Newbie seeks feedback...
troutmaskreplica
expect. The doc asked some questions about my relationship and if we'd
discussed the vas, and then he had me lay down and started feeling my
balls and tubes.
What concerns me most is the discussion of the negatives. He said that
"about 5%" have problems that lead to pain, mostly due to infection.
This seems awfully high for a "standard" operation. I think there are
lower percentages of complications for MAJOR operations! He also said I
could expect to feel kind of like I was kicked in the balls "for a week
or two". That doesn't sound very inviting! I thought it was more like
just a few days... His explanation of the complications is that ANY
surgical procedure can and does have risks, and that the ones
associated with vasectomy are very low.
On the bright side, he said he "can't remember the last time" he had a
patient that had any major problems. But when I asked how many he'd
done, he would only say "Lots". When I further asked "Over 100?" he
would only repeat, "Lots". My hope was that I would go to someone VERY
experienced, and while I liked the guy, and he seemed very good about
explaining everything, I am reluctant to go to someone who could
not/would not answer the question "How many have you done?" with an
answer like "Oh, several hundred..."
I am on insurance, so I don't know how much choice I have in this. I
may or may not be able to get a referral to another guy. But I also
have a plan where I could pay for it myself and get reimbursed through
a medical fund I have which is set aside by my employer (a flex plan,
they call it - and my employer pays 9% of my salary into it for medical
reimbursements).
My question to you guys is, Am I being too nervous about this? I'm sure
if I were going in for another procedure, I probably wouldn't be quite
so nervous. Do you think I am being somewhat silly to want a doctor
who's performed more of these procedures? I'm sure if I call back and
ask about having one of the other doctors to perform it, they'll tell
me "Oh, you have nothing to worry about. Dr. X is a great doctor!" And,
there's a good chance that he probably is...
He is a urologist, he did explain about shaving and not taking aspirin
a week before, and to take it easy afterwards, to bring a jock strap to
the app't, and to be prepared to use ice (or frozen peas, as I've read
here), and to have someone drive me home because they'd be giving me
some valium...
But I am tempted to look for another doctor who's done several hundred
of these...
What's you guys' opinion?
Also, I am interested in finding out more about the "non surgical" vas.
I've read some of the posts here. Is there a place I can go to see a
good UNBIASED comparison of the two types of procedures? From what I
read here, it looks like it's a toss-up, that each has advantages and
disadvantages. This doc said the NSV is really no different, that it's
just a kind of marketing ploy...
Sent via Deja.com http://www.deja.com/
Before you buy.
Jason G
>
>What concerns me most is the discussion of the negatives. He said that
>"about 5%" have problems that lead to pain, mostly due to infection.
I just had a visitation to the "5% zone", a brief bout with epididymitis
(sp?). I'm 7 weeks post-op, and after a weekend of vigorous sex last week my
left side swelled up and got VERY VERY tender. I could hardly walk. Went to
the doc and he gave me some antibiotics. 4 days later things are almost back
to normal and the pain is gone.
So in that 5% may be transient problems like mine. Annoying, but still worth
it.
>He also said I
>could expect to feel kind of like I was kicked in the balls "for a week
>or two". That doesn't sound very inviting!
For me, it wasn't like I was JUST kicked in the balls, but more of a low-grade
achy feeling that was easily controlled with OTC ibuprofen after the 3rd day
(codeine before that.) It went away in a week.
>Do you think I am being somewhat silly to want a doctor
>who's performed more of these procedures?
Not at all. I'd get a different doc if you have a choice. Answering "lots"
to over a hundred could mean "95" or "twelve". When I asked mine, he said
without hesitation "over a thousand, easy."
It was also reassuring that a search on the web turned up dozens of papers
with him as a co-author.
--
Jason G
"Autocross is a precision sport, much like archery or golf.
You must be precise and consistent, all while driving so fast
you can barely concentrate." -- Mark Sirota
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Lee
Most people do not have problems, however, there is a certain percentage
that experience long-term pain, some several months, some several years,
some permanently from what I have seen. The actual percentage has been a
subject of debate on this newsgroup in the past. I have been reluctant to
have it done because of the "percent" that have problems so I have yet to
schedule it.
