Talk:Vasectomy

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[edit] Secrecy

I got my vasectomy done in Pittsburgh (It went just fine, I'm very pleased with the results), but I was sort of surprised at how the priavcy bit went above-and-beyond what most doctor's offices ask for, even in this patient-privacy obsessed age. I had to tell the office exactly who they could speak to at my home about this - by name.

Is this because of modesty issues, or the fact that I live in a very Catholic area, or that a lot of guys get snipped without letting their wifes/girlfriends know? I've always wondered.--Pittsburghmuggle 07:20, 2 July 2007 (UTC)

Probably mostly modesty. Some people would be mortified if their friends and co-workers were to find out they had been snipped, because they confuse their fertility with their virility. Maybe that particular practice had had a bad experience with a meddling relative of a client who found out something they shouldn't. --Slashme 10:00, 23 July 2007 (UTC)

[edit] Lifelong Post-Vasectomy Pain

I thought would preface this thread in defense of the original post below. There is now plenty of written proof of chronic post procedure pain as a result of vasectomy. Do the research about post vasectomy pain and you will find the numbers are high enough to make it part of the decision-making. Tubal Ligation is still done at higher risk (during the procedure) but has significantly LESS post procedure pain statistically, than vasectomy. The original post discusses the lack of disclosure regarding this chronic pain. This is because the evidence is just now coming to the mainstream, that is, being made available in the public domain. I also had the procedure, and have some pain when having rigorous sexual relations which cause lower abdominal pain, enough to sometimes interfere with those 'relations'. Everyone's reaction to the vasectomy will be different, and yes, most will come away from it pain free, or with pain that is not significant. Enough others will have pain significant enough to have regretted the surgery. I personally am on the fence.

The most significant complication of vasectomy is a lifetime of severe continous post-vasectomy testicular and epididymal pain. As a sufferer myself, I know from experience that such pain destroys quality of life to the extent that few other sicknesses can compare. The fact that a procedure, which is advertized to be safe and simple, has a rate of chronic and severe long-term pain in between 5-30% of men (depending on the severity of pain that qualifies for the particular study)), needs to be explained in detail in any article with the goal of elucidating the truth rather than advocating for a cause. Doctors often minimize this complication and sometimes, as in my case, they don't even tell their patients. If patients knew the truth, most, certainly myself included, would not have had vasectomies and this would cut deep into the pocketbooks of some urologists, hence the deception. Wikipedia is a place for truth, not for convenient, money-making "truths" that benefit only urologists and leave innocent people in lifetimes of severe, unbearable pain. Vasectomy is an unnatural procedure and the fact that some men seem to have no pain from it is the fact that should be surprising. Since Wikipedia is designed to cover the truth without the filter of powerful, deceptive, money-grubbing people, we need to create a section that outlines clearly the incidence and severity of post-vasectomy pain. luketh

  • Your non-NPOV anecdotes are not as interesting to others as you might think. If you ever have surgery again, consider yourself informed that all surgeries have a potential for complications. Also read the forms they give you to sign before the surgery. If your doctor truly did not inform you than you have the makings of a lawsuit. More probably he did inform you, you signed forms that you understood the risks, but all you actually absorbed was that it was a routine procedure that normally does not have significant side-effects. Besides which, who is to say you aren't just an anti-birth-control zealot making things up? I'm not saying that's true, but you don't make a compelling case for modifying the article without compelling evidence that your experience is significant and not uncommon. - Gripdamage
My vasectomy cost $500 and there are no side effects. You think a doctor would lie about issues like this and risk malpractice suits to make five hundred bucks?MichaelBrock 03:55, 25 January 2007 (UTC)
Mine went fine, too. No problems. A lot of the people for whom the procedure went well don't talk about it probably. How many guys do you know who talk about how well their vasectomy went?
PVPS certainly does not occur in the majority of patients, but it needs to be adequately addressed, because it is the most troubling complication of vasectomy. The minority who do suffer claim that the pain is really life-altering. —Preceding unsigned comment added by Luqmanskye (talk • contribs) 23:24, 23 September 2007 (UTC)

Guillebaud is busy with a prospective study. Unfortunately, he doesn't have a control group, but his results so far are interesting:

CONCLUSIONS: We have found that in the cohort of men undergoing vasectomy in our unit, one in 10 experiences some form of scrotal discomfort before the procedure. We have found that 7 months after vasectomy one in seven asymptomatic men experienced scrotal discomfort of some kind, although the average level of discomfort is not great. Paradoxically, fewer men with scrotal discomfort before the procedure experienced discomfort at the same point afterwards. These early data indicate that CPVTP is a genuine entity, and longer term follow up in this group will allow further evaluation of how this pain evolves over time.

