Are you okay?" My urologist’s question is less like a friendly bartender checking in on your drink status and more like your friends skiing up to your crash site after you’ve tumbled 700 vertical feet, head-over-skis.
“Yeah? I think so?”
I take a deep, gasping breath.
“I mean, aside from you cutting open my balls, I think I’m okay.”
I’m lying to him. I’m approximately four minutes into a vasectomy, and I’m not at all okay.
I’M APPROXIMATELY FOUR MINUTES INTO A VASECTOMY, AND I’M NOT AT ALL OKAY.
Medically speaking, a vasectomy cuts off the supply of sperm to your semen by sealing the vas deferens, the tubes that carry sperm. Local anesthetic is applied to numb the pain, and your doc does some stuff in your nether-region while the two of you make inane small talk about the weather. Typical operating time for this outpatient procedure is between 10 and 30 minutes. Easy peasy.
But that’s oversimplifying it.
Imagine this: Your scrotum is a grapefruit filled with two big seeds and spaghetti noodles. The grapefruit (your ballsack) is cut open and a noodle (your vas deferens) is removed. The doc cuts a chunk out of the noodle, then cauterizes the ends closed with something that looks terrifyingly similar to a soldering iron. The now-two noodles are shoved back into your grapefruit, and it’s stitched shut. The process repeats for your other testicle. You will be awake for the entirety of it.
Still with me?
I’m a fairly panicky person by nature and wanted non-medical real-talk before I went under the knife. Unfortunately, the internet is a cesspool of dudes either saying the experience was so easy they ran a marathon the next day (stupid, likely false) or complaining that their vasectomy made them feel like less of a man (also stupid, but likely true). So below are all the questions I tried to get straight answers to before my procedure. I hope they’ll help calm your nerves.
Besides, as my wife so bluntly put it, it’s not as if you’re pushing a living, breathing human the size of a watermelon out of your body, now is it?
Is getting a vasectomy worth it?
Are you done having kids? Great! Then yes, it’s worth it.
I’m 37, married with two kids, in generally good health, and my wife and I decided that our family was complete. And while it’s not like we’re lighting candles and pouring wine eight days a week over here, it would be nice to have a moment together without having to worry about life-altering consequences.
Will the vasectomy hurt?
Yes, dummy. But not like you think. The only real pain you feel is the initial anesthetic, which is akin to someone thwacking your balls with a rubber band several times. I had “needle-less” injection, but don’t let the name fool you. The anesthetic is shot out as a high-powered spray from something that looks like an airbrush pen and still hurts.
THIS MIGHT BE THE MOST UNCOMFORTABLE YOU’VE EVER BEEN IN YOUR LIFE.
The real sensation that will get you is one of deep, nauseating discomfort. This might be the most uncomfortable you’ve ever been in your life. Sure, everything down there is numb, but you'll feel tugging, pulling, pressure, and lots of that “kicked in the nuts” stomachache feeling. Add in the fact that once the procedure is started, you can’t take a break to get your shit together mentally, and it all combines to be quite miserable.
Take my advice: If your doctor asks if you want him to talk to you through it, say yes. We literally talked about the times we’ve been stuck in elevators, and it helped bring me back from the brink of a panic attack.
Could something go wrong down there?
Again, yes. It’s a surgical procedure, and with that comes risks, primarily hematoma (bleeding inside your balls) and infection. But overall, it’s considered safe and effective.
Regardless, your doc will make you sign a waiver peppered with words like “bleed out,” “death,” “stroke,” “heart attack," and worst of all, “impotence.” My doc even included a 2015 Harvard study discussing the uncertainty of the connection between vasectomy and prostate cancer in the info packet. That study has since been updated to show no real link between the two, but cool, thanks for the terrifying FYI, doc.
But the concern of bleeding from an area that shouldn’t be bleeding is very real. Case in point, I didn’t read the info packet thoroughly and took Alka Seltzer a few days before my scheduled procedure. Fun fact: Alka Seltzer has aspirin in it, aspirin thins your blood, and thin blood won’t clot, causing your balls to bleed. This all came up after I was bare-assed on the operating table, freshly shorn grapefruit and all, mentally ready to do the deed. But in an abundance of precaution, they made me come back the next day to ensure the aspirin was fully out of my bloodstream.
What about my anxiety?
Some urologist offices will give you a prescription for a single Xanax to help you relax. If yours offers this, don’t think twice; throw that pill down your gullet and mentally drift away. Mine did not offer this and, honestly, the anxiety was the worst part of the procedure. You know medically and anecdotally what’s going to happen to you, but physically and mentally you have no idea what you’re in for. Chemically calm these thoughts and it will be a much better (but still awful) experience.
Furthermore, I suggest you don’t ask questions about things in the room before the procedure. For example, I had to sit on a metal plate.
Hmm, that’s peculiar. Why?
"To ground your body so you don’t get electrocuted while he cauterizes your vas deferens."
Oh. Gonna go barf now.
What’s the post-op pain like?
You know that pain you have an hour or so after your kid jumps on your nuts? That’s generally how things will feel for a few days. It will be a dull, generalized soreness, accompanied by what feels like low-grade stomachaches. You’ll be prescribed pain medication (I was given Tylenol 3—with codeine!), but I found that to be overkill. Regular Tylenol plus a couple of beers and rest was the perfect elixir for me. The only serious post-op pain is when (not if) you catch one of your stitches on your underwear. I dropped like a sack of potatoes, and you will too.
How long until I’m really back at 100 percent?
Your doc will tell you 10 to 14 days, but everyone is different. You’ll definitely want to stay off your feet for the first 24 to 48 hours. My doc had me ice for the first day only, then make sure to shower the day after. That wasn’t fun. But I was walking around without much issue within a couple of days, and I started running again at seven days with very little soreness.
I get why so many men schedule vasectomies around March Madness, but they’re milking it. I was restless, bored, and generally pain-free after two days of sitting around icing my fellas, so I mostly resumed all normal activity by day three.
What about sex?
Now for the blue-balled elephant in the room. Sexual activity is a little different because you have these very invasive stitches on your balls that will remain tender and physically weird for a while. My doc said, “Go for it when you’re ready,” which was about 10 days after the procedure. Things were delicate, but not painful. Once again, the main feeling you’ll have is anxiety of not knowing what it’s going to feel like and whether you’ll be back to your old self. You’ll get over these feelings pretty quickly once you and your wife turn on the battery-operated candles and hit play on the Bedroom Jams Spotify playlist, while the quiet hiss of the baby monitor in the background takes you two away to Sexytown, U.S.A.
This story originally appeared on Esquire.com.
* Minor edits have been made by the Esquiremag.ph editors.