User Submitted Questions and Answers, Part 2.
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User Submitted Questions and Answers, Part 2.

We've compiled a very extensive list of user submitted questions and answers that Dr Karpman has so graciously provided Vasectomy-information.com. You can browse at your leisure or use the table of contents to jump to content. We have divided the questions in to multiple pages as there are just so many to provide.

See Part 1

 

Table of Contents

Is there any way to ejaculate after bladder neck removal?

From Elaine:-
My partner had a bladder neck removal over 6 months ago. We didn’t really talk about having children, but now I’m thinking about them and was wondering if there was anything we could do to try and get him to be able to ejaculate. I think he has a slight ejaculation so is there any thing that would help us have a child together anything at all?

Any type of surgery that “removes the bladder neck” will cause retrograde ejaculation in the male. Semen is normally deposited in the posterior urethra during a process called emission. The bladder neck should close at this time allowing the semen to be propelled forward when the man finally ejaculates. Absence of the bladder neck will cause some if not all of the semen to flow backwards into the bladder. This is inconsequential unless you are trying to have a baby. Fortunately, the sperm can be easily retrieved from the bladder after adequate preparation of the bladder and then injected into the uterus to achieve a pregnancy. A crude method of achieving pregnancy in these situations has been reported as “vaginal voiding.” The man can urinate into the vagina after his orgasm. I do not recommend doing this for multiple obvious reasons. Instead, consultation with a fertility specialist can help retrieve the sperm from the bladder for insemination.

 

Discharge from vasectomy wound

Are you getting a vasectomy?
Plan ahead and get some cold packs and a 3 pack of jock straps for a comfortable post-surgery recovery!

I had a vasectomy 2 weeks ago, now where the incision was on both sides has a gaping hole. The stitches have already dissolved and I am having bloody discharge coming from the holes, I have been back to the Dr. and he put me on antibiotics. I just want to know if it is normal to have gaping holes with discharge?

A poorly healing incision site with drainage usually represents an infection. The scrotum is naturally covered with bacteria and regardless of how much disinfectant is used on it prior to performing a vasectomy, some bacteria still remain. Most infections of the vasectomy sites will improve with a course of antibiotics. Diagnosis, treatment and follow-up with a physician is important to prevent a spreading infection.

 

Post vasectomy problems

From Brian:-
Hello Dr. Karpman,

 

I had a bilateral, no-scalpel vasectomy 2 weeks ago. One opening near the front top of my right side, the other lower down toward the middle of the left. I felt absolutely no “tugging” pain during the procedure, which I’ll assume was due to the fact that the vas did not have to be shifted to the middle of the scrotum.

Despite the claims that I would be back to normal in 3-5 days, I’m still having problems. Since day 3, I have had a quite persistent dull ache in my testicles. The pain sometimes radiates into my lower abdomen and pelvic regions. I have tried jock straps, Cipro, and ibuprofen, but the pain does not seem to be going away. I can best describe it as the sensation that lingers after someone or something hits you in the balls. Both sides seem about equally affected, but the left is slightly worse. Part of my left scrotum is numb from time to time.

My first couple of ejaculations after the procedure have felt “funny”, with less sensation. This pain is not debilitating, but it is frustrating, and I fear it may adversely affect my sex life, which is the ultimate irony. I had the vasectomy done for the opposite effect.

1. My urologist is very nice. He is a male infertility specialist, so I assume he’s also taken care of said people after they have their children and needed permanent birth control. However, it appears that most no scalpel vasectomies use only one hole. Do you think the bilateral nature of my operation added to my post operative-pain?

2. How long does this post-vasectomy pain take to resolve? I typically heal much slower than most folks after surgery. If this situation will take care of itself, then I won’t worry as much. Some sites say 2-12 weeks.

3. How does one determine enough time has passed to pursue non-conservative treatments for the pain? If a reversal is needed, is it better to do it quickly after the vasectomy, or is it wiser to wait for a natural resolution?

4. I have read that the buildup of sperm causes the potential swelling and pain after a vasectomy. How would the buildup of sperm in a post-vasectomy system differ from a man who was merely celibate?

5. I had ongoing pelvic pain/non-bacterial prostatitis for 5 years before surgery. Did this make me more susceptible to this type of pain? My prostatitis symptoms were discomfort during urination and the occasional rectal pain.

 

Thanks,

Prostatitis is a common problem as men get older. The symptoms of prostatitis are varied and different in individual patients. The presenting symptoms of prostatitis can include pain or discomfort in the perineum, suprapubic area, testes, penis and lower back. There are also usually associated voiding symptoms. Prostatitis is oftentimes confused for other conditions such as epididymitis and kidney stones because of the location of the radiating symptoms. Most cases of prostatitis are not due to bacterial infection and should not respond to antibiotic treatment. A discussion of prostatitis is warranted on this website since the symptoms of post vasectomy pain syndrome can overlap with prostatitis and can cause confusion for patients and physicians alike as to the nature of a patient’s symptoms. Any patient with PVPS should be evaluated for and treated for prostatitis as part of the evaluation process.

 

Do I need to give permission for my husband to have a vasectomy?

From Kap:-
My husband scheduled a vasectomy without me knowing and I was wondering if I have to sign the papers for him to have it done?We both agreed that he wouldn’t have it done and that I would have a tubal ligation because I cant take any birth control and I have a heart condition to where I don’t need to have any more kids. Should he get a vasectomy even if i am getting a tubal ligation?

There are no state or federal laws that require a man to have his wife sign a consent form prior to performing a vasectomy. This is similar to the lack of any laws requiring women to have their husbands consent to a tubal ligation. Some private health organizations have voluntary requirements to have the spouse sign a consent form or to have a “cooling off period” prior to the vasectomy. The only requirement for a man to have a vasectomy is for him to be of legal age, sound mind and free of any contraindications for surgery.

 

Are erections after vasectomy harmful?

From Sarah:-
Is it harmful to have an erection in the weeks after a reverse vasectomy even if there is no ejaculation? If yes , why? And in the area of the stitches, in the scrotum, it feels like a hard balloon on each side. Is this normal?

Erections are normal occurrences in young healthy men regardless of whether or not they have had a vasectomy reversal. Every man achieves 5-7 erections in his sleep during REM sleep. We can assume that even men in the published series with the highest success rates are achieving these same nocturnal erections. Most surgeons forbid sexual intercourse for a period of time after the vasectomy reversal not because of the erections, but because of the contractions of the vas deferens associated with emission and ejaculation of sperm. Therefore, most patients should not worry about erections without ejaculation. A hard balloon like feeling in the area of the stitches after a vasectomy reversal may represent a post-operative hematoma.