This from: T.A. Leslie, R.O. Illing, J. Guillebaud and D.W. Cranston, PD-10.03: A prospective assessment of chronic post-vasectomy scrotal pain, Urology, Volume 68, Supplement 1, 28th Congress of the Societe Internationale d'Urologie, 28th Congress of the Societe Internationale d'Urologie, November 2006, Page 35. (http://www.sciencedirect.com/science/article/B6VJW-4M4KY0D-3H/2/dcc70676bd582cb70f361df61a5a9d59)

I don't really have time to hack this into the article at the moment, but if anyone here has the time and inclination, go for it. --That guy whose balls also ached from time to time before his snip 23 July 2007 12:47 SAST

[edit] Discussion on origins of article

Shouldn't this have its own article? --Tothebarricades July 1, 2005 05:55 (UTC)

  • I agree. The article history suggests this has never been anything but a redirect. – drw25 (talk) 15:32, 15 April 2006 (UTC)
Since it does now, I adjusted Defrentectomy to redirect here instead of Sterlization Kuronue 23:28, 30 June 2006 (UTC)

[edit] Psychological effects

There should surely be some data on this? Rich Farmbrough 16:07 16 July 2006 (GMT).

How long must a man wait after vasectomy before it's safe for him to have sex without getting anyone pregnant? It would be nice to add that to the article.

  • There is no answer to that question as such. A semen sample is tested shortly after the operation and again a few months later. Only fater the second has tested clear is it safe to rely on the vasectomy. Unfortunately, from memory, I can't say what the time periods are, but if someone else knows this information should be added. Emeraude 15:24, 3 October 2006 (UTC)
    • One month after the operation is when the first sample is tested, two months for the second. It's been 3 weeks now since I 'supplied' the second sample and I've not heard anything yet.80.42.170.0 22:02, 23 November 2006 (UTC)Thinker

As a rule of thumb, for all other mammalian species it is 60 days before you can be confident there are no active spermatazoa left in the epididymes. I se no reason why humas should be any different. Dlh-stablelights 22:05, 14 June 2007 (UTC)

[edit] Vasectomy vs. Tubal ligation

What is the point "stronger motivation for sterilization in the man" supposed to mean? And why wouldn't the same for a woman be a reason for tubal ligation? I actually don't get that point. 69.124.143.230 04:19, 7 September 2006 (UTC)

This is basically a list of why people choose vasectomy over tubal ligation. One reason would be that because the man in question feels more strongly about sterilization than the woman. The statement is not intended to mean that men in general are more strongly motivated to be sterilized than women are. Maybe this should be reworded for clarity. --Slashme 10:16, 7 September 2006 (UTC)
I get the general idea, I'm just asking if this article is making some claim that couples, in general, prefer to choose vasectomies over tubal ligations because of some "preference" for sterilizing the male? I mean isn't that the whole idea of the list in the first place -- what determines "stronger motivation" for sterilization in the man? It's kind of like listing the topic of the list itself as one of its own points, you know what I mean? (or am I just assuming wildly as I am oft to do?) 69.124.143.230 00:42, 13 September 2006 (UTC)

[edit] Recovery

people who had a vasectomy should follow the doctors rules if they don't want to do this then they shouldn't have one




"For the next 24-72 hours, the patient should remain at home, sitting or lying for most of the time." What? Is this for wimps? Everyone I know (and myself) had the op late afternoon and was at work the next day, albeit taking things gently, especially avoiding sudden movements when sitting or standing. There are clinics who advertise to a vasectomy during the lunch break.... Some clarification please. Emeraude 15:28, 3 October 2006 (UTC)

Having had the operation myself just 3 months ago the "remain at home, sitting or lying for most of the time." is completely justified. After the operation the patient may feel fine after half a day (as you and your acquaintances did), however swelling may occur(as it did in me) and the feeling is not unlike the one you get after having been kicked in the testicles, the only difference being it can last for about a week. I had mine done on a Monday and wasn't capable of working properly until the following Monday when the swelling had gone down and I was then (as you were) taking things very gently.80.42.170.0 22:02, 23 November 2006 (UTC)Thinker
"For wimps"? It's not about the pain.. it's about the fact that a very thin line has been severed in a very sensitive area of the body. Better to err on the side of safety than get pain in your testicles any longer than you have to have it.--Pittsburghmuggle 07:10, 2 July 2007 (UTC)

[edit] Chronic Post-Vasectomy Pain

I just finished reviewing Ref 14. I believe there is an error in this article due to a misreading of Ref 14 by the author of this article. According to the article:

The incidence of chronic post-vasectomy pain is estimated to be between 5% and 30% depending on the severity of pain that qualifies for the particular study.

