An epic vasectomy story

Here is my male surgical sterilization experience. I wanted to record something other than the generic, “I worried, it didn’t hurt, it turned black and blue, we tried it out and it still worked, my balls ache a bit, I am childfree, whee!” story. Repeating the mistake of Polonius, “Brevity is the soul of wit, therefore I will be brief”, my story has progressed to a significant length. But I decided to leave my cathartic ramble long and disjointed to preserve the tone of the moment as it was written, over a period of many months. It also helps to hide behind anonymity. I do not pretend that the reader cares about me, but what I write may still be useful as they reflect upon their own situation. If I had the experience or emotion then it is possible you may also. The personal details may not apply or may even put you off, but the principles probably still apply. I will leave it up to you to decide if this is a success story, a cold sweat nightmare, or a tragedy; you may laugh at me, congratulate me or cry with me. I am not a doctor and don’t play one on TV. My comments are my opinions; they are biased, subjective, may change without notice but conform to the higher standards of a grocery store tabloid.

Caveat lector.

The Setup

I actually like kids, the miracle of birth is an emotional and awesome experience; pregnant wives are too, but in a different way. We have three wonderful children and have been in a stable and loving marriage relationship for over eleven years. Seeing my wife is several years older than I am and over 40, we decided that three would complete our family. Tubal ligation and vasectomy were discussed, but signing up for surgery when you are not in an emergency is hard to do, so, we waited. There never is a good time. Well, actually I waited since the bias was towards vasectomy and I was not excited about the idea. We used other contraceptive methods. The result was a heartbreak roller coaster of an unplanned pregnancy, an extremely unhappy wife, adjustment of the family strategic plans, accepting the thought of a new child, worry about birth defects, getting excited and looking forward to the new addition to our family, being told your baby no longer has a heartbeat, a miscarriage, and D&C. At the beginning of this, the “extremely unhappy wife” provided pressure in the usual manner and made it perfectly clear that a vasectomy was in my future.

I guess it is intuitively obvious to the casual observer that making sterilization decisions in the middle of all that is not the best time, but my guess is that a fair percentage of these decisions are made under similar circumstances. Either you had an “oops”, were scared she was late, or for some other reason, the time is now. Except for the Marquis de Sade, what guy would jump at an opportunity for someone to take a pair of scissors, poke a hole in his sack and then take a knife to his gonads? Such a concept is diametrically opposed to all-male impulses, calculated and rash. There is always some form of pressure, even if the pressure is self-generated.

Sterilization is performed so that one can participate in recreational sex after you have all the children you want or it is too “dangerous” because of birth defects or health issues with the mother to conceive another child. Recreational meaning entirely for its own sake and pleasure of the participants; it does not imply extramarital. The whole purpose of cutting your sexual organs is to be able to have (more) recreational sex. Kind of odd and a bit creepy.

The Research

I am a fairly curious guy and I try to research a subject pretty well beforehand. I figure that to get my money’s worth from a doctor he needs to teach me something not just pronounce a diagnosis by fiat. This method in the past has stopped unnecessary surgery, identified a misdiagnosis, gets strange reactions from doctors (positive and negative), and is instructive and fun. Once, a doctor walked out of his office and left me there in mid-sentence while I was asking questions, but others are excited that someone is interested in their area of expertise and happily explain things. I am also a reasonably good patient; I don’t act morose and play the invalid when sick. So I dutifully drug out Gray’s Anatomy, a PDR, and went surfing the ‘net. I watched at least three different videos of vasectomies being performed.

There was quite a difference in technique. IMHO and IANAD, the bruising and recovery time is significantly related to the amount of “tenderness” which is used by the doctor. If care and time are taken when opening the scrotum and stripping the lumen of the vas, the probability of bleeding and bruising is reduced. If he pulls the vas 2 inches out of the scrotum (that 4 inches had to come from somewhere!) and lets a hemostat fall, then you will more likely have bruising and a longer recovery period, but if he takes his time and pulls only what little of the vas which is absolutely necessary from the scrotum, basically causing as little disturbance as possible, then the recovery period will be less. The trouble is that when things are necessarily numb, your “gift of pain” is short-circuited and the feedback loop of “you are being too rough” is not operating. Additionally, speaking as a layman, even though the doctor may be using a 28 gauge needle, jabbing it around multiple times and injecting 10 ccs of fluid may not cause immediate pain but it simply must cause tissue damage. A local anesthetic is necessary and desired, but please do not be cavalier about administering it! You may do this 100 times a year, but I only do this once a lifetime, and those are my only nuts under your knife.

Post-Vasectomy Pain Syndrome is not really understood, rarely discussed by doctors nor presented front and center. It is frequently dismissed by women; men, who don’t have it, consider those who do wimps; doctors downplay it. But unlike sea dragons, it exists. The reports are wildly varying in what percentages of men have lasting pain or how much, anywhere from 1 out of 3 to 1 out of 100 and from debilitating “I hate my life” to “it’s annoying”. I was and am disturbed by the variation in those figures. From the required reading, it appears that all vasectomy patients have difficulty in dealing with the now unwanted sperm, though some bodies are able to deal with it more effectively and only experience short term pain from the changes. Primum non-nocere.

A closed vasectomy will cause pressure from the closure on the vas to the testes; the question is whether the body can dispose of the sperm fast enough before further damage occurs. Generally, everyone will have enough pressure to create a vasitis nodosa which seems to be when sperm make it into the walls of the vas deferens, or later through the walls. Think of it as enough pressure to start to break down the structure of a radiator hose. Approximately 50% of patients after vasectomy have some sort of an “epididymal blowout” by around 10 years afterward. This is when one of the tubes in the epididymis ruptures due to the pressure. The body increases its ability to absorb the sperm and initiates other actions similar to those during an infection to help deal with all the extra sperm; hopefully, a balance is then obtained. If the sperm leaks out due to a rupture or an open-ended vasectomy, a knot called a “sperm granuloma” will form. Two-thirds of all patients eventually developed antibodies to their own sperm. These reactions will not always cause pain or health problems, but it is what is happening behind the scenes. I asked my doctor about this and he didn’t give much of a description but did say that he could only remember one case of his where there was continued pain and he finally had to remove the epididymis to alleviate the pain.