 

Lumps some months later

From Carl:-
Thank you for taking the time to look over my question. I hope you can give me an answer. I had a vasectomy 6 months ago and I developed a granuloma shortly afterwards. Within a few weeks it went away. Now I seem to have another one. Is it possible to have another granuloma develop so long after my procedure? It is not on the testicles but rather seems to be on the tubes leading to the testicles. It is mildly uncomfortable and extremely tender to the touch.

Vanishing and reappearing sperm granulomas are not well studied. It is important not to confuse a sperm granuloma with another mass-like structure in the scrotum auch as a testicular neoplasm. It is often difficult for the inexperienced individual to differentiate the different structures in the scrotum. Any new masses that appear in the scrotum should be evaluated by an urologist and one should not assume that this is a benign process.

 

Questions on anesthetics

From Charles:-
Two questions:-

 

Years ago I had a conventional bilateral vasectomy done under local anesthesia. Totally pain free except for the antiseptic which stung my freshly shaved scrotum. Though it didn’t hurt at all, I was very aware when he used a needle to anesthetize each side of the scrotum. During the operation, I noted that the surgeon closely watched my reaction each time he snipped the vas (or at least that is what I assumed he snipped) – two snips on each side and the instrument made a noticeable click each time. I assumed he expected me to feel the snip which, fortunately, I didn’t. I have since wondered if the anesthetic used to deaden the scrotum is also injected into the vas or the cord at the same time? Is there any sensation in the vas or the cord with or without anesthetic? Does the cutting of the vas sometimes cause pain?

 

About fourteen years later, I had a vasectomy reversal – successful, by the way. I wanted it done under local anesthetic, but the surgeon refused and insisted on a general. Consequently, I had a epidural which was far worse than both procedures and recoveries combined. Is a general anesthetic always required for a reversal, and if so, why?

There are two levels of pain /discomfort a man can feel during his vasectomy. The first is at the level of the skin incision and the second is deeper and related to the vas deferens. Typically, the local anesthetic is delivered to the skin and the vas deferens through the same puncture site. There should only be one needle stick per side. Since the vas deferens is anesthetized by feel through the scrotal skin, one can never be 100% sure that adequate local anesthesia was delivered. Perhaps the surgeon was confirming that the anesthetic was delivered by the reaction to a stimulus.

Vasectomy reversal is obviously a longer and more involved procedure than a simple vasectomy. The surgery usually lasts a few hours and the patient must remain completely still since the operation is done under a microscope for precise reanastomosis of the vas deferens. If the more complicated epididymovasostomy is required, then laying completely still for a few hours is imperative. Unfortunately, regardless of how well intentioned or disciplined the patient might be, laying still for this period of time on a narrow operating table, while someone is operating on you, is difficult. Typically, a regional or general anesthetic is required and most patients prefer to go to sleep for a few hours versus having a needle placed in their spine and remaining awake throughout the procedure.

 

Can I have a general anesthetic for my vasectomy?

From Marty:-
Can I be put to sleep for my vasectomy or do I have to be awake?

Yes, a man can have the vasectomy performed under anesthesia. This requires additional planning and resources. Prior authorization from the insurance plan is required to avoid unnecessary charges to the patient.

 

Two questions on post vasectomy semen testing

From Constance:-
My question is that my husband scars with keloids really bad and we had the vasectomy done in september of 2007. Can he get a keloid where they did the no scapel vasectomy? Could this keloid if he got one help recanalize the vas deferens? We have two beautiful children and did not want any more and now I am late for my period. Also he has never gone back for his rechecks. Any information would be helpful. Thank you.

From Christina:-
My husband had a vasectomy in FEB 2009. The vas deferens were cauterized. The urologist told us if we wanted to have unprotected sex after 6 weeks to obtain a sperm count first to make sure it was clear OR to wait 3 months before having unprotected sex and it will be fine. Is this true?? I now suspect that I may be pregnant.

These two questions emphasis an important point for men considering vasectomy or for those who have just undergone a vasectomy. A man should not consider himself sterile or have unprotected intercourse until they have two documented semen analyses demonstrating no sperm. This is the most common reason why a vasectomy will “fail.” These situations should not be considered vasectomy failures but, instead, a failure to follow established protocol after a vasectomy. The only true way to tell if a man is sterile after a vasectomy is by performing a semen analysis. I have seen many men with persistent sperm in their ejaculate 3 months after their vasectomy. I would never recommend to any man to have unprotected intercourse after a vasectomy without at least two semen analyses confirming sterility. There is no known relationship between keloids and recanalization. If anything, a keloid would cause more scarring and less ability for the vas deferens to recanalize.

 

What clips might have been used when I had my vasectomy back in 1976?

From Elaine:-
From Harold:-
Hi. I was hoping you may be able to answer a question. I was reading on your website about the history of vasectomy because I was trying to get some info on a vasectomy I had done in 1976. The doctor who did my vaseectomy has since passed away, so I cannot ask him. I am scheduled to get an MRI. I am concerned about the vasectomy staples causing problems. Unfortunately, the MRI tech says that they will not know if it is a problem until they go to do the test, so told me to research it on my own first. Do you know what type of staples were used in 1976? Thanks for your time.

The earliest report of the use of titanium clips in the medical literature in opthalmology dates back to 1960. The reports from the urologic literature demonstrate that vasectomies were still being performed with metal surgical clips as late as 1977. It is perceivable that titanium clips were used by some vasectomy surgeons in the 1970’s. However, there is no way to be sure. Not all vasectomies are performed using clips. Some surgeons prefer to use suture ligature or cautery. A simple x-ray of the scrotum can help identify if any clips are present.

 

Undescended testicle and vasectomy

From Katy:-
What are the percentages or odds of losing a testicle during a vasectomy if you have had an undescended testicle as a young boy?

 

Thanks

The incidence of testis loss after vasectomy is not a well known statistic and there is a paucity of literature regarding this subject. This is likely due to the fact that this is a relatively rare complication after a vasectomy. The blood supply to the testis is threefold. Damaging any of the two blood supplies will still leave the testicle viable in over 90% of cases. Any man who has undergone surgery for an undescended testicle likely has altered anatomy and there is a possibility that any one of the testicle’s blood supplies were damaged at the previous operation. It is difficult to predict the chances of testis loss after a vasectomy because of all of these variables. Despite this uncertainty,the chances of testis loss are still very low in the hands of an experienced surgeon.

 

Does a fast procedure mean it’s less reliable?