This is in contrast to this quote from Ref 14:

Eventually, the pressure would become too great for the compensatory measures; increasing to uncomfortable levels due to the lack of a pressure valve or sperm granuloma. Although this is an attractive hypothesis, it suggests that PVPS is a natural progression of events in the estimated 5%–30% of patients who do not develop a sperm granuloma following vasectomy. However, only a small percentage of postvasectomy patients (less than 10%) develop PVPS. This suggests that other factors besides the lack of a sperm granuloma must predispose patients to the onset of epididymal congestion and pain.

According to this Ref, less than 10% of vasectomy patients experience pain. The 5-30% referers to the number of patients who do not develop a sperm granuloma following vasectomy.

I hope this helps. —the preceding comment is by 24.177.14.58 (talk • contribs) 15:54, 7 January 2007(UTC): Please sign your posts!.

Hmm, it does. I'm not great at maths myself, but feel free to Be Bold and edit! --RedHillian 23:13, 7 January 2007 (UTC)

Ref 14 doesn't seem very reliable. It's best to reference the primary studies. McMahon et. al. (1992) report the incidence of PVPS at 33% of vasectomized men. Choe and Kirkemo (1996) give 19%. The discrepency seems to be in the severity of pain that qualified for PVPS in the particular study. Luqmanskye

[edit] "pregnancy rate" rather than "failure rate"

Note discussion at Talk:Birth control#"pregnancy rate" rather than "failure rate" re replacing occurrences of "failure rate" with "pregnancy rate". I would also like to see the same change on this page. Please make any comments there. --Coppertwig 03:57, 8 January 2007 (UTC)

Note ongoing discussion at above-mentioned talk page including specific mention of this article, and involving need for citations to support the numbers given in the infobox and need for definition of "failure rate" as used in the infobox on this page. I assume any discussion will continue there for now at least; if related discussion moves here please put a note there about it. --Coppertwig 17:36, 6 February 2007 (UTC)

[edit] Misreading of Study (Or is It?)

Compare this passage:

Though much of the content that can no longer exit the body is reabsorbed by these macrophages, examination has shown that, over time, essentially every vasectomized man also experiences an epididymal blowout, which is the formation of a sperm granuloma in the epididymis, to relieve the high intra-luminal pressures in the delicate epididymal tubules.

With the abstract of the study referenced:

Pressure-mediated effects of vasectomy on the epididymis and resolution of this effect via microsurgery of the epididymis are reported, and a technique of vasectomy modified to limit these pressure effects, making vasectomy more reversible, is suggested. Assuming mastery of microsurgical techniques for vas reanastomosis, the lack of which is one reason for low reversibility of vasectomy, other problems are still encountered that result in low sperm counts and demonstrable infertility. All vasectomies produce micromechanical, pressure-induced changes; 1000 vasovasectomies observed through the operating microscope always showed some degree of dilatation of the lumen of vas deferens and some congestion of the epididymis with dilatation of the epididymal tubule. Rather than augmenting infertility, the presence of a sperm granuloma seems to be a safety valve that decompresses the vas and prevents build-up of excessive pressure; this microscopic study discovered epididymal blowouts with extravasation of sperm from the epididymal tubule into the interstitium, causing secondary obstruction. Simple suture of the vas deferens is not sufficient for reanastomosis, but suturing of the inner lumen to the vas directly to the one cut epididymal tube leaking sperm must be performed. Open-ended vasectomy has a greater chance of reversibility as well as greater likelihood of spontaneous recanalization, a problem with solutions if research is started.

The study is completely misrepresented in the Wikipedia article. The study did not find that all men experience an "epididymal blowout." Rather, it found that all men experience some microscopic dilation of the epididymal tubule and lumen of the vas deferens. The study went on to look for reasons why some men have problems with vasectomy reversal and found that some of these men have a secondary obstruction caused by a sperm granule which formed as a safety valve.MichaelBrock 03:34, 25 January 2007 (UTC)