Your testes are a pump or manufacturing plant; the pump does not shut off and you have cut and capped the pipe. Something has to give. There will be increased and increasing pressure on everything below the clamped pipe. The question is, how much will this cause chronic discomfort? It is not simply cutting an unused, “on-demand” or “one cell a month” pipe and putting a cap on it. This pipe is the only conduit for a pump that produces some 85 million cells a day (per testicle) and does not have a feedback loop to shut off.

During the consultation, I would like to see more attention given to the physical and emotional effects and more even presentation of all birth control options, including a presentation to my wife. My doctor did not discuss many of the issues with a vasectomy and took the stance that since I made an appointment to get a vasectomy then we were going to do it, that is what you were here for, right? Sign here, here, and here. There was little discussion except for scheduling, being handed a standard NSV trifold brochure to read, and a short elaboration that he did a no-scalpel procedure. If I had not stopped him with questions, which he seemed surprised at, he would have handed me off in 2 min. to the office manager. One trouble is there is not one doctor dispassionately presenting the all options, the next is would you listen anyway. You have urologists, OBGYN, midwife, and general practitioners. They do not cross disciplines and often you have different doctors for your wife and yourself. You need to do your own research before you approach one of them. Never during any interaction with a doctor did either of us receive anything other than a variation of “It’s no big deal”, even when I brought up the question of complications. The emotional aspects were never mentioned in consultation; neither doctor asked about the spouse’s opinion or more than the most cursory question about why I would want to be surgically sterilized.

When I asked my urologist, he was willing to do an open-ended vasectomy even though he normally clamped both ends and said that a sperm granuloma would (and did) form.

The Sell

For an example of what I will describe next please check out, men check out this link, and women, please click here.

This demonstrates subtleties and statements which are factually correct but convey a different tone due to the language used. It falls into the How to lie with statistics or biased journalism category. IMHO, the descriptions of a vasectomy, whether written by doctors (urologist, family practice or OBGYN), family planning organizations (Marie Scopes, Planned Parenthood, WHO) or “ask us a question” internet sites, generally present a vasectomy in an “its no big deal, calm down, sex still works, and besides everybody is doing it” straightforward (or in the case of WHO/WCFV biased) description. You know the usual institutional filmstrip, soothing music, a manly man and/or a beautiful woman, neither to whom you would ever dream of showing any kind of unmasculine weakness to, calmly describe a painless procedure in short clinical terms ending with Happy Clouds floating in a Bob Ross background with a Happy Family having a Happy Picnic while the Happy Wife gives Happy Come- Hither looks to the Happy Husband in Happy Golden Sunlight (cue “going home” Soylent Green music) or at least something along those lines.

The Vasectomy is presented as a “safe, permanent birth control method for men”, but a tubal ligation is presented as “surgical sterilization” for women. Both may be considered factually correct, but convey a different tone. Birth control is what you wanted your girlfriend to get, contraception is what you did as a teenager when you tried to hook up with some condoms; sterilization is what Dr. Carl Clauberg or Josef Mengele did at Auschwitz. It is a decidedly different picture that is painted. The men’s article mentions “sterilization” twice (in the same sentence), the women’s article uses the word 46 times, not including additional references within links.

Let’s examine the official statement given to me by my doctor to inform me about a vasectomy. The first sentence is the one above, “Vasectomy is a safe, permanent birth control method for men”. It seems ok, but contrast it with a definition from a medical dictionary, and it becomes more obvious. “Surgical removal of all or part of the vas deferens, usually as a means of sterilization.” Notice the lack of the word “safe”. The use of the word “safe” is making a judgment. Notice the use of the concise word “sterilization” instead of the more ambiguous “birth control”. Also notice that it classifies it as a surgical procedure. Nitpicking? Maybe, but as any editor or advertiser will tell you, having the right word is powerful. Is the purpose entirely information or does it also contain a component of persuasion? Therein lies the rub.

The options were presented to my wife by her midwife as, “You can have major surgery under the risk general anesthetic and be out of commission with 3 young kids for 4-6 weeks during summer vacation or your husband can walk out of the doctor’s office in 20 minutes with a little snip and only miss that day of work.” Only a redneck Neanderthal would refuse such an obvious comparison. In reality, the contrast is nowhere near that great. (and there is a “walk out of the office procedure” for women called Essure, plus with new laparoscopic techniques, the downtime is evidently measured in small numbers of days, comparable to or better than a vasectomy, but tubal ligation is also not without physical and emotional risk.) Both of you should get an apples to apples presentation of all the options. Needless to say, the midwife is no longer found on my “credible witness” list. I think non-institutional forms of information are the best. It is hard to find. Although not scientific, do not discount the anecdotes.

Generally, medical procedures are presented with a bit of “worst-case scenario” cast to them. Like reading an MSDS (LD50 for sugar is 29700mg/kg). The dentist says you will ache for several days and prescribes 5 days of pain medication; you ache for 1 and never take the medication, etc. At least that has been my experience, they always want to do a bit of CYA and then the patient feels better when he seems ahead of the curve. IMHO, the opposite is happening here. In a surgery that could be considered elective, the risk is glossed over, the recovery is downplayed and the procedure is promoted instead of presented. Instead of treating your sexuality with the seriousness, it deserves, the attitude has similarities to cajoling guys to bungee jump.

The Questions

Sex. Intimacy. Loving your spouse. Respecting your spouse. Fatherhood. Creating a family. Planning a family and following through. Virility. Sterility. Gender roles. Femininity. Masculinity. What that means as a concept and as a characteristic of a specific person. What it means to feel, be, and be considered attractive, sexy, potent, desired, or rejected. Questions like, could you marry again and have children if your spouse were to die (or there were a divorce)? and even metaphysical, religious, and biological questions like, why am I here on this planet? All of these issues are complex, run deep, should not be dismissed, often have illogical answers, or difficult to articulate responses and are tightly connected with each other. Sterilization can, and even if you don’t recognize it, have an effect all the way to your core and the core of your relationship with your spouse. The sexual relationship is primarily mental and has tendrils which go far beyond the mechanical act, what kind of effect will sterilization have upon it? A vasectomy is not “a safe, permanent birth control method for men” like picking up a case of condoms, neither is it a medical procedure like getting your wisdom teeth pulled. It is more like an invisible double mastectomy without the impetus of cancer.