My question is about pregnancy after a vasectomy. I know that this topic has been covered, but I while I have been
reading up on the statistic’s on failure rates ect , I have become worried about the time it took for my husband’s Vasectomy !!!! In most of these case’s people have said it took about 30 mins to have done , but my Husband was in and done within around 7 mns !!! I was taken to another room a little further down the corridor than my husband and shown where the coffee making facilities were so I made myself a coffee , sat down made myself comfy took a sip of my coffee , and was called back through all done ! Unbelievable really. He had the procedure done when we lived in the UK and had 2 samples done at the specified times and got the all clear but my period is late and I ‘feel’ pregnant although I am waiting for another week before taking a test to confirm this either way. I know pregnancy is possible as the tubes can re-connect themselves but should his procedure taken longer than it did ?????

The amount of time it takes to perform a vasectomy does not correlate with success rates. The average amount of time it takes an experienced surgeon to perform a vasectomy is usually less than 10 minutes. In fact, those surgeons that require more than 15 minutes to perform a vasectomy are likely less experienced and require more time for the procedure. Certain situations such as a tight scrotum, undescended testis or previous scrotal surgery may require additional time to perform the vasectomy. I have published an entire unedited video of a unilateral vasectomy procedure on this website. The entire procedure on one side is performed in approximately 3 minutes.

 

How accurate are home vasectomy test kits?

I had a vasectomy 4 years ago. I did the two follow up semen tests at the recommended intervals. I was told by the doctor’s office that I was clear. Have done no lab tests since then.

 

My wife recently got a product that allows you to test for vasectomy success at home (I won’t mention the name of the company). Anyway it came back positive for the presence of sperm. Motile, non-motile, who knows? Now I am concerned. I was not looking for a reversal. Now I don’t really rely on this home test, but I wonder about the lab tests. Not sure I would trust them either. Is there any test I should specifically ask for (pelleted?) Just hope the doctor knows about this. Any suggestion is appreciated.

The Contravac home sperm check test is a simple way of checking for the presence of sperm after a vasectomy in the comfort of your own home. The test is designed to identify semen samples that contain greater than 250,000/ml sperm in the ejaculate. The Contravac is a surrogate test for the presence of sperm as it looks for the presence of sperm surface antigens to react with the monoclonal antibody provided in the kit. A positive Contravac may represent a positive semen analysis, however, this is not completely accurate and requires confirmation with a formal semen analysis. All men who have had a vasectomy should have a semen analysis performed with a high speed centrifuged (pelleted) method to detect the lowest possible quantity of sperm.

 

When can I start having sex again?

From Elaine:-
From Gary:-
Hi Dr. Karpman. I had a vasectomy procedure performed on Friday. How soon can ejaculations begin?

Ejaculations after a vasectomy can begin as soon as the patient feels comfortable to do so. It is important to remember that men are not considered sterile until they demonstrate no sperm in the ejaculate. Men should utilize some type of alternative contraception until they are cleared by their physicians for unprotected intercourse.

 

Pain, blood, swelling into abdomen after vasectomy

From Elaine:-
My husband had a vasectomy about 6 weeks ago. He has had nothing but trouble ever since. Hemotoma, swelling, pain. After four weeks, after having intercourse only for the second time since, he had a feeling like he “blew up” in severe pain during ejaculation and realized it was mostly blood. He has swelling on the right side about the size of a thumb and even swelling into his abdomon. and alot of pain that it is interfering with his work. He saw the doctor who told him he’d never seen anything like this before (no explanation) and has been taking strong meds for 2 weeks after with little or no relief. He has been in too much pain to have sex. He has been wearing supportive underwear which helps keep things from bouncing too much, but has a very active lifestyle/career and no down time. Although he did take it easy for the first days. What’s the problem and what should he do? He’s becoming very depressed.

Complications can occur after a vasectomy and scrotal hematoma is a known complication of the procedure. Complications such as a hematoma can be associated with variable amounts of bruising, swelling and pain. The resolution of the symptoms is equally variable. Unfortunately, only time will tell tell how quickly someone will improve after a complication from vasectomy. It is important to follow-up with a surgeon to help guide the patient through the slow recovery process. Oftentimes, several visits will be required to the surgeon’s office to ensure that the normal course of events is happenning.

 

Can undescended testicle still produce sperm?

From John:-
I had a vasectomy Feb of 09. As a child, I had an undescended testicle until I had it operated on at the age of 7. When I had my vasectomy done, my doctor did not cut the vas on the testicle that was undescended because there was a lot of scar tissue and he was pretty sure that it was non-functional. 2 months after my vastectomy, I had my 1st test on my semen, which came back absent, but a week later, I had another test and there WAS sperm present. I would understand there was sperm present in my 1st test and absent on the 2nd, but I am a little puzzled by the 2nd one coming back positive for sperm. Is it possible that my testicle that was undescended as a child be somewhat functioning? Where it sometimes produces sperm and sometimes it doesn’t? Please let me know your opinion. Thank you.

Undescended testes (UDT) are usually considered as having poor function, but this is not universal and even very dystrophic testes will produce some sperm. UDT can intermittently produce enough sperm to be seen in the ejaculate. This may explain why sperm were seen on the second and not the first semen analysis. Unless a biopsy of the testicle has been performed demonstrating absent sperm production, UDT should also have the vasectomy procedure perfomed. Granted, this is a more difficult operation, but not impossible to perform by the experienced vasectomy surgeon.

 

Pregnant after vasectomy

From Jamielynn:-
My husband had a vasectomy in July 2008. He got his clearance, free from sperm in August 2008. March 2009 we found out that I became pregnant. We immediately called the surgeon that that preformed the vasectomy, and made an OB appointment. The our gynecologist appointment, unfortunately recommend to my husband and I, that due to the medication that I take on a daily Basie’s the best thing would be to abort the baby, due to the risks on the amount of harm that my medication will bring. That was the most hardest decision for myself and my husband to make. We almost decided to continue the pregnancy, my doctor kept saying that its really not a good idea. So after two extremely stress and emotional days we decided to have the abortion. My husband went in for another sperm testing. That test came back Clear. The surgeon said that it should not have happened. There’s nothing there. Both my husband and myself are just baffled. We don’t know where to go from here? We know that something is there because I would not have gotten pregnant. I saw on one for your answers from questions that people ask you, that there is a test called ” Pelleted Semen Analysis” To get a definite answer for clearance. We called back the surgeon and he said that he has never heard of that test, nor has the lab. The surgeon says that my husband is free and clear, but my husband and I don’t believe it, we cant believe it. It he was free and clear in this would not have happened to us. My question to you is where can this test be preformed at? We need why this is happening. Any information that you can provided us would be greatly appreciated. Thank you so much for all your time!!!!

