A vasectomy is a dependable method of birth control for men who do not want any or any more children. It is simple, highly effective, and relatively painless.
Developed as a means of contraception in the early 20th century, the vasectomy has become a popular, simple, and effective means of permanent sterilization.
It is a simple, 20-minute procedure performed in a doctor’s office or clinic with a local anesthetic. The objective is to prevent sperm from entering the semen, 95% of which is just support fluid made by glands called the prostate and seminal vesicles, located in the pelvis behind and beneath the bladder.
GETTING TO THE VAS
The easiest place to access the vas tubes is just above the testes where the vas tubes are just beneath the thin scrotal skin – easy to feel and very mobile.
ANESTHESIA
During the vasectomy, Dr. CIsu administers an anesthetic solution with a pressure spray applicator (MadaJet®) to numb the scrotal skin and the vas tubes without using any needles.
NO-SCALPEL NO-NEEDLE TECHNIQUE
During the vasectomy, Dr. Cisu uses very fine instruments to perform the procedure through very tiny access-openings (about 1/8th of an inch) on the front side of the scrotum. This usually seals within hours, so no stitches are needed.
EXPOSING THE VAS
Through the small incision, each vas deferens is delivered to the exterior where it can be interrupted.
BLOCKING THE VAS TUBES
Each vas (left and right) is divided about one inch above each testis, where it is just beneath the thin scrotal skin and is very easy to reach. Dr. Cisu removes a small segment of the vas tube and cauterizes (burns) both ends so they seal by scarring. Finally, he places the divided ends out of alignment by closing the vas sheath between the two ends with a dissolvable suture so the ends won’t grow back together. The suture typically dissolves within six weeks.
Any man who is convinced he’s done having kids – or is truly positive he doesn’t ever want children. We do not judge anybody’s decision. Your body, your rights. However, you really should be 100% sure.
Almost always, yes! A tubal ligation is a major surgery for a woman. A vasectomy is a simple office procedure that takes 20 minutes or less. In most cases, it makes more sense for the guy to get the vasectomy.
A vasectomy is, over time, the least expensive method of birth control. Over several years, it would cost more to use the pill, the IUD, even condoms, than the one-time cost of a vasectomy.
Plus, it is the only currently available method other than condoms that allows the man to take responsibility for preventing pregnancy.
The no-scalpel and no-needle technique used by Dr. Cisu produces rapid and comfortable anesthesia, and most men are surprised by how easy the procedure is.
During a vasectomy, the vas deferens from each side is cut high in the scrotum. The sperm stored “downstream” in the channel leading to the prostate may still be ejaculated and cause pregnancy.
The pathway needs to be emptied, which takes a variable amount of time, and will be complete in some men as early as 6 weeks, with at least 15 ejaculations, while other men require 6 months or more to clear. We recommend that guys get their semen analysis 3 months and 30 ejaculations after their vasectomy.
Nope! A vasectomy does not affect your testosterone, libido (or sexual interest), or ability to have an orgasm. It simply prevents sperm from entering the semen. Most guys don’t even notice a different in how much they ejaculate.
Yes, although this is very rare: about 1 in 2,000. However, it is not 100% successful which is why every guy needs a semen analysis 3 months and 30 ejaculations after their vasectomy.
If your semen analysis after three months still shows sperm, this does not necessarily mean it has failed. If this happens to me, you’ll need an appointment with Dr. Cisu to interpret your results and discuss next steps.
Any doctor who has received specialized training can perform vasectomies. More than 80% of vasectomies in the United States are performed by urologists. Urologists are surgeons who have undergo at least five rigorous years of surgical training on the male genitals and urinary tract from the kidneys and bladder to the penis and scrotum. A vasectomy is one of the most common procedures done by urologists.
There are some OB/GYN and family medicine physicians who offer it as well. The most important factor when considering who to pick for your vasectomy is experience and technique. Not every doctor, or even urologist for that matter, offers a no-scalpel, no-needle vasectomy and can do it in less than 20 minutes.
Of course! Most patients don’t want to talk to other people about their reproductive decisions. Having to discuss personal reproductive matters could be inconvenient and uncomfortable, as it is an intimate decision.
Dr. Cisu requires a consultation appointment to discuss the vasectomy in greater detail and answer any specific or unanswered questions before the vasectomy. These appointments can be done in-person or virtually using our telehealth platform.
Sperm are made in the testes. From each testicle, sperm move through a long curled-up tube behind the testis (epididymis) wherein they become mature. From there, they swim up a foot-long tube (vas) which guides them up to the channel (urethra) through which men urinate and ejaculate. Just before entering the urethra, the left and right vas tubes are enlarged, and it is here, behind the bladder, where many sperm are stored between ejaculations.
A vasectomy is the single most effective method of permanent sterilization with >99.7% efficacy at reducing pregnancy risk. Nothing is 100%, so we require all men to get a semen analysis approximately three months after their procedure.
A tested, successful vasectomy is 50 times more reliable than the birth control pill, 300 times more reliable than condoms in preventing pregnancy. It takes less than 20 minutes, and the effects last a lifetime.
