By David Eddie
From the print edition, March 2011
After my wife, Pam, and I had our third child, I sought the advice of several, let’s say, slightly older gentlemen (in any case, men who considered themselves finished with sex for the purpose of procreation) as to what they thought might be the best means of ensuring no further additions to the world’s population would emanate from our domicile.
Pam and I knew we didn’t want a fourth. With three little boys under the age of six, we were hanging on by a very thin thread as it was. A fourth would sink our little ship, we felt. You’d just hear a big BLOOP and we’d be gone, under the waves, down, down to Davey Jones’s locker.
A few of the men I spoke to sung the praises of the vasectomy, proclaiming “It’s the best thing I ever did!” Since these were men I respected, I’d stroke my chin and act all interested and like it was something I might consider. But if you could see the thought balloon above my head, folks, it’d read “Sing on, castrati, sing on. There’s no way I’m having anything like that done to me.” Let someone near my junk with a scalpel? Fuhgedaboudit.
Like many men, I’d heard all kinds of blood-curdling horror stories about this procedure. Men pass these—colourful blends of fact, fiction and urban and rural myths—around like campfire tales of terror. “My brother-in-law’s balls turned purple and swelled to the size of grapefruits!” “I heard about a guy who could never get it up again!” Meanwhile, elaborate “what if” scenarios having to do with divorce, second wives and future families present themselves to the imagination of men contemplating this procedure. What if I get the snip but then we get divorced and I start dating that buxom new hire in my office? What if she wants a family and is crushed when she finds out I’m sterile? What if I then get a reversal but it doesn’t work? I could wind up alone and heartbroken, nursing my bitterness and a pair of incredibly sore nuts!
What Am I in For?
Now, no man wants the word sterile in the same paragraph as his name, let alone the same sentence. I have two male friends who both have three kids and still no realistic birth-control approach who practically clap their hands over their ears and go “la, la, la” if I even try to broach the topic. Men are not rational about this particular area of their anatomy, ladies. To give you a sense, and it may be completely false, I read somewhere that in World War II Italian fighter pilots took their helmets off their heads and put them in their laps because “who cares if they blow your head off?” And when I read that, I thought: “Yeah, that sounds about right. I’d do the same.”
So let’s take it slowly, one step at a time, starting with one of the most rudimentary—but surprisingly persistent—misconceptions about the procedure: You will not be castrated or “fixed.” Your testicles will continue to produce sperm for the rest of your life. After a vasectomy, however, the sperm are broken down and reabsorbed by the body, thus leading some who have done the deed, myself included, to believe the procedure may actually supersize one’s mojo.
Basically, the vas deferens—the tube carrying sperm from the testicles to the penis—is cut or cauterized, tucked back into its sheath and the sheath is closed with a clip, so the sperm can no longer reach the ejaculate and, from there, the fallopian tube and, of course, the ultimate goal (cue celestial music), the egg.
Luckily, the vasectomy has come a long way since it was first performed on a dog in 1823—and particularly in the last couple of decades. Today’s vasectomy is not your father’s or uncle’s vasectomy. Many clinics and doctors these days practise the no-scalpel option. The pioneer of the no-scalpel vasectomy in Canada was Dr. Ronald Weiss, an Ottawa physician who brought the procedure here in 1992. According to Dr. Weiss, it’s been done in China for nearly 40 years. He performs about 80 procedures a week and has done more than 30,000 since he started. (About 55,000 men get vasectomies in Canada each year.) Instead of an incision, a tiny hole is punched—oops, sorry, gentlemen, poor choice of words; let’s say “created”—in the scrotum with a special instrument that also gently stretches it just enough to lift the tube out and block it. Dr. Weiss says bleeding and infection are reduced by 80 percent in this type of vasectomy. So, likewise, are many of the hair-raising post-operative symptoms that cause your swollen family jewels to resemble various types of spherical fruit.
The whole thing, he says, takes from five to 10 minutes. You don’t even need stitches afterwards; the hole heals by itself. Moreover, Dr. Weiss has added a further innovation to the freezing part of the procedure. Instead of jabbing a needle into your testicles, he uses a no-needle freezing technique called jet injection that creates a fine stream of anaesthetic that soaks into the skin to numb the area.
And, rest assured, he says, that your ability to (ahem) perform is altered not a whit. In fact, “many men claim that their sex lives improve after a vasectomy because they don’t have the worry of an unwanted pregnancy hanging over their heads,” Dr. Weiss says. “But the more persuasive data came from several long-term studies comparing groups of men who have had vasectomies with groups who have not. Testosterone levels and sexual function are no different between the two groups over time.” Bottom line: “A vasectomy does not change sexual function. Period.”
