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Posted February 01, 2023 by Kevin Spear, M.D.
Listen to this episode of the Healthy Vitals Podcast.
Dr. Kevin Spear leads a discussion on what you need to know about vasectomies, including the procedure itself and post-procedure care.
Scott Webb: Did you know that March is the month when most men opt to get a vasectomy? Dr. Kevin Spear from Summa Health's Urology Department is here today to discuss vasectomies and a campaign Summa Health calls Vas Madness.
This is Healthy Vitals, the podcast from Summa Health. I'm Scott Webb. Doctor, thanks so much for your time. We've spoken before about urology-type issues, if you will. And today, we're going to focus on vasectomies. So as we get rolling here a little baseline, what is a vasectomy like? What's involved?
Dr. Kevin Spear: Well, vasectomy is cutting a segment out of the vas deferens, and that's the tube that carries the sperm out to the ejaculate. And it's a minor procedure. It's done in the office. It almost exclusively usually would take a half hour or less. And about 500,000 of those are done per year in the United States. So, it's a very, very common procedure and most men that had it feel that it went well and they're happy with it.
Scott Webb: Yeah. And we're going to talk about, you say, 500,000 and many of them happen to be during March Madness or Vas Madness, if you will. We're going to get to that later. So, maybe just take us through this. It sounds like a simpler procedure. Men pop in, they get it done, they're on their way. But maybe you can just sort of take us through the nuts and bolts. How does it work exactly?
Dr. Kevin Spear: You'd always have a consult before, so a patient would have to see someone, maybe it could be virtually or in the office for a visit and review for a consultation, go over medical conditions, different things like that, and an exam, obviously if it's in the office. And then review, go over the procedure, expectations and risks and things like that. Then, you have the appointment for the vasectomy, which would be usually, for us, it's always a half hour appointment. And I have patients take a Tylenol and a ibuprofen before the procedure, say a couple hours before that. Usually, that helps if you take those before, then after. And also, we have them take a Valium, so they have a ride, they need a ride home.
And then, they have the procedure, it's local anesthesia, very, very teeny small incision. We do something called a no-scalpel vasectomy, and that's maybe somewhat of a gimmicky name, but it's a very tiny puncture hole to get the tube out. And then, go home, take it easy that day at least, ice 20 minutes on, 20 minutes off. The next day, you do it also. And no real heavy stuff for a couple of days. That's usually how it goes, basically.
Scott Webb: Yeah. So, generally when we think about post-procedure, if you will, what can guys expect other than having a good reason or excuse to kind of take it easy and watch basketball? What else can they expect?
Dr. Kevin Spear: It does vary from, you know, patient to patient. But in general, it would be an ache and really handled well with ibuprofen and ice. And most people really are pretty fine. And what could happen is maybe we surely try to tone down people. Like, don't start doing something right away because you feel fine, because then you start doing some more activity and it really could ache. And then if it does, it's going to take a while to get better, it could take days. But for most people, I'd say at least 90%, if they just do it at home, mostly take it easy, take it easy the next day, they're pretty good to go. They could drive around the next day, would be feeling basically fine. And in a week, they could, you know, start really regular activities and working out and things like that. So, that's 90%.
As far as what could happen though that are, you know, problems and complications potentially are any procedure bleeding, infection. You get bleeding in the scrotum, is loose, it could get really big. And then the problem with that is sometimes, this would be extremely rare, you have to basically try to get rid of that, what's called a hematoma. Also, you can get pain at the site of vasectomy, that's about 1% to 2% of people. Then, they have some chronic discomfort where the vasectomy was or down to the testicle. Sometimes that requires another procedure to remove either that segment that really is bothersome at the vas site. It's called a vasal granuloma. That could hurt and we'd have to remove that. That would be a minor procedure. Super rarely would it be, you know, really something uncomfortable or infection that would be more significant. But most people, even if they have those things I said, would get better in, you know, a few days.
The other thing is first as followup with a vasectomy would be you got to get checked because there's sperm in there. So, we get a sample about three months later. You don't get it right away because there's sperm in the tract, get that checked. If it's clear, then you're good to go. Now as far as it not being clear or it "didn't work" or it failed, it'd be about one in 250 people. So, that's why we check because it's not a hundred percent. And then, extremely rare would be after a negative sample and you're cleared to go that there is possibility of failure years down the line. But that's extremely rare, one in 2000 or less. So, people don't have to come in here, and I'm being kind of funny, every month to get checked or something like that.