There are several choices available for contraception. You should choose the method that best suits your needs. You may also want to discuss with your partner (if you have one), or other loved ones. Your doctor can also help you choose the best option for you. Alternatively, you can have this discussion with Dr. Cisu at your first appointment, which can be done in-person or virtually with our secure telehealth platform.
Temporary and reversible methods of birth control include condoms, spermicides, a diaphragm, an IUD, the pill, the patch, and the Depo shot.
Permanent methods include female sterilization by tubal ligation and male sterilization by vasectomy. These procedures cannot be performed in a way that makes them easier to reverse. This means only those who have decided not to have any, or anymore, children should choose permanent sterilization.
In general, a vasectomy is a much less-invasive procedure than a tubal ligation so most doctors advice couples to proceed with a male vasectomy whenever possible.
Yes. Some examples:
- If a man does not want vasectomy and is having it because he is told he should, he may feel resentment.
- If he is having problems with impotence or sexual fears or an unhappy marriage, it is not likely that vasectomy will help any of these problems.
- If a man is unsure whether he is going to want more children, he should not have a vasectomy.
- If a man’s sexual fulfillment or his partner’s satisfaction depend upon his being able to cause pregnancy, then sterilization would probably create a sexual problem for him.
Simply stated, this is the least invasive technique with the fastest recovery time. It is a gentle approach to a vasectomy that has been optimized over decades to provide for the most comfortable experience for men.
It is a no-scalpel vasectomy because instead of surgical knifes to make a hole in the scrotum, Dr. Cisu uses very fine dissecting forceps to make very tiny access-openings (about 1/8th of an inch). The opening is so small that it closes on its own within 48 hours after the procedure – no sutures required!
It is a no-needle vasectomy because no needles are used on the skin. Who wants a needle in their scrotum?! Instead, we use a specialized pressure spray applicator (MadaJet®) to numb the skin with an anesthetic solution. Most men say it feels like a rubber band snapping – much less painful than a needle!
Historically, vasectomies were uncomfortable and painful. You may know someone who had a terrible vasectomy experience. Be sure to find a urologist who performs the vasectomy without scalpels or needles on the skin.
Sperm banking — freezing sperm for later use — is available through regional fertility laboratories. While it offers the possibility of future pregnancy, the process of storing and retrieving your sperm (and the assisted fertility procedures of artificial insemination or in vitro fertilization) can be complicated and costly, with no guaranteed results.
Yes. The amount of semen a man ejaculates after vasectomy is only decreased by about 5%. Without a microscope, you could not detect the absence of sperm cells in the fluid.
The testes will continue to produce sperm cells that will go through their life cycle as before. Although the testes produce millions of microscopic sperm cells each day, the actual volume of sperm stays quite small and stable. Old sperm cells continue to be reabsorbed naturally within the body as are all other old cells throughout the rest of the body. Sperm antibodies help in the removal process, but these are not harmful to the body.
The simple answer is: not always. There is technically a way to reverse a vasectomy, but this is a surgery that takes several hours in the operating room using a specialized microscope. Plus, only a handful of urologists across the country offer this type of surgery. It is not always successful (the longer since your vasectomy, the lower the chance of success), nor is it always covered by insurance. It can be quite expensive. Finally, it can take up to a year for sperm to return to your semen. For those wanting children again after a vasectomy, these factors together can amount to a time-sensitive and stressful situation.
If your life plan changes unexpectedly, the options for having children after a vasectomy include adoption, attempted vasectomy reversal, or pregnancy by artificial insemination using either frozen stored sperm, fresh donor sperm (another man’s sperm), or sperm surgically withdrawn from the testes. All forms of assisted fertility involve a considerable commitment of resources and are not generally covered by health insurance.
Dr. Cisu is known for his gentle but highly effective no-scalpel no-needle vasectomy technique, in 20 minutes or less. His experience also helps – not only is he a urologist, but he does more vasectomies per month than any other physician in central Virginia. He prides himself on making himself available to patients 24/7 and ensuring that his patients have all the information they need to make a responsible decision in choosing to proceed with a vasectomy or any other urologic procedure.
Moreover, he is one of the only urologists in the mid-Atlantic region (Maryland, Virginia, DC, North Carolina) to provide nitrous oxide (“laughing gas”) with the vasectomy. This is not required but can be a game-changer as it minimizes both pain and anxiety related to the vasectomy.
For men who want the most comfortable vasectomy experience possible, Dr. Cisu recommends both valium the morning of the procedure, as well as nitrous oxide in the office.
Definitely. Many patients choose to drive an hour or more to visit Dr. Cisu for their vasectomy experience because of his technique and experience. After all, this is a once-in-a-lifetime experience!
The very gentle no-scalpel, no-needle vasectomy is the least invasive technique available, and just a handful of surgeons offer this in Virginia.
Dr. Cisu regularly sees patients from Charlottesville, Crozet, Lynchburg, Staunton, Waynesboro, Harrisonburg, Lexington, Richmond, Fredericksburg, and even Washington, DC.
The first step is to book a consultation appointment with Dr. Cisu in-person or virtually using our telehealth platform.