You should read all of the stories on the website that this group refers to
often and visit the links. It is a very good website.
There is no "non-surgery" vasectomy, only ones that use a scalpel and ones
that use a puncture like instrument which is called the no scalpel
vasectomy. Both types require cutting the vas and the difference is in the
type, size and number of entrances into the scrotum. There are also
open-ended and closed-ended types which you should investigate also.
I don't know if I would say you are being too nervous. Those who have had
no problems might say yes, and those who are part of the minority "percent"
with problems will say no. Keep researching. My urologist said he has done
over 3000 and I have still not set the date.
Lee
David
>Hi, I went in for my first appointment yesterday. I didn't know what to
>expect. The doc asked some questions about my relationship and if we'd
>discussed the vas, and then he had me lay down and started feeling my
>balls and tubes.
This is good - some counselling goes along the lines of "How old are you?
How many kids? You know the chances of reversal are slim, so consider it
permanent? You need to know the NHS doesn't pay for reversals and
recanalisation can happen so don't sue me cos I've told you it can happen".
>
>What concerns me most is the discussion of the negatives. He said that
>"about 5%" have problems that lead to pain, mostly due to infection.
>This seems awfully high for a "standard" operation. I think there are
>lower percentages of complications for MAJOR operations!
I'm reassured by this - some doctors don't tell you there is a risk, or
explain what the risks are. The fact that he's made you aware of negatives
is good. Also among the 5% are included those who just recover slowly, as
well as the problem cases.
>He also said I
>could expect to feel kind of like I was kicked in the balls "for a week
>or two". That doesn't sound very inviting! I thought it was more like
>just a few days...
Not always the case. I think the survey on the website is about right here.
Some men do go back to the office having had an extended lunch break to be
sterilised in, and some are too sore to go back to work for a few days. The
norm is 1-2 days off (usually over the weekend) and pretty well back to
normality after that, but wearing the jock sure helps for a while!
>His explanation of the complications is that ANY
>surgical procedure can and does have risks, and that the ones
>associated with vasectomy are very low.
I'd go along with that, and he was open and honest with you.
>
>On the bright side, he said he "can't remember the last time" he had a
>patient that had any major problems. But when I asked how many he'd
>done, he would only say "Lots". When I further asked "Over 100?" he
>would only repeat, "Lots".
He may well have done thousands for all we know - he has probably answered
this question many times, and finds the most reassuring answer is "Lots".
>My hope was that I would go to someone VERY
>experienced, and while I liked the guy, and he seemed very good about
>explaining everything, I am reluctant to go to someone who could
>not/would not answer the question "How many have you done?" with an
>answer like "Oh, several hundred..."
I get the impression that he's using his standard reassurance technique. I
don't know that this would bother me personally, bearing all the rest of
what he said was open, given freely without asking. If he was evasive on
other points, or didn't give the advice he should have I'd have alarm bells
ringing, but he sounds OK to me.
>
>I am on insurance, so I don't know how much choice I have in this. I
>may or may not be able to get a referral to another guy. But I also
>have a plan where I could pay for it myself and get reimbursed through
>a medical fund I have which is set aside by my employer (a flex plan,
>they call it - and my employer pays 9% of my salary into it for medical
>reimbursements).
If you lived in the UK you'd get rather less choice on the NHS.
>
>My question to you guys is, Am I being too nervous about this? I'm sure
>if I were going in for another procedure, I probably wouldn't be quite
>so nervous.
Nerves are perfectly normal. Also bear in mind that making a choice to have
yourself sterilised is a very big decision for anyone. Your would be less
nervous about an appendectomy for example, as it would be a necessary
routine procedure, as opposed to elective sterilisation.
The main question is are you happy with becoming sterile?
>Do you think I am being somewhat silly to want a doctor
>who's performed more of these procedures? I'm sure if I call back and
>ask about having one of the other doctors to perform it, they'll tell
>me "Oh, you have nothing to worry about. Dr. X is a great doctor!" And,
>there's a good chance that he probably is...