You actually have to read the article. You had no basis for deleting the original text without reading the supporting article. If you don't have access to the article's full text then look at the author's website where he says "after vasectomy, the testicle continues to produce sperm and fluid normally. This causes a build-up of pressure within the vas going all the way back to the epididymis. In most individuals (emphasis added) this pressure causes a "blow-out" in the epididymis, similar to a leak in the thinnest part of a tire that has more pressure than it can handle. Sperm then leaks into surrounding tissue and causes scarring and obstruction." This quotation comes from the section "The Need For Epididymal Repair (More Complex Cases)" at http://www.infertile.com/treatmnt/treats/mvr/mvr.htm. Note that the article cited (of which you quoted only the abstract) strongly supports the original text's claim of "essentially all". Luqmanskye 00:05, 24 September 2007 (UTC)

Vasectomy 10:43, 7 February 2007 (UTC)How soon after ejaculation are the sperm absorbed into the body? How many consecutive ejaculations would it take for "epididymal blowout" to occur? alanVasectomy 10:43, 7 February 2007 (UTC)

Sperm is stored in the epididymis and is released either by ejaculation or being absorbed into the body. "Epididymal blowout" is just a fancy term for the epididymis running out of room and sperm moving into the vas deferens. It can form a granule there, which acts as a "safety valve" (sperm can collect there when the epididymis fills up). This has no consequence unless you try to reverse the vasectomy, in which case this secondary blockage may need to be removed so sperm can continue to travel all the way through the vas deferens. Vasectomized men ejaculate just like normal, as sperm only makes up less than 3% of the fluids ejaculated. The only difference is the sperm itself stays in the body and is absorbed. It has no effect on libido or anything else. MichaelBrock 19:56, 10 February 2007 (UTC)
Actually, Michael, epididymal blowout does not involve the vas. The sperms leak directly from the epididymis into the scrotum. When it is in the vas, it is just called a sperm granuloma. Doksum 23:16, 21 October 2007 (UTC)

[edit] Flavor?

ew —Preceding unsigned comment added by Krazykenny (talk • contribs) 02:54, 18 May 2007 That's right —Preceding unsigned comment added by 99.147.199.127 (talk) 01:15, 22 February 2008 (UTC)

[edit] Point

There is a great deal here about how vasectomies are carried about, its after-affects and success, which is good, but there is not a lot here discussing WHY a man might choose to have a vasectomy. Is there any sense in adding this anywhere? CO.

Hi, there. Please sign your comments by typing four tildes (~~~~) at the end of what you have written. This provides the time and date stamp.
As far as reasons for getting them, perhaps you could search online for research performed involving polling of men who had vasectomies and the reasons for having them. Joie de Vivre T 15:11, 21 June 2007 (UTC)

[edit] Post procedure pain

For those wondering my case seems to be similar to another who posted on this talk page. On the day of the procedure I began to feel better by the end of the day, I had it done in the morning. Mine was done using a single incision and the physician then directed the vas deferens to the incision to interrupt. After roughly two days it was just a persistent soreness, then on the 5th day a much worse pain persisted that was similar to the pain level on the day of the procedure. Given that I have not fully recovered, I will edit this posting to reflect current status. Somehow, this is having a cathartic effect that psychosomatically reduces pain levels. Ardoreal 15:50, 22 July 2007 (UTC)

How long ago did you have this procedure? Delayed pain is not uncommon though most do not experience this. Possible causes include prematurely overdoing it (feeling fine on day 4 and going for a ball-jostling jog, for instance) or developing a sperm granuloma (sometime you can feel a little pea-sized nodule). The good news is both of these causes usually resolve themselves quite simply if you take it easy. Also as you have noted pain, and ball pain in particular, is highly susceptible to suggestion, so if you can relax and realize that it's not so bad and it's going to go away you are likely to feel better a lot faster than if you fret over being doomed to a perpetual ball-ache (an Extremely Unlikely proposition). NTK 03:58, 27 July 2007 (UTC)
The procedure was done 5 days prior to the above posting. Mainly I had taken it easy, but then felt able to do some chores. I went and mowed a portion of our lawn and the next day was when the pain had become noticeable. It is now 11 days after the procedure and the pain is completely gone. It "feels like my old self" so to speak. The incision is still recovering but it has healed to the point that I can now flex and walk normal to how I use to. The sutures were absorbable and are gone from the wound now. For those worrying about pain, your mileage may vary but it is a great thing when you return back to normal. Sex drive is all still there as well.Ardoreal 22:17, 27 July 2007 (UTC)
There you go. Also, you may well have experienced an even easier recovery had you found a urologist skilled in the no-scalpel procedure, which involves only one small puncture and no stitches. NTK 14:26, 28 July 2007 (UTC)

[edit] Misinformation added by anon.