Another term for the pelleted semen analysis is a high speed centrifuged semen analysis. Surgeons performing vasectomies should be familiar with both terms as it is well known that approximately 18% of men thought to be sterile due to vasectomy on a simple semen analysis will still have sperm identified on a pelleted semen analysis. Sperm pellet analysis: a technique to detect the presence of sperm in men considered to have azoospermia by routine semen analysis.
Jaffe TM, Kim ED, Hoekstra TH, Lipshultz LI.
Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
PURPOSE: In men considered to have azoospermia by routine semen analyses sperm may be identified after centrifuging the semen. Because these sperm may be used for intracytoplasmic sperm injection, we describe our technique and findings of sperm pelleting. MATERIALS AND METHODS: Semen centrifugation for sperm pellet analysis was performed in 140 consecutive men in whom no sperm was identified on routine semen analysis and who were categorized as having obstructive or nonobstructive azoospermia. Obstructive azoospermia was defined as failed vasectomy reversal, failed reconstruction for congenital vasal or epididymal occlusion, or an acquired obstruction unrelated to ejaculatory duct obstruction. Patients with congenital absence of the vas deferens or who had undergone vasectomy were not included in the study. Nonobstructive azoospermia was defined as moderate to severe testicular atrophy with markedly elevated serum follicle-stimulating hormone (greater than 3 times normal), or a testicular biopsy that revealed maturational arrest, severe hypospermatogenesis or the Sertoli-cell-only pattern. Obstructive and nonobstructive azoospermia were present in 70 men who provided 109 samples and 70 who provided 103, respectively. RESULTS: Motile and nonmotile sperm was identified in 13 of the 70 patients (18.6%) with obstructive and in 16 of the 70 (22.8%) with nonobstructive azoospermia. Pellet variability, that is the absence of sperm in 1 specimen and its presence in another from the same patient, was noted in 7 of the 17 men (41.2%) with obstructive and 2 of the 17 (11.8%) with nonobstructive azoospermia (not statistically significant). Motile sperm was present in the pellets of 6 of the 70 men (8.6%) with obstructive and 15 of the 70 (21.4%) with nonobstructive azoospermia. The median number of motile sperm was lower in the obstructive than in the nonobstructive group (0 sperm in 17 samples versus 5 sperm in 41 samples, p <0.001). The median value of 0 in the obstructive azoospermia group reflects the finding that 9 of the 17 samples did not contain motile sperm. Similarly the median number of nonmotile sperm was lower in the obstructive than in the nonobstructive group (5 versus 8 sperm). CONCLUSIONS: We demonstrated the presence of motile and nonmotile sperm in a significant number of men considered to have azoospermia by routine semen analysis. Semen centrifugation (sperm pelleting) should be performed in all men considered to have this condition by routine semen analysis, especially those with testicular failure and those in whom intracytoplasmic sperm injection is possible.

 

How much does sperm retrieval and IVF cost?

From Kara:-
My partner got a vasectomy about 2 years ago. He does not want a reversal but seems as the testicles still produce sperm we wanted to know if it would be possible to extract the sperm with out getting a reversal done and how much will this procedure cost???

Sperm retrieval with IVF/ICSI is an alternative to vasectomy reversal in men who have undergone vasectomy and are interested in having more children. The procedure costs will vary from center to center. Usually, the costs of sperm retrieval and IVF/ICSI are twice the costs of a vasectomy reversal. It is important to remember that the costs of sperm retrieval with IVF/ICSI are per cycle with a “take home baby” rate of approximately 30% per cycle. These costs are obviously compounded when more than one cycle of IVF is required to get pregnant. Sperm retrieved after a vasectomy can only be used for IVF/ICSI. Several studies have been published in the literature demonstrating that the most cost-effective means of getting pregnant after a vasectomy is vasectomy reversal and not the alternative of sperm retrieval with IVF/ICSI.

 

Is IVF or a second vasectomy reversal most likely to result in pregnancy?

From Lisa:-
My husband had a vasectomy 18 years ago. Then around 11 years ago tried a reversal which was unsuccesful as he was sure that only one side was done. At this time he also had severe bleeding which resulted in the testicle being drained. Recently we underwent two rounds of ivf where our doctor said that the embryo quality was not great but ok to achieve a pregnancy, both rounds were unsuccesful. Now we are looking into a second reversal but are completely confused as our ivf doctor has told us its not worth trying a second reversal yet a second doctor who specilises in reversal says we have a good chance as my husband is still producing sperm. This operation is costly and we have already spent more than we can afford on ivf so we desperately want to know in your opinion are we better using the money towards more ivf or going through the 2nd reversal? My husband is 10 years older than myself (I am 34, and he is 44) and I have no children but have been pregnant before. Please let us know what your opinion is??

The success of vasectomy reversal is dependent on several factors. The time since vasectomy is highly correlated with which procedure (vasovasostomy or epididymovasostomy) will be required, which in turn is related to the success of the procedure. In a man that had a vasectomy performed 18 years ago and has had an already failed vasectomy reversal on one side, the chances of requiring an epididymovasostomy is very high (>80%) with a success rate of approximately 50-75%. The success of this procedure is highly surgeon and technique dependent. The important variable to know is if the sperm retrieval that was performed with the previous IVF cycle has damaged the epididymis on one or both sides. This can adversely affect the success of a vaasectomy reversal. Otherwise, I do not see any problem with performing a vasectomy reversal in a couple where the female partner is less than 35 years old with proven fertility and no evidence of reproductive problems.

 

Is sperm production linked to sexual activity?

From ken:-
I am considering having a vasectomy performed and I have a concern. My concern is based on an assumption that I have so let me state that first. If I am wrong in this assumption then I suppose my question is no longer valid. My assumption is that sperm production is linked to sexual activity, perhaps arousal or ejaculation. If that is true am I going to feel internal testical pressure as sperm is being produced that no longer gets ejaculated?
Thanks in advance.

Sperm production is NOT linked to sexual activity, arousal or ejaculation. The only purpose of sperm, and sperm production for that matter, are for reproduction. Once a man is no longer interested in having children the sperm serve no other purpose in the body. A small percentage of people will report a change in sensation in one or both testicles after a vasectomy which has been described as a pressure in the testicle. The development of this sensation is highly related to the technique of the vasectomy and any complications that develop after the procedure. To prove this point, the reported incidence of post-vasectomy pain is less than 5% and we oftentimes only see the pain on one and not both sides. If certain individuals were predisposed to developing such post-vasectomy pain we should see it occur on both sides. Unilateral testicular discomfort suggests that the problem of post vasectomy pain is related to the technique of the procedure and any complications that develop afterwards.

