Mar 5, 2015 — Many men cringe at the thought of having a vasectomy. But Dr. William Brant says there’s nothing to be afraid of – there are no scissors involved, so the term “getting snipped” is inaccurate. Dr. Brant discusses some other myths and misconceptions about vasectomies and why it is a relatively simple, pain-free procedure.

Interview

Interviewer: It's funny how big manly men aren't quite so much when you start talking about vasectomy. Somehow we change. But getting snipped isn't anything to be afraid of. We'll talk about that next on The Scope.

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Interviewer: We're with Dr. William Brant, a urologist at University of Utah Health Care. So first of all, I think part of the problem with vasectomy's and us guys being afraid of them is, at one point somebody decided to call the procedure getting snipped.

Dr. Brant: Terrible.

Interviewer: It's a terrible, terrible... I picture scissors. I picture all sorts of nastiness.

Dr. Brant: Clearly a farm boy.

Interviewer: I am a farm boy actually. That's funny that you mentioned that. But the procedure is actually very noninvasive from what I understand, which those two words next to each other also seems a little strange. Tell us more about that.

Dr. Brant: So, the vasectomy is as its practiced now, is done through one or two really small incisions in the scrotum with local anesthesia. The whole procedure takes about 20 minutes and most guys have little to no pain. It's one of the things that concerns guys is that they're going to have a lot of pain, and almost all of them are pleasantly surprised at how easy it is.
Another thing that's nice about the vasectomy as opposed to other forms of birth control is that, in other forms of birth control the only way you know if you had failure is if there's a pregnancy. But with the vasectomy you can get a semen analysis and that will tell you whether the tubes are clean as it were, and whether you're good to go.

Interviewer: And then after that point, after you get the all clear is it 100% effective after that?

Dr. Brant: Nothing is 100%, but it's pretty darn close. A vasectomy's very popular. In the United States it's chosen by about 10% of couples. So we're not the country that uses it the most, but we certainly use it very frequently and it's as good a form of birth control as there is.

Interviewer: Let's get back to the pain thing. I imagine a lot of guys dwell on that so that would be total normal. So its local anesthesia, I'm awake during the procedure, but I don't feel anything. Just like when I go to the dentist and they numb me up properly.

Dr. Brant: That's actually a pretty good analogy. So as you know, when you go to the dentist in a way, the worst part's of going to dentists are number one, the anticipation of going to the dentist. Then number two, getting the local anesthesia, it's got to go in. That's pretty much true for the vasectomy as well. The sharp pain that would be associated from any kind of cutting is totally numb, so that's not something the guy will feel.
They'll feel pressure on each side as the vas is being grasped, sort of like having the testicles grabbed, but that's a very short lived thing. And that should be about the extent of it. And particularly, if they do their homework and do all of the things they're supposed to do at home afterwards, like using ice, like relaxing, they should have very minimal swelling, very minimal pain.

Interviewer: Yeah, and we have a separate podcast that talks just about recovery. So if that's a process or something you want to know more about, be sure to find that particular podcast. Is there any other considerations that a guy should keep in mind if they decide they want to get a vasectomy? Now, we've established that it's not painful or not as painful as a lot of guys think. What about the jokes about my voice is all of a sudden going to go like this? That's kind of a misconception that something else is going on as well.

Dr. Brant: No, guys do have this conception that if they're getting a vasectomy it's going to affect their testicle health, that might affect their testosterone production, it might affect their sexual function, but none of that is true. Just the tube that transports the sperm is clipped and so the other aspects are not affected at all. It will not change testosterone. It will not change sexual function or pleasure.

Interviewer: Are there side effects? I mean, sometimes you go on the internet and you read things. You don't know whether to believe them or not, like prostate cancer can be caused by a vasectomy or cardiovascular disease. I mean, you read some of that kind of stuff on the internet.

Dr. Brant: That's a great question. There have been some studies that have reported to show relationship between having the vasectomy and having these other things. But the analogy I always use is that, you would make the same kind of statement if you said, "Oh, guys who get their blood pressure checked are found to have high blood pressure." Well, that's because they're getting their blood pressure checked, and that's a common thing.
And so, it has been shown that guys who get vasectomy's do go to the doctor and utilize health care more than men who do not. And so, in that sense they're diagnosed with common problems more often, such as cardiovascular disease and prostate cancer. But in any study that's been done to really look at this, there seems to be no relationship whatsoever between vasectomy and cardiovascular disease, prostate cancer, autoimmune diseases, and so forth.

Interviewer: What about a vasectomy being reversible? I've decided I want to do it, and now I've decided, oh, maybe I didn't.

Dr. Brant: We tend to think of the vasectomy as something that's a real permanent form of birth control. But that being said, things change in people's lives. And about 6% of guys, who get vasectomy's, ultimately will want them reversed. Now, the success of that reversal depends on a lot of factors including how long that it's been since the vasectomy.
But generally, they are fairly successful, but they're not as successful as doing the original vasectomy. They're not as easy as doing the original vasectomy. So when a guy gets a vasectomy we want them to think of it as a permanent treatment for their fertility rather than something that's going to be reversed for sure.

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