Again, it would bother me if he was evasive on other points, but if you are
genuinely unhappy about the guy seek someone else.
>
>He is a urologist, he did explain about shaving and not taking aspirin
>a week before, and to take it easy afterwards, to bring a jock strap to
>the app't, and to be prepared to use ice (or frozen peas, as I've read
>here), and to have someone drive me home because they'd be giving me
>some valium...
Much better than some would tell you!
>
>But I am tempted to look for another doctor who's done several hundred
>of these...
You don't know that he hasn't.
>
>Also, I am interested in finding out more about the "non surgical" vas.
It's still surgery. They use a puncture tool to gain access to the vas
deferens instead of a scalpel. But they still cut the same tubes with a
scalpel, and seal the ends. Have you thought about the open ended technique
at all?
>I've read some of the posts here. Is there a place I can go to see a
>good UNBIASED comparison of the two types of procedures? From what I
>read here, it looks like it's a toss-up, that each has advantages and
>disadvantages.
In the links section some of the medical sites have comparisons and studies,
and that's probably your best bet for an unbiased viewpoint. I'm sure that
both methods have their pro's and con's, and you are probably right - it's
a toss up. You just have to decide what's best for you!
>This doc said the NSV is really no different, that it's
>just a kind of marketing ploy...
Interesting for a doctor to say this.
Please keep asking questions - that's why we are here!
--
David
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Visit the Vasectomy Information site at http://www.vasectomy-information.com
Please participate in the on-line survey!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
tri...@my-deja.com
I just want to second David's advice. Your doc. sounds good to me. As
for the 5% complication quote he gave you, keep in mind that infection is
the number one problem post vasectomy complicaton, and it is very easily
treated. As for whether you should hold out for someone who says he has
done more procedures, keep in mind there are probably practitioners who
will say they have done more and haven't, or who have done "hundreds and
hundreds," but have fallen off their game (or are too stubborn to have
learned new tricks). Or that your guy, when he said "lots," meant
"hundreds!" The bottom line is, vasectomy really is a very simple
procedure, especially for a specialist (like a urologist). For me, the
key would be to go with someone you feel comfortable with, and who you
think you could go to if there were problems. The problem with a lot of
urologists, from what I have heard, is that they don't have a great
"table-side" manner when it comes to vasectomy, considering it too simple
and minor a procedure for patients to worry/complain about. But your guy
doesn't sound like this. As for the nsv procedure, I think I agree with
him on this, too, that it is more a marketing gimmick than anything else.
I had the traditional two incision method, and it turned out fine. I was
back to normal almost right away, although did wear the strap for about
two weeks. Since there is less cutting with the nsv, the risk of
infection *is* probably less. But this risk is low to begin with, and
easily limited with proper sterilization technique (don't forget the
shaving!). I suspect there may even be a downside to nsv, in that they
may have to tug the tubes more to get at them from a single puncture as
opposed to getting at them from tiny cuts on either side of the scrotum.
It is the tugging on the vas tubes that causes the "kicked-in-the-balls"
sensivity, I believe. So nsv might even be more painful from this point
of view.
Finally, I agree with David, the big question is, how comfortable are you
with being sterile?
In article <8uc4h3$v92$1...@nnrp1.deja.com>,
troutmaskreplica <troutmas...@my-deja.com> wrote:
>
> What concerns me most is the discussion of the negatives. He said that
> "about 5%" have problems that lead to pain, mostly due to infection.
> This seems awfully high for a "standard" operation. I think there are
> lower percentages of complications for MAJOR operations! He also said I
> could expect to feel kind of like I was kicked in the balls "for a week
> or two". That doesn't sound very inviting! I thought it was more like
> just a few days... His explanation of the complications is that ANY
> surgical procedure can and does have risks, and that the ones
> associated with vasectomy are very low.
>
> On the bright side, he said he "can't remember the last time" he had a
> patient that had any major problems. But when I asked how many he'd
> done, he would only say "Lots". When I further asked "Over 100?" he
> would only repeat, "Lots". My hope was that I would go to someone VERY
> experienced, and while I liked the guy, and he seemed very good about
> explaining everything, I am reluctant to go to someone who could
> not/would not answer the question "How many have you done?" with an
> answer like "Oh, several hundred..."
