Simon’s experience: Childfree Open-ended vasectomy

Since I gained so much information from the site, I’d like to contribute my story. It’s pretty detailed and a little long, but I appreciated details in the other guys’ stories, so I included them. I’m 27 and child-free.

The Decision

I’ve known for years that I don’t want kids. By my mid-twenties, the idea of getting a vasectomy starts rattling around in my head. A few years and a pregnancy scare later, and I was ready. I still put it off awhile just to make sure it wasn’t a knee-jerk reaction to the scare (even though I knew it wasn’t).

Once I’d made my decision I did a lot of research, not the least of which was reading the stories on this site. I decided that I didn’t care whether my procedure was scalpel or no-scalpel (which seems to basically mean stitches or no stitches), but I did develop a distinct preference for the open-ended variety (which seems to be the norm in Australia and is catching on slowly here in the US). Having taken human physiology at university and noting that some instances of post-vasectomy pain might be caused by pressure buildup, the open-ended method just made sense to me.

In my small town, there is only one urologist. I had a consult with him and didn’t like him. He was quite old-school and dismissed anything I said that I’d read on the internet with disdain. I’ve been using the internet for years and I’m a fairly smart guy, so I’d like to think my bullshit detector works pretty well. Thus I was offended that this guy just outright dismissed my concerns. Needless to say, I wasn’t going to have him perform my vasectomy.

So I had to wait until a while later when I found myself in a big city. I had just come off a job so my coffers were relatively full (an issue because I’m not insured), and I had a few months off, so this seemed like the perfect opportunity.

I opened the yellow pages and started calling urologists. I told them I was shopping around, and that I was looking for a urologist who would perform an open-ended vasectomy. The responses I got were mixed, including one rather rude receptionist who told me, “I’m sorry, you need to schedule a consultation, the doctor will not discuss the operation outside of one,”. Most of the doctors I talked to hadn’t heard of the procedure, and a few offered to leave one end open for me if I wanted. I thanked them but continued my search. I wanted someone knowledgeable in the procedure since it’s slightly more specific than just leaving one end open (I recommend the “open-ended vasectomy” paper on this site for details). I finally found a urologist whose nurse said he did the open-ended op, and I immediately scheduled my consultation. I was optimistic, especially since this guy did it regularly. I didn’t have to be a guinea pig.

The Consult

They took a urine sample and then I met with the doc. The first things he asked me were how old am I, am I married, do I have kids. I’m 27, not married, and have no kids. He said, “ah, well, that presents a problem.” He told me that in cases like mine, he asks patients to wait six weeks between the consultation and the vasectomy. I said no problem. For the first part of the consultation, he seemed a little nervous, which might have been my imagination, but might have been because, well, I am fairly young (and look even younger) and he probably didn’t want to be helping me make a mistake. As the consultation went on, though, he relaxed. I’m certain of my decision, have made myself knowledgeable on the subject, and I was able to ask very specific questions. So I think I made it clear that I’m serious. In fact, at the end of the consult, he allowed me to bump the actual vas up by two weeks, to a month later.

I was annoyed by the arbitrary waiting period, but otherwise really impressed with this doctor. I’ve read some of the stories on here in which the doctors don’t go over very many of the risks beforehand, but not this guy. He was quite thorough. He described himself as a “perfectionist” (a good quality in a doctor that’s going to perform surgery on you!). Every possible risk that I’d read about online he brought up and described, including PVP. None of his vasectomy patients have had PVP, although two guys with PVP were referred to him who had had their vasectomies performed elsewhere (he said he’s the head of the department at the medical center or something like that, so he gets these referrals). His belief was that these cases were caused by too much activity too soon: one of them ran a marathon two days after a vas, the other played in a tennis match three days after. From what I’ve read it seems like the causes of PVP are more nebulous than that, but I appreciated the doc’s success rate.

One risk he mentioned that I hadn’t heard about before, was the possibility of the existence of a third vas deferens so that he’d close up one on each side but the third one would still be operative. In this case, my sperm count would drop but not go away entirely. I’d never heard of this, and he assured me it was rare but 1 out of every X number of guys (sorry, I don’t recall the statistic) have a third one.

He explained that he does open-ended because he feels it causes fewer postoperative problems. I asked him to describe in detail what he’d do and was satisfied with his description. One wrinkle I hadn’t expected was he said he’d “lightly” cauterize the testicular (open) end to prevent it from bleeding, but it wouldn’t form a hard seal, and the end would open up within a few months.

The doc prescribed valium to relax me before the op, a course of antibiotics to begin taking the day of the op to hold off infection, and Tylenol with codeine for pain. I don’t like the idea of taking antibiotics unnecessarily, but I figure surgery is a legitimate use. (I’m convinced all the people who prescribe and take antibiotics for viral infections, like colds and flu, or as a constant preventative measure, have set up the human race for a nasty kick in in the form of resistant bacteria.) He checked my plumbing to make sure he could find the tubes and pronounced me ready to go. During this check, he found my epididymal cyst (I have a small one on the left side), and also noted I have a varicocele on the left side. This latter discovery was news to me, but upon doing more research I guess it’s pretty common. He explained that the only risk that they bring to the procedure is the possibility of more bleeding on that side since it’ll be “like a minefield” in there with the swollen veins. He didn’t seem concerned, however, and I made my vas appointment, quite pleased to have found a doctor whose attitude and methods I liked.

