Who here got a vasectomy?
- Thread starter Gamble
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I would never question it with my wife. However just for everyone elses piece of mind we will do one.
After the surgery I think he said 10 shots then come back with a sample. And I did and it was clean. Went back last week with another sample and it was clean too. Will go back again this week with yet another sample
still hasn't hit home yet that we are having another. but i'm a little excited
mmmmmm booby milk
So, success rates are very high. Failure rates are very very low because even if you do the least conservative technique--which would include fulguration of each vas deferens without separating it into separate tissue compartments or without suture ligation--any obliteration of the vas deferens is generally enough to disrupt the flow of sperm.
The advice that your urologist (or family doc, whoever did it) gave you about multiple ejaculations before repeating analysis isn't really sound advice. Generally it's a time constraint, not a set number of ejaculates. The reason being that the life of a sperm is 90ish days and so you generally wait this period of time in case you would have any viable sperm remaining in the vas deferens. So the most common method of testing success would be two semen analyses a week or so apart at least three months after the vasectomy.
However, presuming this was a failed vasectomy, it just means that you had recanalization of the vas deferens on one side. Said another way, it doesn't necessarily mean that he did a shoddy job and it was flawed surgical technique; its just testament to the reason success rates are quoted--some people just get unlucky. The free ends of the vas deferens found a way back to each other and re-cannulated. Very very very very rare, and I personally have never seen it, but I've heard of colleagues that it's happened to.
Regarding the comments on suing the doctor, you would have to show gross negligence on his part, which most likely didn't happen. So just because you were the guy that falls into the very small percentage that is explained during your consent, it doesn't mean that you can sue him. I mean, you certainly can if you want, but unless you could prove that he did the surgery in a substantially different fashion than the standard of care, then it will be going nowhere.
At any rate, congratulations on the baby!! My wife is pregnant with our first so I'm in a current state of disbelief still as well haha.
Edit: shit just re-read that and left out that I'm a urologist. Might help to know. [emoji13]
The advice that your urologist (or family doc, whoever did it) gave you about multiple ejaculations before repeating analysis isn't really sound advice. Generally it's a time constraint, not a set number of ejaculates. The reason being that the life of a sperm is 90ish days and so you generally wait this period of time in case you would have any viable sperm remaining in the vas deferens. So the most common method of testing success would be two semen analyses a week or so apart at least three months after the vasectomy.
However, presuming this was a failed vasectomy, it just means that you had recanalization of the vas deferens on one side. Said another way, it doesn't necessarily mean that he did a shoddy job and it was flawed surgical technique; its just testament to the reason success rates are quoted--some people just get unlucky. The free ends of the vas deferens found a way back to each other and re-cannulated. Very very very very rare, and I personally have never seen it, but I've heard of colleagues that it's happened to.
Regarding the comments on suing the doctor, you would have to show gross negligence on his part, which most likely didn't happen. So just because you were the guy that falls into the very small percentage that is explained during your consent, it doesn't mean that you can sue him. I mean, you certainly can if you want, but unless you could prove that he did the surgery in a substantially different fashion than the standard of care, then it will be going nowhere.
At any rate, congratulations on the baby!! My wife is pregnant with our first so I'm in a current state of disbelief still as well haha.
Edit: shit just re-read that and left out that I'm a urologist. Might help to know. [emoji13]
It sounds like his sperm samples are coming back negative. Is it still possible that one ejaculation can still contain sperm? Is it a random possibility or once you are clear you are clear?
Don't really want to have an instigator's role here...but strictly medically speaking, he shouldn't have azoospermia (zero sperm) on analysis intermittently and then some with sperm. It's conceivable, but I've never heard of it and certainly not what you would expect in a scenario such as this. Now, if he is getting semen analyses that show very low sperm counts and they're just telling him "hey they're negative" because they're below what we would generally consider capable of conception, then that's different, and is genuinely a failed vasectomy and even though a low sperm count makes it difficult to get pregnant, it's still very possible. That's my long way of saying, if you have multiple semen analyses that show azoospermia (zero sperm), you're sterile. You can read between the lines on that however you'd like.
Failure happens when they are cut but some how the two cut ends on one side find their way back together and stick together and recannulate. It'd be like if you had a hose underground and you cut it and separate the two ends and tied them shut but after people walking around on the dirt the ties came off and the cut ends were close enough together that now the water can flow from one into the other. That analogy is a stretch, but hopefully that helps.
That's why I mentioned there being more conservative techniques. A lot of people will cut it, burn both ends, and tie off one end. But some are super nervous and tie both ends, clip both ends, burn both ends, and bury them separated by tissue. And everything in between.