Not using reliable birth control is simply not demonstrating respect for the female, who has to bear the brunt of childbearing and early child-rearing It can be a significant damper on your sexual relationship and in turn probably makes the man and woman feel rejected. Yet similarly, taking an ironic “just be a man, it is just a little snip, what are you, a wimp? It is finally time you men did your share.” approach is also lacking. The decision must not be forced in any fashion and needs to recognize that a vasectomy may have emotional similarities to mastectomy, hysterectomy, or even an abortion or miscarriage. As a man, you are permanently losing the ability to father children. It is a permanent loss. If she were to die or leave you next year, would your possible new wife want to have children with you? What if one of your children were to die or weren’t going through the terrible twos, would you later be sad if there were no possibility for another? You will be sterile. Is this a desirable state? There is a subtle but quite significant difference between “no children will be produced” (birth control) and “you will never be able to father children” (sterility).

The murky and wonderful world of sexual attraction is usually not logical. “I don’t want any more kids” does not necessarily translate into “I want to remove my sexual potency”. She may swear up and down she doesn’t want any more kids and truly not want any more children, but a sterile man may be much less attractive than she could explain or she thought it would be.

These are questions you both must answer first, individually, then as a couple, and be able to live with your answers for the rest of your changing lives, not just until the end of the crisis de jour. Approximately one out of every 100 vasectomies is reversed. How many more reversals were considered or desired? Do not approach sterilization like getting a cavity filled, a corn removed, having knee surgery, plugging a heater hose, or digging up unneeded landscaping, it is not the same. One study reported that over 50% of the men in the fertility clinic were seeking reversals and between 5 and 11% of men regret the decision to become sterile. Usually, the statistic is presented in the more positive fashion of, “over 90% of men are satisfied”. If my odds of winning the lottery were 10% I would enthusiastically play. So why do we think 10% is inconsequential here?

BOTH partners need to do research and read the same sources. BOTH need to go to the doctor’s visits. I am now finding that the sources I consulted (internet, urologist) and the ones my wife consulted (OBGYN, friends) were quite different in content and tone. If I come across article X and try to relate to my wife say, X% of men have a form of long-lasting pain from a vasectomy, she thinks I am proof-texting and being a wimp. If she reads this on her own, especially if she finds it on her own, or if the doctor gives us a list of questions for us to answer, separately and together, he said/she said activity is removed from the negotiating agenda.

The Medication:

I debated a long time about taking the diazepam (valium) which the doctor said was optional. I generally prefer my head to be clear and in control of my facilities, to be fully mentally present, and not have my judgment impaired, especially when my gonads are on the table! My wife recommended I take it and I went with her suggestion. Wikipedia was a useful resource for understanding the action of this drug. For the surgery to go well the scrotum needs to be well relaxed. Valium, among other things, is a skeletal muscle relaxant, so that combined with a warm room, help to make things drop down and be loose. I did not feel sleepy, although my wife did report after the surgery that my eyes looked “dull” and “without life”. No pink elephants, no pleasant relaxation, no euphoria, no sleepiness, no change in alertness, the primary effect of the medication was I noticed about 30 minutes later that I “didn’t care.” This was not a happy-go-lucky state, just plain apathy. I could have (and to some extent did) calmly discussed the amputation of some body parts without the normal inhibitions, fear, or revulsion. This “Whatever. Sounds cool to me. Do whatever you want” attitude lasted until the next day. From reading up on it, the half-life is 20+ hours, but additionally, the primary metabolite of valium is a similar drug in its own right has a half-life of 50+ hours. So this drug takes a long time to get out of your system. Taking the pre-surgery medication is probably a good thing, but be aware that you will have an apathetic attitude for a while. These subtle effects take a long time to wear off and affect your decision-making process. I found it physically anticlimactic, and pragmatically useful, but philosophically and ethically unsettling. If they think it is necessary to give me “don’t care” drugs to convince me to allow them to cut my sexual organs, something is not right.

I exercised before we left for the doctor and found this very helpful. I pushed myself further than normal. It relieved stress, was a last “How about them Bears!” kind of activity and it reduced the couch potato feeling over the next few days, plus you won’t be doing any kind of physical activity for at least a week (three weeks, I later found out). I recommend it.

The Reaction

When we told people about our (oops) pregnancy, the female response to my wife was a concern “How are you doing?” and some female bonding. The male response was “Congratulations!!!!”, a big smile and a hearty handshake. When you talk about vasectomy the female response is, (bright smile) “I know of several men who didn’t have any trouble at all!” The frequent male response is “Dude, I’m sorry.” and either an embarrassing conversation pause or a joke about their dog. For myself, I consider sterility an unfortunate, embarrassing, unwanted albeit necessary state. C’est la vie.

The Deed

As for the actual procedure and recovery: The overcast day matched my mood as we drove my Green Mile. I was checked in by some bubbly young nurses. I asked the doctor and (male) assistant to describe what they were doing while they were doing it. I knew the basic steps well enough to follow along in my head and know what was going to happen next. I probably could have even watched. The assistant and doctor were pleasant and treated me with as much respect and dignity as could be expected while shaving your sack, moving your member around, and cutting on your gonads. I only felt a dull ache once and he added more lidocaine 2%. I walked out and rode home. My wife’s description of me when she first saw me was that my eyes had no life. By the time I got home the lidocaine was wearing off. I lay on the bed with frozen peas or corn for all the first day. Took a short nap, watched a movie, read a book, and generally didn’t move at all. At all, meaning no movement which might cause a change in position of the ravished family jewels. Thankfully, my wife is an excellent and compassionate sick nurse, a much better one than I am.

The Diary

Day two. I did more of the same, but probably only used the frozen peas 75% of the time, and waddled around a bit more. I went out to the kids’ piano recital but just rode there, watched, waddled out, and rode home. I had no desire to see, be seen by, or speak with anyone I knew. The “don’t care” pill was wearing thin. Watched a movie, took a nap, read some more.