Scott Webb: Yeah. So, for most, not a lot of complications. For most, very effective. I think one of the questions that probably comes up, and I'll ask it for those who are listening is: Are vasectomies reversible?
Dr. Kevin Spear: People that, you know, are coming in for a vasectomy, they should consider it permanent, but it is reversible. So, we do consult people on that, that they shouldn't think, you know, get this and then maybe in two years, "I'll just get it reversed." So, the vasectomy is, at least from my standpoint, pretty simple, it's quick as we described. But a reversal's much more involved. So, it's a long procedure. It's technical. You'd want someone trained in that. I did a special training, a fellowship in microscopic surgery and infertility in doing those reversals. But that takes three hours or more, and it's a very tedious procedure, but it's not a hundred percent effective. So, that's really kind of the thing why you shouldn't bank on that, that it's for sure going to be effective if I get it reversed. And part is it's just not a hundred percent that it's going to be open. And other issue is the length of time since the vasectomy, the longer the length of time since you had the vasectomy, the less chance it's going to work out. So, that's what people should realize.
There are some other advanced techniques or reproductive techniques where you can aspirate sperm and do in vitro fertilization, things like that. So, there are things you could do, but those are involved and could be very expensive.
Scott Webb: Yeah, it is not like flipping a switch. You don't just turn it on and off. It's much more complicated to undo something like this, to reverse a vasectomy. And I think one of the other questions, folks would have, guys and couples may have, is: Are vasectomies covered by insurance?
Dr. Kevin Spear: Usually, yes, vast majority are. But I think people have to keep in mind and they would know when they either made an appointment or during or shortly after what is their deductible and their status with that. So in general, it's a covered service. So, I almost never get people saying, "Wow, this isn't covered." But deductibles usually apply. So, the issue with that is that people have to just be aware of it and it's very common that at the end of the year also is a time where we get a lot of vasectomies, so the reason being is the deductible. So, patients are saying, "The deductible, I used it, we should get in and get this done."
Scott Webb: Sure. Yeah. And, you know, the advice for everybody would be, you know, check with your own insurance, right? You know, Dr. Spear does his part to answer the broad questions. But check with your own insurance, make sure that it's covered or that you can afford it if it's not covered, whatever is involved.
Dr. Kevin Spear: Correct.
Scott Webb: And so, doctor, the kind of the headline for our podcast today was about Vas Madness. And you talked about, you know, for guys vasectomies are an opportunity to maybe take it easy for a little bit and certainly both men and women love to watch basketball in March Madness. But men, specifically, when we think about vasectomies, what is Summa Health's Vas Madness?
Dr. Kevin Spear: Just as you outlined, March Madness is a big mainstream item that most people in the country know, especially men, and people take advantage of it for fun, usually over weekend. And so, it's just gotten bigger and bigger. I would assume this started in full force somewhere 10 years ago or more, but it seems to get bigger and bigger every year. So, it's a very, very, very common thing that in many big metropolitan areas for sure, you would see advertising even for this. And men plan around this and it's just a perfect match of you can watch basketball and you have your vasectomy, you have to take it easy. And like I said earlier, it's somewhat like a free pass to hang out for a couple of days and watch the basketball tournament and you have no distractions. Actually, I'll have groups of men, buddies, that say, "We're all going to go get our vasectomy, you know, this time and hang out." So, it's really a very, very popular thing. And even, you'll see it in the media.
Scott Webb: Yeah. I'm sure, and I'm sure you guys probably put the games on the TVs there in the office and then really make a thing out of it. And that's so funny to think of guys like scheduling this, "All right, we're all going to get our vasectomies and then we're going to sit around and eat junk food and watch basketball."
It's always great to have you on. There's a multitude of topics we can speak about and we've done a few of them and I'm sure we'll do more. But great to just learn more today about vasectomies, what's involved, recovery time. As we discussed here today, it seems to be a pretty easy "procedure." Usually not a lot of complications, just a little bit of downtime and a great reason or excuse to watch basketball. So, doctor, thanks so much for your time. You stay well.
Dr. Kevin Spear: All right. You take care.
Scott Webb: Call the Summa Health Urology Team at 330.374.1255 or visit summahealth.org/urology for a consult or to schedule your vasectomy. It may be more affordable than you think. And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.