 

“Tight scrotum” and vasectomy

From Dave:-
I am 48 and went to a urologist to schedule a vasectomy appt today. He said that my scrotum was tight and my testes were “riding high”. My scrotum gets tight when nervous, cold, etc. (It is back to normal now for instance). He said this would be a problem and require general anesthetic in hospital. He also said I should consider having my wife’s tubes tied instead. Does this sound right?

 

He also scheduled an ultrasound to check things out. Thanks

Most experienced surgeons will be able to perform a vasectomy in a man with a tight scrotum in the typical office setting without requiring general anesthesia. The scrotum will tighten up with stressful or cold situations. The scrotum can be relaxed by applying a warm compress to the scrotum for a few minutes prior to the procedure and performing the procedure in a warm room. In fact, the only time that I have done a vasectomy in the operating room under general anesthesia is when I have had to perform the surgery after a failed attempt by another surgeon and the thought of re-doing the procedure awake was too traumatic for the patient. Anecdotally, I did not find those re-do vasectomy procedures any more difficult than a first time vasectomy. The only time that tubal ligation should be considered a better alternative to vasectomy is if the tubal ligation can be performed simulatneously at the time of the woman’s C-section procedure. Otherwise, the risks of tubal ligation are significantly higher than with vasectomy.

 

Please comment on my lab analysis

Please find the attached scan copy of my lab test report and guide me further for getting my wife pregnant also the name of medicine which are helpful for me I am very thankful to you for this kindness because I am too much worried.

Webmaster’s note:- The lab report was attached for Dr. Karpman, but as it is a confidential document we cannot publish it online.

This semen analysis demonstrates a few abnormalities. Most significantly, the density of sperm is low and the motility of the present sperm is low as well. We can not come to any conclusion about a man’s fertility potential after a single semen analysis as semen parameters can fluctuate. In order to assess what is wrong and what can be done to improve a man’s fertility potential, one must obtain at least two semen analysis with an abstinence period of 2-5 days. Additionally, a hormonal evaluation and physical examination by a male fertility specialist would help us understand if there are any correctable impairments in the man’s sperm production. Specialized tests and /or ultrasonography may be necessary based on the initial results of the above mentioned tests. Impairments in spermatogenesis can occur as a result of several causes and it is important to evaluate all of these causes prior to considering treatment options.

 

Is 24 too young to get a vasectomy?

From Eddie:-
I’m 24 with two kids. Am I old enough to get a vesectomy?

The only age limit for having a vasectomy is that a man be of legal age to sign the consent form. The number of children prior to requesting a vasectomy is not important nor is it required prior to having the procedure. Vasectomy surgeons will always question the intentions of a man desiring a vasectomy to ensure that he is making an informed decision, but the patient should not interpret that as an attempt to discourage a well informed man from having the procedure. Individual surgeon bias may modify some of these requirements.

 

Failed vasectomy after 8 years?

From Alfred:-
Hello. I had a vasectomy 8 1/2 yrs ago. Never did any follow-up tests. My wife became pregnant. Had a semen analysis which came back zero. I knew this was incorrect because my wife wasn’t with anyone else. Had a ‘complete semen analysis’ done and the results are:
ANALYSIS TIME, SEMEN 11:57
SEMEN VOLUME 3.0 >1.9 (standard)
mL
SPERMATOZOA, NORMAL % >29 % (standard)
WBC COUNT, SEMEN <=1 <=1 (standard)
SPERM COUNT, SEMEN <2 >19 M/mL(standard)

 

My value for the SPERMATOZOA, NORMAL % was blank with no answer, so I don’t know if this was tested. Anyway, what does this mean? Does this mean I had about 6 million sperm in this sample? If the vasectomy is failing, will my sperm count increase over time? Also, what are the odds of another pregnancy if I don’t not have another vasectomy?

 

Thank you for your help

Recanalization of the vas deferens can occur many years after the vasectomy. Potent growth factors are released after the vasectomy procedure which stimulate re-growth of the ends of the vas deferens. Histologically this is characterized by tiny channels with sperm between the cut ends of the vas deferens and with certain types of vasectomies (VasClip) it has been reported to be as high as 25%. The total sperm count in this semen analysis is less than 6 million, however it is not clear if any of the sperm were motile or alive based on the results presented here. It appears that the morphology, a predictor of fertilization potential of sperm, was not done here. It is dificult to predict if this number of sperm will increase, stay the same or decrease over time and so long as there are live sperm in the ejaculate then pregnancy is possible.

 

Vasectomy costs question

From Eric:-
Hi, I am going to be married later this year and my future wife and I do not want to have any more children. Unfortunately, I do not have medical insurance at this time and I will have to pay for the procedure out of pocket. Can you please give me an approximate cost for a no-scalpel vasectomy and the cost of a traditional vasectomy. Of course, when the time comes for me to decide to go through with this, I will schedule a consultation with the doctor.

 

Thank you

There should not be any difference in cost between a traditional and no-scalpel vasectomy. It is difficult to approximate the cost of a vasectomy procedure because of variances of costs in geographic areas, individual surgeon and clinic rates. Many communities provide free or significantly reduced cost vasectomy procedures for indigent patients and graded costs based on individual income. Planned Parenthood in the United States is an example of a clinic that offers these types of services for indigent patients.

 

Can I get someone pregnant 30 years after vasectomy?

Dear Dr Karpman:

 

I had a vasectomy in 1977 but did not know that I should be tested for sterility in 2-3 months so I never did. My wife and I continued to have sex for years after that until she died in 2000. I remarried in 2004 a 49 year old lady and we had increased sex for the 2 years we were married. She did not take any kind of birth control but relied on the fact that I had a vasectomy years earlier. Unfortunately we were divorced on 2006.

Currently, I have proposed to a lovely younger woman -36 years old- who has never been married and never had children nor does she want any. Furthermore she will not take birth control pills nor does she want me to use condoms–“everything must be natural” so my question is: Could I get her pregnant even after 30+ years of having my vasectomy? This is very important to her so I need to know. It seems to me–that if I did not get my 2nd wife pregnant and we were very sexually active at all times during the month, how could I get my new wife pregnant.

Will you please comment of this because we will be marrying soon and she needs to know.

 

Thank you so much for your kind consideration.

Pregnancy is a couples issue and the presence or absece of sperm in the ejaculate is only half of the equation. It is important to check if any sperm are present after a vasectomy to ensure a successful procedure. The fact that a pregnancy did not occur with previous partners could be related to the fact that the female partner had some undiagnosed fertility problem and whether sperm were present or not was insignificant. Therefore, if there has never been confirmation of a man’s sterility, it is important to have a semen analysis performed to ensure that you don’t have an unwanted pregnancy.