Day Three. I only used the ice twice and waddled around more. My balls seemed as big as tennis balls and I was acutely aware of them. There was a dull ache, but if you moved wrong then they kicked you again or someone used them as Chinese stress balls. They were a bit visually swollen and there was some dark blue colorization visible on one side that eventually confined itself to a silver dollar sized spot above and to the side of the midline incision. I moved from the decidedly unglamorous hospital “compression underwear” to normal briefs and a jockstrap. I felt deeply sad on this day, more time was spent staring out the window than reading.

Day four. I moved around much more, but quite slowly. I worked under the car and did a few light honey-do projects. Moving around without briefs or jockstrap is not pleasant. It is like having two china balls swinging down there and whenever they clink… I move like an old rickety bowlegged cowboy who got thrown off the electric bull — minus the drawl. The line the doctor tells you about a quick snip and going back to work the next day or even the day after? pure, undiluted (censored), I mean, um, hogwash.

Day five. There is still a noticeable hole, as in there are still spots of blood and you can see into the incision. Every day I dribble some hydrogen peroxide and put a small bit of antibiotic cream on it. No gauze was used since day three. I have to consciously work on moving more normally, but I am definitely not moving at a normal pace. It is not as much because it hurts, but more from the fear that it would bruise more. But when it does hurt, it is enough that you want to avoid a repeat. When I have moved more quickly or jarred things, it was like someone kicked you in the balls – again. It was mostly ok during the day, but by late afternoon, I just wanted to lay down with an ice pack on my very annoyed cojones and not move. They ached just to heft. The bruise is still there. It is several inches above and to the side of the incision but doesn’t seem to hurt. IMHO the doctor must have either jabbed something there or pulled too hard. The stubble from shaving is starting to get prickly.

I had an important and positive but emotional and draining discussion with my wife about the feelings involved. Not very chest-beating manly, but vital and one which brought us more intimacy. She was surprised at my feelings, as “It wouldn’t have crossed my mind you were thinking that”. My thoughts were an animated, “How could you possibly not know!” Shouldn’t at least some of these things be intuitively obvious, in addition to our discussions and my actions? Men have no corner on the market of not listening. One of those Mars/Venus epiphany moments which hopefully moved the planets closer together.

Day six. The day was ok, but even though I have a desk job my nuts were exceedingly not happy with me by the time I got home. They felt huge, hurt to touch and you wanted to kick the dog, yell at the kids, and snub the wife or some combination of that. One side still is a little more purple and yellow that the other side and the upper bruise persists, but none of the discolorization seems to be linked to pain. The nerds’ headgear in “16 Candles” is not very comfortable and the 6x increase in price for an “Under Armour Boxerjock” is well worth the investment.

Day seven. For the first time since I went back to work, I didn’t feel like kicking the dog when I got home, but a Tylenol and placidly laying on the couch were very welcome. Things are still sore enough that gentle sex might be considered (male one-track mind) but exercise is not on the radar yet.

Day eight. The doctor said things look ok but come back in a week. One of the testicles is much sorer than the other, but he said that the sore one was less swollen than the other. He was quite gentle but the examination was very unpleasant. He reported that he can already feel the granulomas forming. His answer to the continued soreness was simply that you have disturbed a very delicate portion of the body and it takes time. I don’t remember this being in the vasectomy cruise brochure or him stating it quite that way when I had the initial consultation (remember the BS about little snip and go back to work the next day?).

Day nine. Holy Freaking Cow!!! I did a self-exam and noticed that I had four balls instead of two. It was not a pleasant discovery; think queasy, need to sit down. We both were really freaked out. There were two extra lumps in there which were one half to two-thirds the size of the swollen testicles, about the size and shape of an unshelled Brazil nut. The extra two masses were located above the testicles and are painful. I expected sperm granulomas, but not anywhere near this huge! It is nearly like having an extra set of huevos (de plomo) swinging around in there. It is not a good feeling.

We threw caution to the wind and slowly and gently tested the equipment the night before. It worked – thankfully, but it laid me up for most of the next two days. I spent the better part of the next two days on my back or moving very slowly. And for the record, we were not rambunctious. My wife’s unsolicited comment was “I am starting to regret this decision.” The recovery process is much slower, more painful, and riskier than we were led to expect and the appearance of what I would describe as “huge” lumps in my scrotum are quite worrisome. I started to pour on the ibuprofen in the hope that it would lessen the swelling and the size of the lumps.

Day ten to day twelve. I rested most of the time and didn’t do much of anything. I am taking 1000-1200mg of ibuprofen/day. Tylenol seemed to be more effective for the pain than ibuprofen, but I hope that I can reduce the swelling and soreness. By day twelve it is feeling much better but the lumps have not reduced in size. My testicles aren’t nearly as sore to the touch as they used to be, but now they have this huge lump resting on top of them which hits them at every step. That can’t be good for activity in the long term. I am still wearing the boxer jocks all the time except for sleeping. Moving about unsupported for any amount of time is not desirable. I can walk mostly normally, but at about half speed and gingerly. The outlook is much better than it was a few days ago.

It is kind of funny what you will go through on the promise of future sex. My current opinion is that human reproductive systems are quite delicate and were not designed to be screwed with. As the ancient Jewish king and poet wrote, “I am fearfully and wonderfully made.” And messing with them, male or female carries consequences. We are willing to not only deal with considerable discomfort but more importantly take a lot of risk with a symbolic and necessary body part, both of which are counterproductive to the end goal of possibly having more sex. The risk is the unsettling part; it was not communicated to me in an effective manner. Ok, so my recovery period is longer than most even though I was a Good Boy, but the potential long term fallout to sex and to an active lifestyle is quite worrisome.

Day fifteen. Doctor’s visit. He was encouraged and admitted he was concerned after the last visit. Everything is feeling better. On day fifteen I actually felt like I could start walking at a normal speed and gait although only with support. The walnut-sized extra nuts haven’t shrunk any, but they are not as painful as they used to be. I was feeling good enough that I inadvertently jumped while demonstrating something, the fact that my pavlovian inhibitions to jumping were gone is a good thing, but the outcome was not, my gonads woke up and immediately told me on no uncertain terms to Sit Down! ‘n’ Stop all the’ ruckus. I won’t be repeating that mistake.