For the nerds in the group, here's the AUA's guidelines on vasectomy which goes over acceptable techniques. Success rate super high with all of them. https://www.auanet.org/common/pdf/education/clinical-guidance/Vasectomy.pdf
Great info dude
Ok so talked with my wife since she remembers better than me
Had it done in march of last year. Gave a sample on June and got cleared
Now she is 9 weeks pregnant. Gave a sample last week and still negative.
How could that happen?
Not sure if cut them or tied them or what. I do remember smelling something burning and hearing a lot of clipping. I don't think he did any thing wrong. He has been doing it for 30 years.
Ok so talked with my wife since she remembers better than me
Had it done in march of last year. Gave a sample on June and got cleared
Now she is 9 weeks pregnant. Gave a sample last week and still negative.
How could that happen?
Not sure if cut them or tied them or what. I do remember smelling something burning and hearing a lot of clipping. I don't think he did any thing wrong. He has been doing it for 30 years.
Well, that math would mean she got pregnant around 6-7 months after your vasectomy. So it's conceivable that you had a partial recannulization on one side that remained for a few months and has since sealed. Again, this is kind of shooting from the hip, cuz if you were negative 4 months after and are negative now at 11 months after, seems like you would've been negative the whole time. But listen, not everything can be explained and there are certainly exceptions to every situation. So the above scenario is possible.
They wouldn't. If it recannulated it would be an enclosed system. Like, the surrounding tissue would either form a tunnel, or the ends would physically meet and re-seal.
Yeah, that I do understand. I was talking more on if the canals never reconnected. Could a simple ultrasound be used to check and see if the canals are still seperate?
Semen analysis would be a more accurate way. Because you would likely see granulomas in the region of the cut ends. And an ultrasound that didn't show a physical connection wouldn't rule out a functional connection. The only imaging test would be a vasogram which is a procedure. You have to cannulate the vas upstream with a needle and inject a contrast media and take x-rays as you watch a road map of the dye and see if it makes it past the vasectomy site. Again, all of the above is overkill, because a semen analysis that shows zero sperm means it's successful.
There was a few times where my balls were killing me. Couldn't even walk or shake after a piss without wanting to cry in pain. They said it was a "sperm leak" and happens to less than X percent (don't remember the number but it was low)
Anyway. Took some Advil and it went down but then happened awhile later.
Could that have anything to do with her getting pregnant? Or can you explain more about this sperm leak
Btw congrats on the baby
Yeah, so post-vasectomy pain is like the albatross of urology. It's so hard to find the root cause, and harder to treat. Luckily, most cases resolve (as yours did), but sometimes it persists. And it's likely more related to an obstructive process in most situations (blockage and teste still producing sperm up against the blockage). A "sperm leak" just means you could've had sperm coming out the testis side (because some people don't seal that side for the above reasons) and that caused inflammation in the area. This is a little more theoretical than definitive, but patients don't like not having an answer to their pain. Could this all be related to your current situation, I guess it's possible, but again, can't confirm anything 100%.
Props to you for going into urology. The only thing that has made me squeamish in healthcare are urology procedures. Especially assisting with catheter insertions the size of garden hoses for bladder irrigation. Thankfully these patients have been heavily sedated on a vent.
Ha, yeah you get used to it I guess. When my wife and I were in med school, I remember once telling her that I would do any surgical subspecialty except urology. You can see how that ended ha. But it's a great field for a bunch of reasons that would be boring to people here. My specialty is actually urologic oncology, so I do surgery for cancer of the urinary tract (kidney cancer, prostate cancer, bladder cancer, testicular cancer, penile cancer). So general urology isn't really my wheelhouse any more, but obviously still part of my universe. And most times when I put an oversized catheter in someone, they're generally awake, so I'm not always the most popular person in the hospital.
Good shit.
Not the catheter insertion in awake people...that suuuuuuuucks. Side note, oncology is part of what inspired me to go into nursing. I respect you do that. Now I don't hate you as much for having a skyline that I don't have.
Depends on your urologist. Most physicians (reasonable ones at least) will require a face to face with both members of the couple. But that's not legal or mandatory or anything. Some physicians require more than one visit when the patient is very young. In those situations, you have to practice a little bit of medical paternalism. For example, if a single 27yo guy comes to you and is like "I never want to have kids, I'm 100% positive of that" do you think its ethical to say "sure, sign here kid and I'll see you in the OR on Friday" ? Oh the joys of practicing medicine.
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