00:00Why? Who told you to do this?
00:30So that's like the most common type of person that comes in and maybe they have a partner who's on some other form of contraception that might be causing a side effect.
00:40There are some men who come in who do not have, you know, are not in a current relationship, do not have children, but are fairly certain that that's not something that they want in the future.
00:51I have a conversation with those men too. I don't think that that negates their ability to have the procedure done.
00:58But I just counsel them to be certain that this is what they want because we tend to counsel patients to think of it as a permanent form of sterilization.
01:08What is a vasectomy?
01:13A vasectomy implies that you are cutting the vas deferens, which is the tube that takes the sperm from the epididymis where they mature after they're made in the testicle, and it delivers the sperm into the ejaculate.
01:29When men are interested in sort of sterilizing themselves and are interested in a permanent form of sterilization, they can opt to undergo a vasectomy, which involves cutting that highway and often tying it off and doing everything we can to make sure the highway isn't put back together at some point afterward.
01:51How long does a vasectomy take?
01:56It's pretty quick. I would say anywhere from like 20 to 40 minutes. It's done in the office setting in most cases, so it's a pretty easy procedure as they go.
02:07How often do you do a vasectomy?
02:12Generally speaking, we try to do these in my office at least on Fridays just to allow patients to recover on the weekend, assuming they're not having to work on the weekend.
02:23There's not any significant pain in most cases. We don't prescribe pain medications as part of the recovery. I encourage a lot of my patients to use ice, which helps reduce inflammation and swelling and can often help with any potential discomfort that's experienced after the procedure.
02:42It's also really important to have men wear some kind of compressive garment, and if you can manage the inflammation and the swelling, you've won the battle.
02:51Is a vasectomy reversible?
02:57It is technically reversible, but that's not always the easiest process, and so we don't want people making sort of rash decisions and ultimately regretting having the vasectomy and having to find a way to get it reversed.
03:10If they were to opt to reverse it in the future, the process is the exact opposite of what they are going to go through with a vasectomy.
03:21A vasectomy reversal is typically done in an operating room. It requires an operating microscope because you're trying to essentially put together two pieces of like a tube the size of a string of pasta.
03:38It takes several hours to do, and remember, you have to do both sides, and it's not always guaranteed that it will result in sperm returning to your ejaculate, and it's definitely not guaranteed that after the reversal, you'll be able to get somebody pregnant.
03:54Is a vasectomy reversible?
03:59It doesn't have any detrimental effects on sexual health, assuming that the procedure was straightforward and the recovery was as expected.
04:06I do get a lot of patients concerned about that, right, because you're sort of interfering with their manhood, and so they're concerned that it might have a detrimental effect on their sexual life, but there's no evidence of that.
04:21Is a vasectomy reversible?
04:26It does not prevent you from passing on sexually transmitted infections or HIV, again, because the fluid is something that you still make, and you still make the sperm, it's just that the sperm aren't allowed to get into the fluid.
04:42So the vasectomy just prevents the ability to get somebody pregnant, but the various infections that we screen people for, including HIV, are transmitted in the semen, which you do still make.
04:56Is a vasectomy reversible?
05:01There is always a risk of infection any time you're cutting into the body, right, even though it's a tiny, tiny incision.
05:09You are breaking the skin, and you could introduce an infection, but the infection risk is so low, it's not standard to put people on antibiotics to prevent infection, which is commonly done with other procedures that have higher risk of infection.
05:25A lot of the procedure is done through palpation until you can feel the vas, and then isolating it from the other structures around it.
05:34But because there's lymphatic vessels, there's veins, there's arteries, there's fat all kind of surrounding it, there is the potential that one of those other structures could be injured, and that's what I was kind of alluding to in terms of a potential complication.
05:50But that's exceedingly rare.
05:52So it's, in general, of the things that we do in our office, it's probably one of the safest procedures.
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