Day sixteen. Felt good enough to attempt an engine swap on an old farm truck. By the end of the day, it was ok, although the lame ducks were beginning to squawk and I was starting to walk like an old cowboy again.

Day twenty. Walking mobility is pretty much back to normal, but I think I will wait a few more days and get a super supportive jockstrap before attempting something like running; quick or jarring motions still are not desirable. I still have to wear the boxer jocks as normal undergarments. The granulomas have shrunk a bit, but they still are at least as big as the last knuckle on my thumb. The equipment functions as modified, not designed, but care still must be taken not jostle things much. As I come out of the other side, my outlook is improving! The sack finally looks normal and not swollen or discolored.

Day twenty-two. I wore jeans for the first time since being cut.

Day twenty-three. Two milestones. 1. I jogged for 10 minutes for the first time in over three weeks and my nuts did not ache. Now they were strapped firmly up with a new jockstrap which was about as comfortable as an Everlast chastity belt, but it worked! 2. Today was the first day I did not wear a jockstrap for normal movement but only tighty-whities. Ah, life’s little pleasures, I feel ancient. I get excited about the first day of not wearing support undergarments, what is next, Metamucil? Boxers or swimsuits are still out of the question; I tried that for a while and got complaints from the fire sale family jewels. The “equipment” was a bit sore by the end of the day, but a successful pilot run!

Day twenty-eight. It is about time to end this diary, not much new to report. The situation is mostly functional, but not pre sterilization status. There is a hard to describe feeling with jarring motions. It really isn’t pain or pressure, a dull ache of “thereness”. It is not really painful, but not pleasant. More of a reminder that something happened down there and to back off whatever motion I am currently doing. The granulomas are reduced in size, one side more than the other. One side is the size of a peach pit, the other more like a fat almond, but they are not as hard or tender as before. The testicles seem to be no longer swollen. There is a small knot at the incision site. Warning: Mushy Stuff! I wrote and mailed my wife a letter thanking her for loving and supporting me through this.

Day twenty-nine. Today was odd. My wife told me a friend had a vasectomy today. My unthinking automatic response was a sincere and quiet “I am so sorry.” And it brought everything back again with a rush, not the physical pain, but the mental and emotional anguish. Our relationship is going well, we have enjoyed sex several times since my sterilization. At the moment, the emotional turmoil is separate from our sex life or marriage relationship. Rousing sex does not take away the void, although lack of sexual intimacy deepens and darkens the chasm; talking about it with her helps a lot. I am sad and angry. And what is really weird is that I am usually Mr. Level Headed (yes, you can verify this with my wife and friends). Thankfully, it wasn’t as bad as right after. I didn’t kick the dog mad, but a brooding Heathcliff sadness.

On day 29, these are my current feelings on the matter: I don’t have regrets per se, but I do not want to be sterile. It is a repugnant but necessary condition. It is like having a breast removed: you didn’t want to, you don’t want to be this way, you are frustrated there wasn’t another way, you don’t regret it, you just live with it, mourn the loss, you are determined to make the best of it, but it is no fun sometimes. Aron Ralston would understand. You did what was necessary and it sucks.

It is not something I would ask my wife to go through, and I am glad that it was me and not her who has had to deal with it because I would have felt very guilty if she had gone through something similar as a result of my persuasion. Yet I do not want her to feel guilty at all. It is done. But I still have to work through things. I find it impossible to have the loving selflessness of Della or Jim, but at least her hair would grow back.

The discussions at this level are almost only possible afterward, in the sobriety of the aftermath. The tensions of simultaneously not wanting to yet knowing that asking for what was presented to my wife as the alternative was an impossibility. Nevertheless, one of us not getting sterilized would have de facto killed our sex life and put a lot of strain on our marriage. Even unconsciously, the desire for sex on her part would have been quite depressed and I would have felt rejected because of it.

I feel sad, angry, frustrated, and somewhat betrayed by the medical community and even women as a group. The last one is harder to explain or defend, but the conversations my wife has with other wives go something like this, (Conspiratorially) “Has your husband gotten The Snip?” (giggle) (giggle) “Yes.” “Well, maybe your husband could go to lunch, talk to my husband, and convince him.” “You should probably wait until some more time has passed.” “Really? Ok.”

They both love their husbands. They do not have a “get back at men” vendetta, but there is a bias, not to seek information or understand the reluctance, but to persuade. My wife has participated in both sides of that conversation more than once. She would disagree with my conclusion but agree on the content (since she is my source). It is my Day 29 opinion, chronicled here and it is subject to change and chagrin as time moves on. And while I am stepping in it, men don’t giggle about this, we laugh in the manner which one attempts to make light of uncomfortable topics “–” what Laurence Gonzales would call gallows humour. Do women giggle when they discuss getting their tubes tied? No, they ruefully laugh about how chicken their husbands were.

Words to the wife: Listen and be devious in getting your husband to express himself. It is quite difficult, especially for non”–”expressive men, to talk about this stuff, and even more difficult to talk about it in a way that is not offensive to one party or the other. Do not minimize the turmoil, even the 10th time you discuss it or make light of it. Yet do not encourage dwelling on it. Gently inquire at appropriate times (NOT before/during sex or during a ball game), even long after, what he is feeling about the matter. What he says may ruffle your feathers.

Words to the men: We are tough, things like this don’t hurt us, we are Adonis – all women lust after our kouros-like bodies, anyone who is scared of a vasectomy is a pansy and if they complain of pain afterward they are just mamma’s boys anyway. I am One with Pain. That which does not kill me just makes me stronger. How ’bout them Bears! (Beat Chest, shoot large guns, scratch, belch, and reach for another beer) Well, when the peacock lowers his feathers and the strutting is over he has to live with what is left. Talking about it is hard when everyone is making their own antler scrapes.