 

Success of vasectomy reversal question

From Natasha:-
My husband had a vasectomy 13 years ago. He has 3 children with his ex-wife. We have tried IVF however it failed as I miscarried. Last week he underwent a reversal. The doctor said after the procedure he cut away quite a bit of the vas deferens as it was blocked and reopened it. Was this the right way to proceed? What do you think the success will be? I am trying to be very positive.

It is imperative to cut back to the healthy portion of the vas deferens in order to do a vasectomy reversal. If it was necessary to cut that far back it means that whoever did the initial vasectomy damaged a large segment of the vas deferens. There is nothing you can do about that during the reversal. More importantly, were sperm identified in the fluid of the vas deferens and was an adequate amount of vas deferens available to complete the surgery? A well done anastomosis will work as long as the tubes could be re-sewn in a tension free manner. I assume that a vasovasostomy and not the bypass procedure was performed? Every surgeon should be able to give you their own success rate based on the operation that was performed.

 

Post vasectomy reversal care advice please

From Aaron:-
I was wondering what post-vasectomy reversal procedures and practices impact successful reversal. For example, is it better to wait more than 4 days to go back to work, is it harmful to have an erection without ejaculation up to 2 weeks following the procedure, how important is icing for healing of the surgery site? Are there any other recommendations you would offer for post-reversal care and practice? Thank you very much.

The post vasectomy reversal recommendations are variable and depend on how the surgery was done. In general, patients should refrain from any strenuous activity or ejaculation for at least 2 weeks. Some physicians require longer periods of inactivity or avoiding ejaculation. Ice on the scrotum is usually helpful in the immediate post-operative period for the first 24-48 hours. Afterwards, warm baths seem to help the healing process. All men should be sent home from surgery with a scrotal supporter and continue to use scrotal supporters for at least the first two weeks. The timing of returning to work is highly dependent on the type of work done. I will usually allow those patients with desk jobs to return to work 5 days after surgery.

 

Vasectomy at age 21?

From Mike:-
I am 21 years old and have been looking into a vasectomy since I first studied the procedure in a Human Sexuality class. My interest in Vasectomy is a result of a few thought processes, the most important of which is my lack of desire to have children of my own. I feel that becoming a Father at any age is nothing to be left to chance. I always use condoms, and even if I were infertile I still would for the prevention of HIV/STI’s. I understand that if I undergo the procedure that my mentality about fatherhood may change in the future, which is something that I take seriously, and with full responsibility on my part. I have studied the procedure for close to two years on and off, and have consistently felt that a Vasectomy is right for me. I know that in many Cases a Vasectomy is Reversible, and barring a Reversal there are some procedures used to extract sperm from the testicles to use in invetro fertilization. There is also the possibility of storing sperm at a sperm bank. My question for you is this, I wish to explore the idea of a vasectomy with a professional with your kind of expertise, what Criterion would I have to meet to have the procedure at my age, 22? I am committed to my ideals, but your opinion would largely effect my perspective on the matter.

It seems that you are an individual that has given this subject a significant amount of thought and are aware of the consequences of this procedure. There is no obligation in life to procreate and if you have made a sound decision that having children is definitely not in your future then vaectomy is an option. I always recommend that men who have not had any children strongly consider sperm banking prior to undergoing vasectomy in case there is a change of heart in the future. Vasectomy reversal and sperm retrieval with IVF are other highly successful alternatives if you should change your mind. My only age criteria is that the man be of legal age and sound mind when making the decision to proceed with vasectomy. I usually give patients some time to think about the procedure prior to performing a vasectomy in such a situation. However, you seem to be very informed about the subject through your own research and have given this extensive thought. Discussing this subject with your chosen surgeon would be the next course of action.

 

Abstinence after vasectomy

I have read on different sites that you have to wait to have sex from anywhere from 2 days to 2 weeks after the procedure. What could happen to you (if anything) if I did have sex or masturbate (doing either gently) only 2 days after procedure? In short’ will the vasectomy not hold, get infected or other?

Abstinence after vasectomy is recommended mainly for patient comfort and to allow for a period of healing of the wounds. Early ejaculation after a vasectomy is unlikely to have any consequence on the effectiveness of the vasectomy. The worst things that could happen with early ejaculation are slow wound healing or unnecessary bleeding.

 

Ejaculation 10 days after vasectomy reversal

From Warren:-
I had a vasectomy reversal 12 days ago and on the 10th night I ejaculated in my sleep, a little embarrassing. I am 33 years old with a VR 3yrs after the original vasectomy. We have 2 healthy children and got pregnant within days of starting, basically I sneeze, and my wife would get pregnant. I called my doctor out of concern due to the fact that I was only able to have 1 side
done. Should I be worried? He said that this has happened to other patients with no negative results. I forgot to ask what can happen due to this? He also mentioned something about voluntary ejaculation and in-voluntary ejaculation and one is worse then the other, I don’t understand???

Some men will experience an involuntary ejaculation in their sleep, especially after a prolonged abstinence period. It is difficult to say if any damage will be done from ejaculating sooner than required after a vasectomy reversal. The reality is that the vas deferens begins to have peristaltic movements (contractions) shortly after surgery and this is not much different than what occurs to the vas deferens after ejaculation. I am not sure what physiologic difference exists between a voluntary and involuntary ejaculation. The results of the first semen analysis should help determine if any damage to the surgical site occured.

 

I’m having complications following my vasectomy

From Kent:-
I underwent a non-scalpel vasectomy 6 days ago. I researched the procedure and was familiar with the potential complications. I followed all of the pre and post operative instructions explicitly. Everything that I read stated that this particular procedure was quicker and nearly painless, but this wasn’t my experience.

 

To start things off, the surgeon didn’t warn me before the injection to numb the site, so obviously he caught me off guard and I flinched. His response was “please remain as still as possible”, my response was “thanks for the warning”. I couldn’t see what exactly was happening, but immediately after injecting I felt a sharp hot poke and flinched again. His response was “it must not be fully numb yet, I’ll inject again”. As he isolated and manipulated the vas deferens on the left I felt an intense pressure with pain and spasming. He asked me if I was o.k. and I responded that it was pretty painful. I assume that at that point he was pulling the vas deferens through the puncture site, but the pulling and tugging seemed really rough!