The Good, the Bad and the Ugly
Now, I don’t want to be all sunshine and smiley faces when it comes to this procedure and thus even be indirectly guilty of convincing anyone to do something they might later come to deeply regret. There are aspects of the operation that some might describe as “unsettling”—and that others might describe as “rightly to be feared” before urging everyone in the vicinity to run for the hills. One is an aggregate of symptoms loosely gathered under the aegis of the term “Post-Vasectomy Pain Syndrome,” or PVPS. Basically, it’s when, for one reason or another, the post-operative pain in your nut sack lasts longer than a year. Unfortunately, there are no credible statistics on the percentage of men with PVPS. Dr. Weiss says it’s incredibly rare, about one in 10,000 vasectomies. Short term discomfort called epididymitis is more common, occurring in about six in 1,000 vasectomies. Further, he says, after performing 30,000 vasectomies, he’s only seen one case of PVPS.
The good news is that, according to one small study, getting your vasectomy reversed appears to have a high success rate in curing PVPS. The bad news about the good news is that if you thought you had to steel yourself to get a vasectomy,you won’t like the reversal. It’s a much more drawn-out and serious operation, requiring general anaesthetic, and it’s quite costly (unlike vasectomies, reversals aren’t covered by health insurance) so it’s not only a scrotum-tightener but also a real wallet-lightener to boot.
This is a handy segue to the much more statistically significant question of regret and reversal. About one in 15 men will live to regret getting a vasectomy enough to seek out a reversal. Dr. Ethan Grober of Toronto’s Women’s College and Mount Sinai hospitals specializes in reversals. In fact, he actually performs about an equal number of vasectomies and vasectomy reversals, but since the reversal operation takes so much longer—two and a half hours versus about 10 minutes—it constitutes the bulk of his practice.
The vast majority of men who come in for a reversal are looking to start a second family, he says. In other words, the exact scenario they feared when contemplating the vasectomy has come to pass: The marriages they thought would never fail did, and the women they eventually met wanted families. And, hello, Dr. Grober.
Yes, often the man does leave the woman, but it’s particularly tough when the girl leaves the guy shortly after he gets the vasectomy, within a few months or weeks. Dr. Grober has seen it happen.
And, yes, that would really fry your onions.
Fortunately, Dr. Grober assures, by the time they make it to his office, his patients are usually “in a pretty good place,” having found a new relationship and preparing to start another family. The other good news is that in the most straightforward type of reversal—known as a vasovasostomy—the likelihood that a man will once again become a sperm-shooting, lady-impregnating love machine hover at around an impressive 95 percent.
The downside is that due to a variety of factors—compatibility, the age and fertility of the man’s new partner and so forth—only about 50 to 60 percent of vasectomy reversals result in a pregnancy, meaning about half the people shelling out for this operation—it’s about $5,000—are cruelly disappointed and probably full of a renewed kind of double regret. This is why, despite the fact he specializes in reversals—or perhaps because of it—Dr. Grober sternly warns his patients to consider a vasectomy to be a permanent step. For that reason, he looks very closely at anyone under 30, especially the childless ones, who comes to him wanting one.
“I think the vasectomy is the best form of contraception a couple can get,” he says, “as long as I’m convinced it’s a well-thought-out decision. I’m not comfortable with patients thinking it’s a reversible procedure.”
There has never been a shadow of doubt in my mind, since about halfway through our first date, that Pam and I would only part if one of us died. And a vasectomy, it struck me, is a great gesture of monogamy and faith in a relationship—even more so than marriage, in a way, when you consider how many of those end in divorce. It’s a way of saying “For you, baby, I relinquish—barring a drawn-out, expensive and not always successful operation—all notions of trophy wives and future families. I truly believe that you and I will go the distance, so much so that I will allow a doctor to do some very counterintuitive things to one of the most precious and cherished parts of my anatomy. And, hint, it’s not my heart.”
Unfortunately, even after I made the decision, I still dragged my heels—for nearly two years. I stalled and I’d schedule a consultation with the doctor, but then fail to book the appointment for the actual procedure itself.
Then we had a pregnancy scare, and Pam, fed up, said: “Look, Dave, it’s obvious you don’t really want to do this. Don’t worry about it. I’ll get my tubes tied. It’s no big deal.” She was very brave and matter-of-fact about it, as she was about everything, I reflected—as she was all through the labour and birth of our children.