Day thirty-five. My friend seems to be doing pretty well, at least for the first few days. I have not received any secondhand reports since day three and it is not a common male activity to ask the status of ones’ balls. He had more mobility and more natural mobility on day two than I had after three weeks. I have to say I am quite jealous. I guess I was just on the tail of the histogram, but let me tell you, the outer reaches of the probability curve is a scary place, those Black Swans are dispassionate, merciless, and hit hard. Being that 1 in X will make you devoutly wish you had read and heeded the fine print and not flirted through Probability and Statistics. Are you ready to roll the bones and put your ‘nads in the pot?

Day thirty-six. In a rare moment, I discussed some of these issues with the guys I have a weekly Bible study with. Our Wedding Tackle is not a frequent topic of conversation, but it was helpful to talk about the physical and emotional aftershocks with someone other than my wife. And they kept the took-my-dog-to-the-vet jokes to a minimum. They intrinsically could understand in ways that she couldn’t.

I am still astounded at how the emotional side of this jumped up, drug me into a back alley, and is ravishing me. I have done my fair share of adventurous activities in my life: jumped out of a perfectly good airplane, went scuba diving into a very cold and very dark lake, trekked in the Andes, ate ice cream in Red Square in January, saw the sunrise at 18000ft., played in hydraulics, rebuilt a 4×4, survived an armed robbery, played collegiate sports, landed on a grass strip in the Amazon, survived a wet night without protection at 3700m., sailed in regattas, traveled on top of trains, ridden in (and outside of) South American buses, romped in the Eifel Tower fountains, chased my future wife around the world, rocked climbed, went caving, have been caught between rioters and police (and teargas), shot iron sight rifle matches, learned other languages, backpacked, ran a marathon, drove on the open autobahn. But the empty place in my soul from a vasectomy was not what I was expecting.

Day Thirty-Nine. The weekend went well; still have the impulse to provide some “hand based support” when jogging quickly downstairs. I also noticed that I have picked up a habit of a penalty kick-esque pose while negotiating a room with active ankle biters. I wore tighty-whities most of the weekend and decided to stick with the jockstrap for now. Anything other than brand new briefs just don’t give the support which I evidently now need. It isn’t really painful, but not pleasant either. Pre-sterilization it would have been considered a gentle warning to watch whatever I was doing. I have been thinking about how to describe it, but the best I have yet is a damped dull knock on a heavy aluminum or pewter pot or a tiny deep thorn or puncture in your foot, not piercing but dull and flat. I noticed that in retracted “cold water state”, the scrotum is larger than normal and the lumps protrude forward. The sensation is nothing that requires pain medication or a visit to the doctor, BUT it is definitely not like it was beforehand. I have noticed that sexual, genital, gender, or virility related jokes, stories, or comments are just not funny anymore. When the kids ask about babies, as they are wont to do, I don’t hang around too long.

Day Forty-Nine. I just want to put this behind me, it is dragging me down. I am still a couple of squirts from my first test. I both dread hearing the official news and just want to get it over. Had a pleasant weekend; we went to a bed and breakfast together.

Day Fifty. I did some tooling around the web and find it intriguing from a detached POV how frequently men who wanted to be sterile and had an uncomplicated surgery speak/write with derision to and about those who did not have the same experience. Frequently some variation of: must have a poor self-image, wimp must be a moron who didn’t follow doctor’s instructions, just need some counseling, confused about his masculinity, dismissive, “that’s just anecdotal”, it’s in his head, etc. As a rule, I tend to avoid such trolls, but from reading the responses, it also seems difficult to have a constructive or civilized conversation. Why is it necessary for those who do not empathize to react condescendingly?

Day Fifty-Three. One of our friends is due in three weeks. I was at their house last night, looked at their ultrasound pics, and talked with them. Pregnant couples do have a glow. It is tough.

Day Fifty-Four. Had a constructive talk with my wife. Her support is essential. Constructive is probably the wrong word. The emotional aftershocks just won’t go away, they get less though. I feel like I am rehashing stuff we have already discussed. I guess the point is that it isn’t a discussion, but an expression of feelings. She catches herself now. She related a “humorous” story the other day after she came back from a kid’s party about other moms explaining to their kids (who wanted more siblings) that their “Daddy doesn’t work like a Daddy anymore.” There was this long uncomfortable pause in the telling of the story at the dinner table and a less than glamorous recovery as she realized it was impolite to talk with a mouth full of foot. “Out of the mouths of babes and sucklings.” Children are not meant to understand adult issues, but sometimes the lucid and cataract free eyes of a child help us to strip off the euphemistic veils with which we drape objects in our adult world.

Day Sixty Two. We just have to laugh at ourselves sometimes. It keeps us humble, earthy, and sane. Today was Jack-Off-While-Aiming-Into-Small-Plastic-Cup-Day, known in hiding-the-details medical parlance as “collect a specimen”. Who are they kidding? Definitely not the bubbly blond nurse telling me what to do. At least I can get my Jack Nicholson jollies by watching them squirm as they attempt to tell me what and how I need to go about this, and then later how often I need to have sex (as if I am in control of that). Then to accomplish this ignominy while the four-year-old pounds on the door. My loving wife was essential in the acquisition of this bit of fluid. Seeing I was unable to bring myself to set foot in the urologist’s office or hand either Grandma or Miss Bubbly a jar to peruse, she was also the courier service, and I waited all day like Lady Jane Grey to find out if it would be sterility or a postponement of sterility.

In spite of the large helping of humble pie consumed this morning, the urologist office called and stated that I still had “stuff swimming around in there” and to wait six more weeks before repeating my um specimen collection and in the meantime, you need to um, well, uh, someone did tell you what you need to do, um, frequently? So I guess I didn’t do enough of whatever she was insinuating that we should be doing. It has been nearly 9 weeks and 20+ squandered “specimens”. I just want this to be over. I want to find one of those special MIB “Neutralizing” pens and direct it upon myself. The more I can block the memory of this experience and its effects, the better off I will be. The additional six weeks just prolongs this vexatious commencement of the paracme of my virility.

