Considering Vasectomy?

Short answer:

No

Cheeky answer:

About 1% as much as giving birth.

Detailed answer:

It is completely normal to be anxious about having a procedure that involves your scrotum, as men appropriately spend their life protecting their groin from harm. At Twin River Urology, Dr. Curtis performs a “Minimally Invasive Vasectomy”, which is much more comfortable than the conventional procedure.

There may or may not be a momentary pinch or sting, as well as a mild “pressure” sensation. That being said, Dr. Curtis has found that almost all men leave the office saying that it was not nearly as bad as they anticipated it would be.

To aid with your comfort, you get to choose the mood of the room during the procedure. If you want to zone out with music and a mild relaxant pill, great. If you want your partner in the room and we get into a three-way conversation about an esoteric topic of interest to you, that works as well. We will discuss this more when you make your appointment.

Minimally Invasive Vasectomy

A vasectomy is simply an interruption of the sperm duct, otherwise known as the Vas Deferens. We can do this because sperm represents only about 1-2 % of the volume of fluid that comes out with ejaculation. Sperm has a limited life span, and it will continue to be produced after a vasectomy, live adjacent to the testicle in the epididymis, and ultimately just get processed by your body after it dies.

“Minimally Invasive Vasectomy”

With this technique, a tiny skin opening is made (perhaps 2 or 3 millimeters) after the tissue is numb. The worst you might feel when the skin is numb is comparable to a bug bite. The opening made in the skin is so small that it is purposely not stitched closed at the end of the procedure because it just seals up on its own. This tiny opening also serves as a “pre-positioned drain” so that if there is any fluid buildup right after the procedure, it has a way to get out.

The skin entry is made in the middle of the scrotum about an inch below the base of the penis. The instruments used allow Dr. Curtis to bring the Vas Deferens through the tiny opening, above the scrotal skin surface. Dr. Curtis is methodical in his approach, taking whatever time is needed, to dissect any attached fibers away from the vas deferens itself. By occluding only the vas deferens, rather than incorporating some of its fibrous attachment, Dr. Curtis has found that this limits the post procedure pain.

Once the tube is freed up, a small segment is removed and each end is sealed off. Before returning the cut and occluded ends of the vas deferens to the scrotum, any common attachments are freed up. This key step allows the two ends of the vas deferens to retract away from each other into different tissue planes.

An advantage of doing the procedure through a single skin entrance in the middle of the scrotum is that having completed one side, the other vas deferens can be done almost completely through the already numb tissue. In some instances, additional local anesthetic will be used to keep you as comfortable as possible.

Once the procedure is completed, some bacitracin is applied to the skin puncture site, some gauze is put on top, and in a couple days, it is likely you will not be able to see where the procedure was done. Dr. Curtis purposely does NOT stitch the skin closed. By using this approach, it helps prevent post procedure scrotal swelling by giving any little oozing of blood or fluid a way to escape rather than building up inside. This is the point in the procedure where we hope you can say, “That was not nearly as bad as I thought it would be.”

The actual procedure work usually takes about 30 minutes. It can sometimes be done more quickly, but we allow all the time that is needed to completely free up the tube (as described above).

If you ask Google what the vasectomy failure rate is, you will get a mixture of both accurate and ridiculous information. As an example, in summer 2024, Google AI appears to mix data about the “success of a vasectomy reversal” with the “failure rate of a vasectomy”.

Dr. Curtis has performed over 1000 vasectomies in his 30-year career as a urologist. In that time, he has had only two patients who experienced a vasectomy failure – both were in his first seven years and within the first 300 vasectomies that he performed.

Around 2008, after ten years of performing conventional vasectomies through two separate incisions, Dr. Curtis switched to a “Minimally Invasive” technique through a single skin entrance. Since using this approach, he has not had any patients with vasectomy failure, wound infection, or chronic pain. That being said, we cannot guarantee a perfect result, but we do promise that you will get the time and attention needed for the best result possible. As a Board Certified Urological Surgeon, Dr. Curtis is comfortable handling unusual anatomy or a bleeding vessel. At this point in his career, he receives referrals of patients who have had a challenging or unsuccessful vasectomy somewhere else.

If you have any questions or would like to discuss the technical details of the procedure further, please contact our office and we would be happy to provide more information.

• Vasectomy is the most effective method of male sterilization and should always be regarded as “irreversible”
• You will not be sterile immediately and will need to continue alternative contraception until you have been given the “all clear” from your post-operative semen test after at least 12 weeks and 15-20 ejaculations
• Late failure, due to a channel forming, is technically possible, but extremely unlikely
• There is no reproducible evidence that vasectomy causes any long-term health risks

Common after-effects within the range of “normal”:

• Bruising and scrotal swelling, with or without seepage of bloody fluid from the incision
• Blood in your semen
• After a period of weeks of feeling good, sudden pain and swelling after strenuous activity

Reported, but extremely unlikely:

• Chronic testicular pain severe enough to affect day-to-day activities
• Significant bruising and scrotal swelling requiring surgical drainage
• Infection of skin, testicle or epididymis
• Early failure (post-operative semen analysis shows persistent motile sperms) so that you are not sterile This is very unlikely but it is why we suggest you do the semen analysis.
• Late failure (re-joining of the ends of the tubes after initial negative sperm counts) resulting in fertility & pregnancy at a later stage (Data says 1 in 2000 patients)