And I confess, ladies, I considered her offer, even though compared to tubal ligation (major surgery, involving general anaesthetic) a vasectomy is akin to getting a toenail clipped. But around this time I read somewhere that Olivia Goldsmith, author of The First Wives Club, went in for a chin tuck, slipped into a coma and later died. She was apparently, and unfortunately, one of the one in 250,000 people who die from general anaesthetic complications each year. Now, true, many of these people have underlying and/or hitherto undiagnosed conditions—but still! A chin tuck? What if Pam went in for a tubal ligation because I was too big a chicken to get a vasectomy and she died on the table? How big of an asshole would I be then?
Don’t answer that! It didn’t happen! Instead, I, the big baby, spat out my pacifier, booked an appointment (“Finally!” I can hear you all mutter) and did the right thing, the only thing, the manly thing to do. I changed into a little buttocks-baring shorty nightgown, lay on a table with my feet in stirrups, my genitals exposed to every little breeze and allowed a nurse to shave my balls before a surgeon numbed them with an old-fashioned needle and then slit them open like a fishmonger guts a sturgeon, in order to sterilize me.
I am sort of kidding—mostly because I know it’s a hard sell to pitch this procedure. On the bus on the way up there (they urge you not to drive, because you might be a little woozy afterwards) I had my swinging perma-bachelor best friend—let’s call him Max—on my cellphone, going “Dave, this is the biggest mistake you’ve ever made. This is for other guys, not you. Just reach up, pull the little string and get off the bus at the next stop. Pull the string, Dave. This is a terrible, terrible mistake.” But to me it was an expression of the manly virtue of self-sacrifice. I was falling on the grenade, taking one for the team. It was a rite of passage into mature manhood.
May I add, gentlemen, it was also the gateway to a worry-free playground of sensual delights. Now, any responsible doctor will tell you the vasectomy is not 100 percent foolproof. Sometimes the sperm will find a way to bridge the gap, even apparently building themselves little tunnels (How? Who knows? They don’t even have hands!) prisoner-of-war-behind-enemy-lines-style so they can wriggle through the penis and impregnate a woman after all! (For which you’ve got to love the tenacious, single-minded little buggers!) But these cases are rare, about one in 3,000. It should be noted that while you can get back into action a week after the procedure, an alternative method of birth control is required until a semen sample test 12 weeks post-procedure indicates the absence of sperm in the ejaculate. About 90 percent of men will have a zero sperm count after three months. (It can take up to 12 months.) But after that, the vasectomy is as close to absolute contraceptive certainty as you can get. And with great contraceptive certainty comes great sexual freedom. Yeah, baby!
“If I do this terrible thing, Pam,” I said on the morning of the procedure, “I’m picturing quickies in the kitchen, morning glories, afternoon delights…” “No problem,” she said, smiling. “I agree to your terms.” Now, Pam forbids me from divulging in print any details of our sex life, but I hope it does not contravene the statutes of that covenant if I casually observe we have lived (so far) happily ever after.
In the Bag
Well, that pretty much wraps up all I have to say on the topic. Actually, here are two more minor pieces of advice for anyone considering this procedure. One, don’t look down. I babbled nervously to the doctor the whole time, and at one point, I looked down. Big mistake. What I saw is burned into my retinas forever. Therefore, I say unto thee, gentlemen, and I can’t emphasize this enough: During the procedure chat with the doctor all you want, but keep your eyes glued to the ceiling.
Two, procure not just one but at least two bags of frozen peas for your recovery period. This way you can have one freezing while the other is thawing and cooling your throbbing nut sack. During my recovery period I lay in bed watching Snatch over and over again in an attempt to recapture my mojo (Snatch is a great film for that; it’s just a bunch of guys insulting each other, punching each other, swearing at each other, killing each other and ripping each other off), with one of two rotating bags of peas on my aching tackle. While one bag thawed, Pam or one of the boys would take it down to the freezer and grab the other.
Quite a pleasant weekend, all in all. My family waited on me hand and foot, and how often does that happen? And, as I say, life has been pleasant and procreation-free ever since. Afterwards, for fun, I issued a challenge to my friends: $50 to anyone who would eat a nice, steaming bowl of hot, buttery, salted peas made from one of my two relief bags. Strangely, there were no takers. “Come on, people, the peas were protected by a plastic bag the whole time!” I pointed out, and upped the ante to $100. Still no takers. And, in the end, I found I couldn’t eat any of the peas myself. They had to be tossed out. I know, I know, ladies: not exactly rational. And, some might add, a waste of perfectly good peas! Which are delicious and nutritious! You have a point, but … sorry, some things a man just can’t bring himself to do, ladies, no matter how much the rational mind says it’s all right.
For another take on The Big V, check out this post by Karen Green.