For about five days after the consult, I experienced pain on my left side, which I figured was a combination of real pain from his squeezing my cyst (the only time it gives me discomfort), a little bit of tugging pain in my abdomen from his finding the vas, and psychological pain because I was, of course, totally focused on my balls. My varicocele was making me nervous, so I read a little about it, thinking maybe I should get it fixed. (It turns out they can cause lowered sperm counts – oh the irony!) I decided it wasn’t worth it, and a few days later the pain went away anyway.

The Big Day

The month went by quickly and suddenly it was the big day. Shaving was interesting; I was surprised by how much hair I had in that area! Once I looked like a prepubescent boy, I made sure I had all the necessary gear and we headed to the doctor’s office. I started getting nervous and bitchy at the bus stop, but taking the valium and actually getting on the bus (having all the preparations finished) both helped. I arrived at the office, and I was pleased to find out they were lowering the cost of the op because I was paying for it myself.

The operation was pretty standard. The nurse had me undress, covered me with a sterile cloth, made sure I was comfortable, and then called the doc. As many have noted, the worst part was the anticipation, the second-worst was the “bee stings” when the doc injected the anesthetic. Due to nerves, I was a blabbermouth the entire time, but the doc was nice and chatted with me. At one point he confirmed that I wanted an open-ended vas. I said yes, but asked what he usually does since I thought he did do open-ended normally. He said he clips the testicular end to crush it somewhat. That sounds pretty closed-ended to me (maybe he means he doesn’t leave the clips in, he simply crushes the vas?). Anyway, he said he only does fully open-ended ones like mine on guys who have had post-vasectomy pain. I asked if those guys had experienced any recanalization or “miracle babies,” and he said no. He said he was making it as hard as possible for the ends to find each other again. He sutured the prostatic end of the vas and tied them so they point in different directions. He assured me that if I get a couple of all-clears I’ll be fine.

The Aftermath

Afterward, I took a cab home and laid down. Cycled bags of frozen peas, a half-hour on, half-hour off. One side started to hurt pretty badly after a few hours, so I took a couple of tylenol w/codeine. Went to sleep, and woke up feeling much better. I spent the next three days in bed, moving only when necessary, and steadily felt better. Besides the first evening after the op, it was just general uncomfortable soreness, and not truly painful. Three days of little movement is pretty conservative, but I didn’t want to take any chances. And I didn’t experience any bruising or swelling at all, so I must have done something right.

Day four: I went and saw a movie, which involved a bit of walking. I was sore but it felt good to get out. Put the frozen peas back on when I got home just to stave off any potential swelling.

Day five: I felt pretty normal, and left the house as usual. No problems, except I’ve never been so randy in my life (again, being conservative, I’m waiting a full week before any ejaculations).

Day seven: I ejaculated for the first time since the op. It went well, just a very small bit of old blood in the ejaculate (a tiny dot). Later that day, I experienced pain on the left side that lasted a few hours and drove me to take some ibuprofen. It was discouraging – I had been feeling great, and I didn’t like that it happened after my first post-vas orgasm!

Day eight: I woke up feeling no pain or soreness. A couple hours later, I ejaculated again, and it felt okay afterward, just a tiny bit of soreness, this time on the right side. More soreness than I want to deal with in the long term, but only eight days out I won’t let myself get demoralized.

Day nine: Beginning to feel like a whole man again. I actually have been forgetting I’ve had the op but then I do something like run across the street or jump, and I’m reminded. I pretty much feel normal!

Days 10-12: Bumping and grinding away with no problems.

The Waiting Game

I’m still a few weeks away from my first post-vas semen test. Since about two weeks after the op, I can’t even tell I had it done. The only thing that would make me unhappy with the procedure at this point will be if it doesn’t work!

The All-Clear

I submitted my first sample at six weeks post-vas: clear. The second sample was two weeks later (a total of two months after the operation): CLEAR! Three weeks later and my partner had her period. It worked!

I should mention that I hadn’t been “saving myself up” before taking samples for testing, so I had a rather low volume of ejaculate. This was a little embarrassing and I was worried it wouldn’t be enough to do the test, but the clinic never said anything about it.

One weird thing, about four months after the vasectomy I had about a week where I would feel sharp pains in my testicle/vas area. They didn’t last too long, but they did hurt quite a bit. They stopped happening after a week or so, and I haven’t had any problems since. I can’t even be sure they were vasectomy related.

It’s now been almost a year, and I still seem to be sterile. I’ve had absolutely no problems with the vas, and am very happy I had it done. Not worrying about an unintended pregnancy is a major relief!

Thanks for running the site! It’s a very valuable resource!

Submitted by Simon