>
> I am on insurance, so I don't know how much choice I have in this. I
> may or may not be able to get a referral to another guy. But I also
> have a plan where I could pay for it myself and get reimbursed through
> a medical fund I have which is set aside by my employer (a flex plan,
> they call it - and my employer pays 9% of my salary into it for medical
> reimbursements).
>
> My question to you guys is, Am I being too nervous about this? I'm sure
> if I were going in for another procedure, I probably wouldn't be quite
> so nervous. Do you think I am being somewhat silly to want a doctor
> who's performed more of these procedures? I'm sure if I call back and
> ask about having one of the other doctors to perform it, they'll tell
> me "Oh, you have nothing to worry about. Dr. X is a great doctor!" And,
> there's a good chance that he probably is...
>
> He is a urologist, he did explain about shaving and not taking aspirin
> a week before, and to take it easy afterwards, to bring a jock strap to
> the app't, and to be prepared to use ice (or frozen peas, as I've read
> here), and to have someone drive me home because they'd be giving me
> some valium...
>
> But I am tempted to look for another doctor who's done several hundred
> of these...
>
> What's you guys' opinion?
>
> Also, I am interested in finding out more about the "non surgical" vas.
> I've read some of the posts here. Is there a place I can go to see a
> good UNBIASED comparison of the two types of procedures? From what I
> read here, it looks like it's a toss-up, that each has advantages and
> disadvantages. This doc said the NSV is really no different, that it's
> just a kind of marketing ploy...
>
> Sent via Deja.com http://www.deja.com/
> Before you buy.
>
--
Check out the Vasectomy Support webpage:
http://www.vasectomy.fsnet.co.uk (includes survey and survey results)
tri...@my-deja.com
jrgu...@yahoo.com (Jason G) wrote:
> I just had a visitation to the "5% zone", a brief bout with epididymitis
> (sp?). I'm 7 weeks post-op, and after a weekend of vigorous sex last week my
> left side swelled up and got VERY VERY tender.
For about a year after my v. I would occasionally experience a kind of
ache in the area of the epididymis on the right side the day after
ejaculation. It seemed associated with long sessions involving delay of
ejaculation or with multiple ejaculations in a single day/night. But the
symptoms were very mild by comparison to yours, and there was no
swelling. So I never went to a doctor about it. Nor did I avoid the
cause ;-)
troutmaskreplica
I am 110% comfortable with becoming sterile. If there were a completely
safe, painless method, I'd do it as soon as I possibly could!
As is, I have an appointment for 5 weeks from today, more or less. But
what concerns me is that I get it done by someone who is an EXPERT at
it, someone who has a long track record with the minimum number of
problem cases due to his mistakes orlack of skill...
I liked my doc, yet it still bothers me that he didn't answer that one
question "How many have you done?" with a higher number. If he'd have
said, "over a hundred", or "hundreds", I'd feel better about it. But he
looked to be in his 30's, so I'm thinking maybe he hasn't done that
many, and I don't want to be his practice subject...
I think I am going to call the office and ask if one of the other more
experienced doctors in his office of 3 urologists might do the
operation. I feel very uncomfortable calling his expertise into
question in this way, but hey, it's my balls we're talking about here!
So in that spirit, I think I'll call and express my concern...
Also, let me say that vasectomy is necessary for me, as I absolutely
positively do NOT want a baby (I'm 48), and I don't want to rely on my
wife to remember to take pills, nor to get sterilized. Likewise, I
don't feel comfortable with the option of an IUD for her. I've had a
girlfriend with a diaphragn before, and they are a pain in the ass to
use. As for condoms, they decrease the fun so much, I can't stand them
(though this is what we've been using). So, for me, vasectomy is the
only real option. I just wish that "5%" figure was more like 1%!
norther...@my-deja.com
some more than average Post-vas pain. Mine lasted about three months,
it very slowly decreased from a constant "toothache" feeling to now
virtually nothing. I had the traditional because I didn't do too much
research first. If I had my choice to do it over again, I would have
the nsv method done, based on anecdotal feedback from here and the
Beaver Cleaver website.