Day Sixty-Three. Today is noteworthy because it was the first time I have had a positive feeling about the vasectomy. It waltzed into the room, had a beer, then mumbled something about needing to get a resupply of wings and left. Usually, the logic half of my brain is involved in a Sisyphean struggle with the emotional side. Previously the best it was able to do was to attempt to get Emotion into The Sleeper and hope to be able to hang on long enough to get it to pass out, then I could relax in a bit of a respite. Usually though, Logic ends up on the mat and the count climbs nearer to 10.

Day Seventy-One. Things have been going pretty well, except for two oddities. I was running around in the rain playing freeze tag with the munchkins in my bathing (not birthday) suit. It didn’t take too long fuer mein Hoden to start meckern about the rough treatment they were receiving. The bathing suit was evidently not providing enough support for their newly acquired sensibilities and they were touchy the rest of the evening. The next day I went jogging, and die Nuesse were strapped in like Michael Schumacher, when I got back the area around the incision was swollen, puffy, and red. Evidently, it had rubbed, somehow. This is a bit odd because it isn’t in a location that would lend itself to rubbing and the Hodensack was in the equivalent of a five-point harness. It wasn’t just red, but a nickel-sized area was swollen, pushed out and you could measure the volume of the localized swelling. Thankfully, the swelling went away by the end of the day.

Day Eighty-One. This past weekend was a grey one, for two reasons. One explained, one nebulous. The first one is that our friends had their baby this weekend. It is fun to hear reports from people who are excited about pregnancy and the birth of a new child, in spite of the difficulties and pain. It was a time of celebration when the party was over then the melancholy set in. Rationality has little to do with it. The other one is much less distinct. The conclusion that I have come to is that I am currently fragile; it doesn’t take much to poke through the armor. Irritations that normally would roll-off or where I would normally quickly find my even keel, pitch me into a rut, and put me into the doldrums. This is problematic enough, but it is a significant shift from my normal personality. With apologies to the ladies, the shoe is on the other foot, I am now the moody one, the one dishing out the silent treatment or quickly barking at the kids. Not all the time, but too often for my tastes, the standard operating colour is grey and it takes a frequently ineffective effort to change the hue. Previously if it was grey, there was a known reason, now it often is simply the default and I can feel it making me older. From a narrator’s perspective, it is peculiar to watch myself and have the same dreamlike impotence to alter a scene.

OTOH, this record is incomplete because an entry is made usually when the journey is at a peak or valley and mins and maxes do not completely describe the curve.

Day Ninety Four. One of my testicles has been throbbing for the last few days and is tender to the touch. Today while sitting quietly and minding my own business it all of the sudden felt like someone stuck it in a vise and started squeezing. This lasted about 10 seconds. This was not puke level pain, but enough that it would have stopped a conversation. Sigh. While flipping through my copy of How to Lie with Statistics it makes me wonder how frequently this kind of data is captured. Not just is the sample random and representative, but is the measuring tool the same? You have to cross a varying threshold before your typical man will acknowledge something is wrong and an even higher threshold before one will speak with a doctor about it. A case in point, I have no plans to discuss any of this with a doctor. Physical or emotional pain. What is he going to do? Show me my hurried scrawl on the consent form? We have very few options: Ibuprofen, steroids, or reversal. Alea iacta est. I just wish now for the other poor schmucks who will be persuaded to call the urologist, that the doctor would spend less time minimizing the issues.

Someone asked me the other night how it was going and my autopilot response was “It was the worst decision of my life.” You could feel the metal crunching and tearing as the conversation hit the wall. I was a bit surprised to hear myself. When my brain is providing a bit more logic to what falls out of my mouth, I do not know if I would take it that far, but it definitely is starting to fall into the bad decision column and not the “I just bought a boat today” or “I got into the wrong checkout line” kind of bad decision.

Day One Hundred and Four. Confession: I have been fighting feelings of resentment towards my wife. They are not very logical or mature, which just makes matters worse. I love her; it is not fair to her. The feelings make sex less attractive, her less desirable, and emotional intimacy more distant, all counterproductive results. It is nearly impossible to think about sex without dragging the sterilization along with it and sterilization is much more effective than a cold shower at killing an amorous mood. After awhile those gray feelings become associated with her. During sex, the vasectomy thought has to get compartmentalized and the active focus must not go near that compartment. I don’t know what to say to her when the subject rarely comes up. We generally don’t talk about it anymore, yet I think about it every day. I am into the “If you can’t say something nice then don’t say anything at all” phase. Yet that kind of attitude does wonders for pinching off an emotional connection.

My sterility is something I acknowledge, yet it produces feelings of emptiness, frustration, and sometimes anger. The thought that what life creating ability and anticipation I once had has been taken from me is life-sucking. P.D. James relates the ambiance quite well in Children of Men. Logic doesn’t apply. I can step back and see the why, the reasons 1, 2, 3, replay my verbal concession, and also acknowledge that given the circumstances few pieces of information or messengers would have been effective to stop the process. It still doesn’t change that I don’t want to be this way. It isn’t that the living room wall color now assaults my senses or I chose a honey baked ham instead of salt-cured; the feature in question is an integral characteristic of Who I Am. To add insult to injury, this kind of behavior is very atypical for me.

An interesting side note is that, if you don’t already understand what I am saying, you probably have no empathy. People who have walked in my moccasins “get it”; those who don’t, dismiss me as brooding chauvinist Neanderthal with pre-existing “postal” conditions. Doctors get offended. The distribution is bimodal. Additionally frustrating is that I can’t think of a way to communicate the aftermath effectively. I don’t think I would have paid attention to what I have written; my wife would not have even read it. My reaction would have been, “Nah, that won’t happen to me. I am not that way and plus bad medical things don’t happen to me. The internet seems to attract anecdotes like this. I am young, healthy, and don’t have issues.” The positive side is that 90% won’t end up like me, but it is a tragic day for the 10%.