As he began to cauterize the vas deferens I could feel every bit of it. I guess that all I can say is that it felt like a series of sharp electrical shocks and I was obviously squirming on the table. He asked again if I was hanging in there and I said that it was painful, which he explained was normal. As he proceeded to the right side it was uncomfortable when he isolated and extracted the vas deferens through the puncture site, but far more tolerable that on the left. He seemed to be being more gentle and I felt absolutely nothing when he cauterized the right side.

Once the procedure was finished he immediately left the room and the nurse told me that I could apply my scrotal supporter and get dressed. I assumed that they had covered the puncture site with gauze or some sort of dressing, but when I got up I realized that I was bleeding all over the floor. I frantically went through their cupboards in the treatment room and found some sterile gauze, applied pressure to the area, packed the area with gauze, and then got dressed. I was the last patient of the day and it was obvious that they just wanted to get out of the office as quickly as possible. They even made me pay my co payment and deductible before I even went in for the procedure, because the billing manager was “leaving early for the day”. As I walked out of the treatment room and into the lobby where my wife was waiting, I felt nausea’s, sore, and stressed out completely! Having read so much before the procedure, I guess that I wasn’t expecting the experience that I had at all.

I had the procedure early last Friday afternoon and took the rest of the day off and was in quite a bit of pain over the entire weekend. I followed the post operative instructions and rested the entire weekend, iced the scrotum as advised, and wore the scrotal supporter any time I was up on my feet. I am a Physical Therapist and returned to my office on Monday for patient care. I had them schedule me fairly lightly and although I am a manual therapist, I was very careful to avoid techniques that are strenuous to me. It is now Wednesday almost 6 days post. op. and I have been very careful all week to avoid any strenuous activity. I have also worn the supporter every day since. I am experiencing a lot of pain, intermittent swelling, and severe point tenderness on the right more so than the left. There is severe tenderness and fullness at the site of the right vas deferens and it is only mild on the left. The right side of my penis and my right testicle are completely black with bruising and there is a moderate amount of ecchymosis at the puncture site. I have been icing frequently and consistently since the surgery both at work and at home to control pain and swelling. During the procedure, the left side was far more painful than the right, but I seem to be having a lot more pain, swelling, and bruising on the right in comparison to the left.

When I got home from work today and removed the scrotal supporter, my testicles felt like they were literally 20 lbs. apiece and without any support, the pain on the right side doubled me over. With my scrotum unsupported I am experiencing the same pain and spasms as if I have been struck in the testicles. Although there was only a moderate amount of swelling, I am finding it impossible to even walk around the house without the scrotal supporter. I called the office today where I had the procedure and got the standard answer that I expected, which was that “pain, swelling, and bruising were normal”. I guess I am just wondering if what I am experiencing is acceptable or should I demand that I be seen at his office. Please help!

 

Thanks for your time and understanding.

Any type of surgery that “removes the bladder neck” will cause retrograde ejaculation in the male. Semen is normally deposited in the posterior urethra during a process called emission. The bladder neck should close at this time allowing the semen to be propelled forward when the man finally ejaculates. Absence of the bladder neck will cause some if not all of the semen to flow backwards into the bladder. This is inconsequential unless you are trying to have a baby. Fortunately, the sperm can be easily retrieved from the bladder after adequate preparation of the bladder and then injected into the uterus to achieve a pregnancy. A crude method of achieving pregnancy in these situations has been reported as “vaginal voiding.” The man can urinate into the vagina after his orgasm. I do not recommend doing this for multiple obvious reasons. Instead, consultation with a fertility specialist can help retrieve the sperm from the bladder for insemination.

 

Is sperm retrieval possible 30 plus years after vasectomy?

Hello – I was wondering if you can tell me if there are procedures to retrieve sperm from a man who had a vasectomy in 1975?

 

At age 61, my husband is now experiencing a lack of ejaculation. His urologist referred to this as Retrograde Ejaculation. This problem seemed to occur after a catheter was placed in his bladder during knee surgery. In knowing this, are his testicles producing sperm or are there variables? He is healthy, non diabetic, and very physically active. We would like to hear your professional advice/comments.

There are various approaches and techniques surgeons can use for sperm retrieval after a man has undergone a vasectomy. The length of time since the vasectomy is not important as most men who were fertile prior to their vasectomy will continue to make sperm throughout their lives.

Retrograde ejaculation (RE) is a separate problem and is unrelated to the vasectomy. RE is when the the ejaculate of the man flows backwards into the bladder instead of out the tip of the penis. There is usually complete absence of sperm in the ejaculate of men after a vasectomy and whether a man has an antegrade or retrograde ejaculate is irrelevant with respect to achieving pregnancy. RE can be caused by many reasons, but catheter placement is not a known cause of this condition. Most commonly, acquired RE is caused by certain medications, illnesses or surgery.

 

Is my daughter’s boyfriend the father?

My daughter is pregnant even though her boyfriend says he had a vasectomy at 19 or 20 …he’s now 25. I don’t believe he had a vasectomy and why would he have had one at so young an age? He keeps telling her it must not have took. I believe he’s lying to her but don’t know how to prove this. She has decided to continue her pregnancy but is not in love with this guy and knows they will probably not be together for long. He lied to her to trap her. Any suggestions….as her Mom I don’t know how to get to the bottom of this.

Unfortunately, there is no way of knowing whether or not anyone has had a vasectomy without their authorization to view their medical records. I am not a lawyer and therefore uncertain of any law compelling him to disclose his medical records in this situation or provide a semen analysis. Perhaps speaking with a lawyer would be useful. As the supposed father of the child, he has legal obligations and the veracity of whether or not he has had a vasectomy might be revealed in this process.

 

No ejaculation

From Elaine:-
I tried to find information on your web site, but couldn’t. I am dating a gentleman that had a vasectomy about twenty years ago. When we have sex, there is no ejaculation. None at all! Is this normal? I thought men had ejaculation but it is without sperm.

After vasectomy, men continue to have a relatively normal ejaculation except for the absence of sperm, which is not noticeable. The absence of an ejaculate can be caused by medications or several other medical and surgical problems. There is likely some other underlying reason why a man can not ejaculate, apart from his vasectomy.

 

Slow recovery after vasectomy reversal

From Shawn:-
I had a vasectomy just over 3 years ago. In December I had a reversal. Since the reversal I have had a constant pain and tightness in my vas deferens and sometimes in the testicles. Sometimes it is very painful. It feels like the Vas deferens are just stretched tight. EVERY time I ejaculate it is quite painful to a point now where I don’t want to ejaculate during sex. Any thoughts and suggestions on what may be going on?

 

I recovered from my vasectomy in about 1-2 days and was shocked at how long this has been going on.

