they all found videos, computer games, etc.

As others in the newsgroup had said, it’s not easy getting everything into a small jar that’s not much wider than your penis! First, there’s the problem of having to change grip at the last moment to get the jar in place – not too early or you’ll lose the momentum to achieve the necessary result. Then there’s the angle problem – how to get something to go down, that’s normally pointing more or less upwards at this stage. Not easy to work out the best position. The end result – not exactly planned, it sort of came together at the last minute – involved crouching over the bed with one foot on the floor, balancing on the other knee & my head, one hand holding the jar and the other, well you know. This looked so ridiculous that my wife (who was watching) and I were laughing hysterically at the critical moment. Anyway, I succeeded in not spilling anything.

Wrote the time on the jar, then back to the pathology center to drop off in time for the courier. The woman at the counter checked the jar (embarrassing!), noted the time (8 minutes old at this point), said “Hot off the press! Beautiful” and that was it.

All clear

Five days later, just a month after the snip, I rang up for the result. The doctor’s receptionist told me it was all clear: “You’ve obviously been very thorough; I was going to put a “good boy” stamp on the report”. She sent the report out with the result: “Microscopy: no spermatozoa seen”. Unlike reports from the UK and US, it seems to be normal here to do just a single sample, so this was it!

Perversely, at this point, I strangely felt a bit down spirited, and (for no good reason) started to wonder if I’d done the right thing. I just had a feeling I’d lost something. Since it was something I hadn’t wanted to keep, this wasn’t totally reasonable, but (from other comments on the newsgroup) I don’t think it’s uncommon to feel a bit like this. I must be the only person who, having had sex on the night of the snip, didn’t feel like it for a few days after the all clear! Anyway, of course, sex is the best cure for feeling depressed (at least that’s what I always tell my wife!), so I got over it soon enough, and since then have been enjoying the benefits to the full!

Submitted by Matt