An anon (User:71.251.34.77) added a bunch of misinformation over a year ago to this article. Some of it was overblown recovery information that has since been removed, but it also included changing the "Benefits" from "local anesthesia compared to general for female sterilization" (which is true, except for new and uncommon procedures like essure for female sterilization that can use local), to "local except in some US states like NJ that now require "full" anesthesia," which is totally false. I find it unbelievable that ANY state requires general anesthesia for vasectomy, and a quick Google shows that this is total bullshit with regards to New Jersey. Given that vasectomy is an incredibly simple outpatient office procedure, no state could possibly legislate to require general anesthesia, which carries a small risk of DEATH. I know some doctors will allow general anesthesia if the patient wants it, but most won't offer anything more than some sedation for the squeamish, if that.

It speaks very poorly of Wikipedia that this uncited, outlandish statement added by an anonymous IP editor survived for more than a year right on the sidebar. NTK 03:23, 27 July 2007 (UTC)

[edit] Spontaneous vasectomy reversal?

I know this is known to happen. A man I know had had a vasectomy and was convinced his wife had been unfaithful as she had gotten pregnant. It turned out his vasectomy had simply healed itself. I'm trying to search for citations of this, but no luck so far. Anybody want to help? Professor Ninja 13:53, 6 August 2007 (UTC)

Wow, found it immediately after posting this. Do I ever feel silly. Professor Ninja 13:55, 6 August 2007 (UTC)
A really good link on that is available here http://www.vasectomy-information.com/moreinfo/recanalisation.htm . The term is called "recanalization". Although it is an extremely low occurrence my physician mentioned it to me as one of the risks for failure. Though he stated that 1 in 300 suffered this problem, I can't find sources to ratify that.Ardoreal 14:05, 8 August 2007 (UTC)

[edit] Rasmus

I've reverted the claim that the procedure for a Vasectomy is also called a 'Rasmus', mainly on the basis that I can find no evidence of any such thing, the cite tag wasn't responded to and thee's a pile of similar edits by the IP editor who made the claim, all of which have been reverted as well. --RedHillian 14:48, 13 August 2007 (UTC)

[edit] "A recent study..."

I have removed to references to "A recent study by John Guillebaud on 5000 patients studying the effects of PVP" as this is nothing close to a verifiable source. At the moment, the statements attributed to this vaporous "study" remain with a "citation needed". Barring a source in the near future, I'll axe the associated claims. Mdbrownmsw 13:07, 29 August 2007 (UTC)

[edit]  %

In the first source cited for 15% to 33%, it says "Of 396 replies, 108 (27.2%) patients complained of some testicular pain following their vasectomy operation. In 88 (82%) of these 108 patients the pain was brief and was not defined as CPTP, while 20 (19%) patients had pain for > 3 months;". That's 20/396, or 5%. - Mdbrownmsw 18:36, 24 September 2007 (UTC)

Thank you for this correction. I had been briefly confused by the 19% figure. I have also added a citation for a study, McMahon et. al., with a 33% PVPS incidence. User:Luqmanskye 23:56, 24 September 2007 (UTC)

[edit] Electrocautery procedure

When I had my vasectomy done a few months ago, the procedure involved electrocautery of the vas. Can anyone look up some more information about it? There's a study here: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&dopt=AbstractPlus&list_uids=4009138 which indicates the electrocautery method is more successful. I was surprised to see that this page doesn't mention electrocautery at all. 82.152.210.132 (talk) 19:28, 11 January 2008 (UTC)

[edit] Is there really a reversal?

Is there really a reversal, or is this just another evidence of faultiness of Wikipedia. --Kid Sonic (talk) 18:05, 6 March 2008 (UTC)

Yes, there is - it's called Vasovasostomy, and is also covered in the article under Reversal. --RedHillian (talk) 03:02, 9 April 2008 (UTC)

[edit] How old do you have to be?

I live in NY. How old do you have to be to get a vasectomy in NY? --Kid Sonic (talk) 23:14, 8 April 2008 (UTC)

Wikipedia probrably isn't the place to ask that - you'll be able to get much better medical advice from a professional local to you (WP reference desk guidelines on medical advice). Also, this talk page is for discussion of the article itself, not the issues within it. --RedHillian (talk) 03:08, 9 April 2008 (UTC)

[edit] Vasectomy-Dementia Link

The above section is referenced, currently within the article - it needs to be changed to a proper referencing & citation and put into more wiki/encyclopedic style, but it's all referenced. --RedHillian (talk) 18:15, 9 May 2008 (UTC)