The amount of vas deferens that was removed at the time of vasectomy determines the degree of stretch that will be required to reconnect the ends during a vasectomy reversal. Usually, the vas deferens will stretch over time releasing any tension. Pain associated with ejaculation might be due to this phenomenon and should be relieved with another vasectomy. This is not a commonly encountered problem after vasectomy reversal and whether or not it will improve after any further time interval is uncertain.

 

Getting a vasectomy age 21-24

Is it possible for young men to get vasectomies between the ages of 21-24. What’s the success rate? What type of questions should I be prepared for if they ask me around that age gap?

Any man of legal age and sound mind can get a vasectomy. However, most physicians would question the intentions of having a vasectomy a such a young age. If the patient has already had several children or his convictions are strong about not having any children then it should not be a problem to find a surgeon willing to perform the vasectomy. Vasectomy should not be used as a form of temporary contraception to avoid using condoms or other types of birth control. Vasectomy reversal is an extremely successful procedure but not 100% of the time. Men who have not fathered any children prior to a vasectomy should also consider sperm banking.

 

The “Pregnant after vasectomy” posts

I was reading your topics about women getting pregnant after their husbands had a vasectomy. How could they get pregnant after a vasectomy? Should married couples have sex with a condom, even though the man already had a vasectomy?
I would like to get married and have sex someday, but I would hate to be in that situation. Are there any good urologists who would perform vasectomies?

We are oftentimes asked to comment on similar situations where a woman has gotten pregnant after her partner has had a vasectomy. Vasectomies rarely fail, but patients more often fail to follow the instructions given to them after the vasectomy. For example, the most common reason women get pregnant after their partner’s vasectomy is because the man does not confirm that all sperm has been cleared from his reproductive tract prior to having unprotected intercourse. This usually happens within the first 6 months after the vasectomy. Studies have been done demonstrating that as little as 30% of men complete the required two semen samples after their vasectomy. We also have heard from patients who have gotten pregnant several years after a vasectomy and after their partners were confirmed to be sterile on a recent pelleted semen analysis. In these situations I have always offered the couples the opportunity to review their semen analysis reports along with the paternity test of the child, if they desire. To date, there have not been any responses. In a few instances where a pregnancy has occurred several years after vasectomy, the initial semen analysis did not demonstrate any sperm, but only after obtaining a pelleted sample were sperm identified. In these few cases, re-canalization has likely occurred rendering the man fertile. These cases of re-canalization are uncommon and the likelihood of causing a pregnancy in these situations is even less likely than the re-canalization in the first place.

 

Vasectomy reversal question

From Joanne:-
Thank you Dr Karpman for this site, it must help lots of people and we appreciate your time. My husband had a reversal in December and has waited for a month or so before commencing sexual activity. The first few ejaculate were very different to normal. It was very gel-like and gritty. Could this be a sign of old, built-up sperm being passed? Now after about another month it is looking more like it used to.

The prolonged period of abstinence required after a vasectomy reversal can result in the build of prostatic secretions. The prostate continues to make fluid in the absence of ejaculation. These secretions can actually form into cast-like structures which can appear gelatin-like on ejaculation. Fortunately, resumption of a normal ejaculatory frequency will clear the build up and restore the semen quality to its normal consistency.

 

Does vasectomy alter semen volume and other characteristics?

From Gary:-
I had a vasectomy about 20 years ago. Now I am considering a reversal procedure, but not for the reason most commonly given by men – potentially fathering a child. My reason is entirely to change the quality of my ejaculate, and my orgasm experience.

 

Over and over again I read this site and I read comments by others in the medical profession and the most frequent idea proposed is that the ejaculate does not change substantially in appearance or other qualities following a vasectomy. Yet many of those men who have had either a vasectomy – or a reversal – state emphatically that their ejaculate and/or orgasm experience has changed. Even some women agree the ejaculate changes. While the evidence is only anecdotal, it remains compelling for me against no factual data posed on the medical community side.

Since my vasectomy was so long ago I have difficulty remembering any change after my procedure. Maybe I didn’t want to notice any change so I ignored it altogether. But now as a result of too many birthdays having passed or because I have time to actually ponder my ejaculate, I notice the change. Unfortunately I can only compare my ejaculate to that of men in pornographic films, but suffice it to say mine has no “body”. My ejaculate has lost its gel-like viscosity and now it’s clear and watery in appearance immediately upon being expelled. Of course, each orgasm is mildly different, but consistently during the past decade the strength of the expulsion, the number of contractions, and the watery yield makes for a less than exciting experience.

I am aware that age certainly has some affect. But just to ensure that you don’t assume I have other medical problems which would influence my sexual function, let me assure you that I am in excellent health with good muscle tone, strong heart, healthy prostate, no ED problems, proper free and total levels of testosterone, etc. etc.

Have there been any bona fide studies done on quality and characteristics of ejaculate pre-vasectomy, post vasectomy and post vasectomy reversal? Can you offer any empirical evidence which supports or refutes the supposition that a vasectomy changes ejaculate and orgasm?

 

Thank you for your consideration.

The traditional thinking, experimental evidence and anecdotal experience of physicians performing vasectomy and vasectomy reversal is that there is no significant change in semen volume after vasectomy or vasectomy reversal. The quality, but not quantity, of the semen does change after vasectomy and vasectomy reversal as the contribution of the testes and epididymis is no longer present after a vasectomy and returns to the ejaculate after vasectomy reversal. Whether or not these changes are noticeable by the patient is questionable and not very well studied. There are differences with respect to certain electrolytes and factors in the semen of men in these two groups. The impact of these changes in certain constituents of semen is not correlated with the qualitative appearance of the sample in any of these studies and it would be very hard to do so objectively. I re-did a search of the medical literature to specifically find a study demonstrating some changes in semen volume associated with vasectomy and vasectomy reversal. One small study of 76 patients did demonstrate a decrease in semen volume after vasectomy. The study dates back to the 1970’s and does demonstrate a 0.66ml average decrease in semen volume in men after undergoing a vasectomy. However, it is unclear from the abstract if they controlled for abstinence period prior to evaluation.

 

“No needle” vasectomy

From Mark:-
Are “no needle” vasectomies different from the regular kinds? Are they more successful?

The only difference between no-needle vasectomy (NNV) and conventional no-scalpel vasectomy (NSV) is in the delivery of the anesthesia. NNV utilizes a high pressure jet anesthesia tool instead of a typical small needle to deliver the local anesthetic. NNV has been shown in a limited number of studies to decrease the pain associated with delivery of the local anesthetic. The remainder of the procedure is similar to NSV.

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