I am happy to say that now, I am virtually pain free. I experience
mild discomfort if I have more than one orgasm per day, but it
generally doesn't last very long. I feared the worse when my
experience lasted longer than I expected, and the doc wasn't very
helpful. But, now I am happy everything is fine.
One other note of caution, you may not be able to use the money in your
Flexible Medical Spending account for procedures that are normally
covered under your regular insurance. Just check with your HR
department to make sure. It sounds like you have an HMO, so maybe your
primary doc can refer you to another urologist if you feel
uncomfortable.
Best of luck!
Dave
right about that 5%. It's too much of a risk. I myself ended up among
that 5% and if I had it to do over again I would not have gotten the V.
It's probably the worse decision I ever made. Also, I think Steve Law
is correct about the hormone drop but I think it occurs to different
guys in different degrees. Sorry to be a humbug guys, but that is how I
see it and that is my advice for anyone contemplating a V.
Dave
David
>I liked my doc, yet it still bothers me that he didn't answer that one
>question "How many have you done?" with a higher number. If he'd have
>said, "over a hundred", or "hundreds", I'd feel better about it. But he
>looked to be in his 30's, so I'm thinking maybe he hasn't done that
>many, and I don't want to be his practice subject...
You are quite right about the more experienced the surgeon, the less
likelihood of problems. One of the papers we link to ("Safety and
effectiveness of vasectomy") does go into this subject. They quote incidence
of haematoma and surgeons "Snips per year". It varies from 4.6% in those who
perform less than 10 per year, to 1.6% for those performing over 50 per
year. So yes, you need to make sure he's in regular practice.
>
>I think I am going to call the office and ask if one of the other more
>experienced doctors in his office of 3 urologists might do the
>operation. I feel very uncomfortable calling his expertise into
>question in this way, but hey, it's my balls we're talking about here!
>So in that spirit, I think I'll call and express my concern...
I have to say that your guy doesn't seem so bad - I've got a new story that
I'll be posting to the website either later tonight, or tomorrow. It's a
story called "Steve #2's story", and he details his first consultation.
You'll think yourself lucky when you read it!
>
>Also, let me say that vasectomy is necessary for me, as I absolutely
>positively do NOT want a baby (I'm 48), and I don't want to rely on my
>wife to remember to take pills, nor to get sterilized. Likewise, I
>don't feel comfortable with the option of an IUD for her. I've had a
>girlfriend with a diaphragm before, and they are a pain in the ass to
>use. As for condoms, they decrease the fun so much, I can't stand them
>(though this is what we've been using). So, for me, vasectomy is the
>only real option. I just wish that "5%" figure was more like 1%!
Interestingly, the biggest chunk of the 5% are post vasectomy infections
that could be easily avoided in most cases. We do stress at the website
("Advice from the newsgroup") that your doctor should warn you about
infections. Specifically what to look out for, and how to get it treated
straight away. Doctor's don't always give this information, and if they do,
us stubborn men sometimes won't go to the doctor in the belief it will clear
up soon. Men really do have the power of existentialism refined! A lot of
the "Horror stories" in the group and at the website involve infections, so
if your guy warned you about this without prompting this is good.
I don't think the age is quite so relevant. OK, if Doogie Howser MD was
wielding a knife near my nut's I'd worry (and run!!), but the other end of
the spectrum you could get some crusty old dinosaur who's not read a
research paper for years but done thousands!!!
I'd give the practice a call, and explain your concern. Given this they
should be able to give a ball park figure, and hopefully this will put your
mind at ease.
troutmaskreplica
> You are quite right about the more experienced the surgeon, the less
> likelihood of problems. One of the papers we link to ("Safety and
> effectiveness of vasectomy") does go into this subject. They quote
incidence
> of haematoma and surgeons "Snips per year". It varies from 4.6% in
those who
> perform less than 10 per year, to 1.6% for those performing over 50
per
> year. So yes, you need to make sure he's in regular practice.
