earlier this year, i went through a vasectomy. it’s important to write about, as so many people have questions about it, and are afraid to ask about it (for a variety of reasons). i’ve divided my response into two parts: the first is about the physical procedure itself, while the second part is about the reasons behind willingly undergoing such a thing.
many months ago, i finally elected to cash in on my health insurance and abundant sick days, and start receiving annual physicals again. this is when you visit the doctor and they check up on your general physical well-being, learn of any lingering aches and pains, investigate current possible symptoms of what might be larger problems, and so on. amid complaints about my chronic knee pain and recent bout with acid reflux, i mentioned that i wanted a vasectomy. after mentioning that he had one himself several years ago, my physician referred me to a doctor within the same hospital i was visiting for a urology appointment and initial consultation. the only unusual thing he asked about the procedure was whether or not i was thinking about the procedure as a ‘permanent, irreversible’ one. i know of methods where you can have the tubes reconnected, but i’m definitely not interested in that. so he seemed fine with that, and gladly passed along the referral.
after finding a ‘plan b’ urologist due to my insurance not being accepted by the first referral, i had a consultation appointment set for a few weeks away. leading up to that time, i didn’t have to do anything unusual or different with my time; the appointment time came along, so i went to meet with the doctor who would be performing the procedure. his office is on the sixth floor of a professional building that’s part of the hospital campus; i mused that walking up or down the six flights of steps would be the last thing on my mind after it was done.
in the examination room, the doctor did a brief check of my testicles, essentially handling my scrotum and i assume taking note if any unusual shapes, growths, or other malformations were present. apparently everything was okay, as he finished quickly with no questions, and recommended i pull up my pants. we set the date for the middle of the following month, almost an entire month away.
time was uneventful leading up to the procedure. i had no second thoughts about having it done (which is apparently fairly common for any procedure not related to a life-threatening illness), and basically waited for the day to come along. since i currently had no prescriptions for pharmaceuticals, there were no other special instructions other than to avoid using aspirin or ibuprofen in the week or eight days leading up to the operation. i assume that this is because of how those drugs affect the liver/endocrine system. not a problem. the doctor also recommended bringing an ipod or music device to listen to during the procedure; i don’t own one, but i figure it wouldn’t be so bad sitting there for less than an hour.
also of note was the recommendation that i purchase some tight-fitting briefs for the week to follow, and basically stay off my feet for the weekend afterward (the procedure was scheduled for a friday morning). i later purchased two three-packs of tightie whities, and arranged for my girlfriend to drive me to and from the hospital on the day of (for which she graciously used a vacation day).
on the day of my procedure, we arrived bright and early at the hospital on a foggy winter morning. instead of an ipod, i brought a book, thinking i’d be able to read while someone was poking my scrotum with sharp things.
while my girlfriend waited in the lobby, i went to an operating room that was larger than one of the examination rooms, but smaller than what i always imagined operating rooms would be like; i’ve never been to an emergency room or had surgery for anything in my life, so i was just going off of what i’d seen in films and television. the nurse present told me to drop my pants and underwear, lay on the operating table, and cover my nethers (my wording, not hers) with a dressing cloth.
the doctor arrived shortly after, and took a moment to shave part of my scrotum, where the incision was to take place. after setting the razor aside, he replaced the dressing cloth over my crotch. after tearing a hole in the dressing cloth, he pulled my scrotum through, so only it showed; i imagine it appeared as some strange transplanted nose of Jimmy Durante.
he asked jokingly, “so, are you sure you want to go through with this?”