David,
Thanks for this. This is more what I was thinking - that someone should
be in practice, and have been at it for awhile. I'm going to call the
office of my doc and just tell them point blank that "I've been advised
that it is better to have a doctor do it who does over 50 per year. Does
Dr. X meet this criteria?" If not, I'll ask for one who does. If none
there do, I'll go elsewhere.
It does seem to me, as well, that what you say about infections and
complications probably often arise from men who don't follow the
instructions (no lifting, or exercise afterward) and who don't call soon
enough at the first sign of infection. I, on the other hand, will follow
the instructions to a T, and will call at the first sign of infection!
Thanks for your feedback! This is just what I needed to hear to give me
the courage to call the office and question the doctor's "credentials",
regardless of whether or not they like to answer this type of question
(I'm sure they don't. And doctors, being mostly arrogant types when it
comes to their own knowldege and skills, certainly don't like answering
them, especially IF they DON'T have a whole lot of experience or
knowledge in a certain area...)
troutmaskreplica
> the nsv method done, based on anecdotal feedback from here and the
> Beaver Cleaver website.
I am curious why you would choose it. I have read that the extra tugging
and pulling may cause healing to be slower, and more pain during the
first week or two...
>
> I am happy to say that now, I am virtually pain free. I experience
> mild discomfort if I have more than one orgasm per day, but it
> generally doesn't last very long. I feared the worse when my
> experience lasted longer than I expected, and the doc wasn't very
> helpful. But, now I am happy everything is fine.
Thank goodness for that! Must have been very stressful when you didn't
know if the pain was going to go away....
>
> One other note of caution, you may not be able to use the money in
your Flexible Medical Spending account for procedures that are normally
> covered under your regular insurance.
I have a very good Flex Plan. They cover just about ANYTHING as long as
it's medical related. I'll double check, though. Thanks for the warning.
troutmaskreplica
knowldedge? Did you physically exert yourself shortly afterward? Did you
follow the doc's advice, use ice, etc.? And did you call the doc as soon
as you had signs of infection? or did you wait a little too long?
> I am happy to say that now, I am virtually pain free. I experience
> mild discomfort if I have more than one orgasm per day, but it
> generally doesn't last very long. I feared the worse when my
> experience lasted longer than I expected, and the doc wasn't very
> helpful. But, now I am happy everything is fine.
Sent via Deja.com http://www.deja.com/
Before you buy.
David
>be in practice, and have been at it for awhile. I'm going to call the
>office of my doc and just tell them point blank that "I've been advised
>that it is better to have a doctor do it who does over 50 per year. Does
>Dr. X meet this criteria?" If not, I'll ask for one who does. If none
>there do, I'll go elsewhere.
>
>It does seem to me, as well, that what you say about infections and
>complications probably often arise from men who don't follow the
>instructions (no lifting, or exercise afterward) and who don't call soon
>enough at the first sign of infection. I, on the other hand, will follow
>the instructions to a T, and will call at the first sign of infection!
>
>Thanks for your feedback! This is just what I needed to hear to give me
>the courage to call the office and question the doctor's "credentials",
>regardless of whether or not they like to answer this type of question
>(I'm sure they don't. And doctors, being mostly arrogant types when it
>comes to their own knowldege and skills, certainly don't like answering
>them, especially IF they DON'T have a whole lot of experience or
>knowledge in a certain area...)
Well, 50 per annum is only one a week, and I'm guessing that most will
achieve this with ease. My gut feeling on your doctor is that he's a good
guy as he gave you all of the info without you asking.
troutmaskreplica
> Well, 50 per annum is only one a week, and I'm guessing that most will
> achieve this with ease. My gut feeling on your doctor is that he's a
good
> guy as he gave you all of the info without you asking.
>
> --
> David
I agree he seems like a good guy, well trained, etc... But my question
is How good is he at performing the vas. procedure? Since he wouldn't
answer my "How many have you performed?" with a figure, I am skeptical
about how many he has performed. IF he has performed over 50 in the
past year, I will let him do it. If not, I won't. I can only hope they
can give me a figure, and that it is an accurate one.