“there’s no turning back now,” I replied, my nut sack shriveled and vulnerable under his care. i can’t believe i just typed that.
earlier he had mentioned that a local anaesthetic was to be used. an acquaintance of mine had received a vasectomy earlier this year, and he was under complete anaesthetic, and unconscious; i was curious to know how this would be different: awake while being operated on in such a fragile place. fortunately, after a noticeable pinching pain of a needle being applied, the local anaesthetic took effect, and as far as i could tell the entire right side of my scrotum was numbed into senselessness. i was still able to move my legs and the rest of my body; the weight of my scrotum was being supported by the dressing cloth; i was completely aware as the procedure took place.
it was fairly straight-forward, as procedures go. the doctor makes a very small incision, perhaps 1.5 cm wide, or half an inch or so. through that single hole, the doctor attends to a single testicle and vas defrens at a time. using a cauterizing tool, the vas deferens is simultaneously severed and burned closed. a faint aroma of (what i assumed was) my own burning flesh, similar to the smell of burning hair, could be detected.
the book i brought with me to the operating room was about board game design. the attending nurse asked, ‘so, are you a game designer?’ and we were off to the races at that point. before i knew it, the doctor addressed me, looking me in the face instead of the crotch.
‘well, the good news is that this one’s done,’ he said. ‘the bad news is that i have to do the other side. you doing okay?’
i remember saying something about how, if i had wanted to just shave my ball hairs off, i would have stayed at home that day. so he resumed his work. the second anaesthetic shot seemed more painful than the first, and i noticeably squirmed in my seat. at least he apologized for that one.
quick anatomy trivia: the scrotum is actually divided in half, with a fleshy barrier separating the two halves and ostensibly the two testicles, from ever touching one another. by placing the hole in the center of the scrotum, in eyebrow-raising proximity to my penis, the doctor could easily reach either side, and either hemisphere, of the scrotum. i thought of how the brain was structured in a similar way, with dura mater separating the two hemispheres of the body’s nerve center. the brain and the scrotum are very similar, in a variety of ways.
the atmosphere was a little less comfortable during the second cauterization for some reason, and i remember attempting to perform my qigong meditation while he was down there burning things closed: envisioning the amber sunset a hundred miles away, the golden orb of the sun surreptitiously peering over the top of the mountainous horizon. once again, i smelled burning flesh. he concluded the episode by stitching me up with thread that would eventually dissolve.
the nurse departed (after i thanked her for such excellent conversation about board games), and the doctor urged me to press a large piece of gauze at the incision point. he went over to my disrobed clothes, brought them over to the operation area, and assisted me in putting on my pants and underwear. i gathered the rest of my belongings and joined the doctor for a brief chat in his office. he basically recommended i stay off my feet for the entire weekend, and not shovel any snow (although it was foggy and a bit temperate outside, a tremendous snowstorm had been forecast for that weekend). i’ll need to “clean the pipes” (my wording, not his) with 15 to 20 ejaculations; at that point, i should submit a specimen so they can do a sperm count to confirm that i’ve emptied all possible hangers-ons from my vas deferens, and that my testicles weren’t somehow miraculously re-attached to the rest of my reproductive system. with that, i shook his hand and left.
the path to recovery has also been quite smooth. i came home that day and my girlfriend basically tucked me in for a long afternoon of napping and film-watching. i elected to eat, drink, and watch movies while resting a bag of frozen peas on my crotch: 20 minutes on, 10 minutes off. the peas worked well, but after about an hour after the operation i could tell the anaesthetic was mostly dissipated; i elected to take one of my painkiller medicines (prescription ‘lortab’) to tide me over until i fell asleep.
it in fact did snow, and i have the feeling i would have recovered even sooner had i not needed to dig my car out of the snow the following monday. tuesday morning, i noticed a little bruising on my scrotum, and a lingering ache had returned. things were tolerable at work during the day, although to help me sleep that night i took another painkiller pill.
now, almost a week and a half later, pain only comes if i absently jostle my scrotum (and dare i say that’s normal). there’s absolutely nothing wrong with my penis at all, and comparatively speaking it was untouched through the entire experience. my doctor’s note mentioned that ‘normal sexual activity’ could resume after five days. your mileage may vary.
my next post on this subject will deal with the non-physical, social/psychological/ethical/etc. aspects of vasectomies, and where my rationales fit in.