Day One Hundred and Seven. Ok, I will try to do this without calling the harpies. One of my gonads has been tender for several days, as in an absentminded quick adjustment feels like you brushed a live wire. This has been a difficult last couple of days, but with an upbeat ending. I finished a 2-hour run after which is often a good time to talk; there is a mellowness and a clarity which is often present. She asked out of the blue, “Is everything OK? You have seemed distant in the last few days.” This opened the discussion about “that damn vasectomy”. She was able to voice some of her frustration with my attitude, responses, and slowness in moving on. I was able to articulate a bit more of my frustration with myself, the situation, and my sense of being wronged. She even offered to save up for a reversal. It cuts to see her cry over our spilt milk. I don’t know how to discuss this with her without wounding her and digging a larger pit which is easier to fall into in the future. Yet there is always this pressure release when we talk about it like you realized you had your sunglasses on while indoors and then took them off. I think the benefit goes both ways somehow. It is not just me talking, she explains her thoughts and feelings; barriers are removed. An obvious invocation of our wedding vows, this situation was definitely not on our minds when we made them. She asked what she could do, my response was to just love me, pray for me, listen and talk with me about it, and as much as possible to not take what I say personally. She is responding so much better than I would if the roles were reversed.

The next day we went to a party and I overheard a bit of conversation which was simply not meant for male consumption. I was loading my plate up at the food table like any self-respecting guy and idly monitoring the kids to make sure a trip to the emergency room would not be in our future. There was a group of women sitting near the food watching their husbands play with the children in the pool and somehow the discussion turned so that the conversation went similar to this: (whisper) “Charlie is fixed. (loud laughter from a group) So I couldn’t be pregnant.” (giggle from the speaker) Then another lady affirming “Bob is (loud whisper) fixed, so we couldn’t get pregnant either” (loud laughter from the entire group). I decided it would be best to just move on before I heard my name mentioned in the roll call by a Proud Wife of a Fixed Husband.

That set me back a bit. It just seemed so crass, insensitive, even a bit victorious and so oblivious. Of all of the stereotypes of men’s crude conversations about women, at least with the men I hang out with, I can not imagine a similar conversation. I don’t think any of their husbands would refer to “getting their wife fixed” much less follow that statement with a laugh. Well, I decided that instead of letting the pressure build I would discuss my feelings with my wife; I would attempt to use this coarsely woven and preciously won the tenacious line of communication we were working together on. A rocky and animated discussion ensued. She was able to present to me her perspective of the conversation, one which is probably more likely, at least consciously, and I tried to get her to understand that a conversation which includes “My husband is fixed (laughter)” upon reflection should reveal, if not overt, at least subconscious feelings on the subject at hand by the participants. And no, she did not mention me in the ignoble roll call of Fixed Husbands. We were on the way to a class, so I played hookey and spent the next two hours effectively rubbing a hole in my foot with my Birkenstocks, thinking, and praying.

After the class which didn’t get much of her attention, I asked her forgiveness for how I handled the conversation. We talked for quite a while. She pointed out to me my hypersensitivities; I acknowledged it and explained to her my reasons why. There seems to be quite a bit of animosity built up against those who encouraged my sterilization, from the midwife, the urologist, my wife herself to her friends who said it was “no big deal, do you want a doctor’s number? (giggle)” Amazingly enough, she said she understands – now – and regrets. She asks why didn’t I tell her before? I don’t really know how to answer that question. My response goes from an exasperated hand waving Holy Freaking Cow! didn’t I. For years even? to how could not want to be sterile be something which is not intuitively obvious, especially to a woman? I wouldn’t have been able to explain this in such detail or passion without having experienced it and spending hours attempting to articulate it. The animosity part is hard because I see a part of me that wants to push hard enough so that she feels some of my pain. Consciously I don’t want that, but my actions speak otherwise. It shows all kinds of flaws in my character.

For those who dismiss me as an anomalous nutcase, “everyone I know of had no trouble at all”. I probably am, but be careful that your sample is representative. I can assure you, that unless you asked directly, were a close friend and the circumstances were right, you would have no clue what is happening to me. Men simply do not talk about this stuff. This portion of your data universe is intentionally silent, yet your vasectomy puzzle is not complete without it.

I think this is a gaping hole in the “ask a doctor’s experience” methodology of gauging satisfaction or problems with sterilization. The doctor is giving you his feedback from a population that doesn’t go to see doctors anyway, doesn’t talk about things like sterilization unless absolutely necessary, and furthermore as a group has a very difficult time admitting sexual or emotional problems. The doctor simply is not getting representative feedback and therefore cannot include it in his experience. He has a myopic view.

Additionally, the question has some similarities to asking him to describe his medical mistakes. Vasectomy problems do not necessarily mean medical mistakes, but you are asking them to describe when something went wrong with one of their patients and the impact upon someone’s life which was screwed up because of a procedure they performed and recommended, and that is a difficult question for any even the most saintly. This is an acknowledgment, not an indictment.

This chapter does have a happy ending. We talked mostly calmly for quite a while and listened to each other. We spent the rest of the evening talking, giving, and receiving massages. This vasectomy has brought us greater intimacy, but oh, how it has been expensive. For now, the demons have been exorcised, it frustrates me to know they shall return. The incantations which conjure them are legion, but hopefully, we will be better prepared for them each time. I am walking a gusty and jutting mountain ridge hoping that it will widen into a plateau.

Day One Hundred and Nine. Just so I am not always chronicling my days when they are overcast. Although the touchy gonad is getting old, the last few days have been a relief. I must say I have not been manically extolling the virtues of a vasectomy, but at least I the last few days have been mostly un-grey a welcome relief. Regular love-making goes a long way in maintaining an even keel and not just in a “get my rocks off” (as I am technically incapable of doing that now and one is throbbing anyway) concept but in nurturing the emotional connection. I think this is the best I can hope for: a tacit and absentminded acknowledgment.

Day One Hundred and Ten. Balls just wanted to ache today; one of them has been consistently sensitive for the last two weeks or so, but today is the worst since about a month after my sterilization. I can be sitting in a chair not moving a muscle and then it feels like someone randomly gives them a nasty sharp squeeze and this happens several times an hour and lasts from a few seconds to a minute. They also feel swollen. While riding a bike today, they just seemed to be in the way and touchy. They do not appreciate their gravid but corked state.

Day One Hundred Fifteen. The Family Baubles do not ache as they have for the past several weeks. The swelling has gone down, but the granulomas in the scrotum have grown and one of them has an additional harder knot the size of a garbanzo which is new. Sometimes I feel like I am living out the immortal words of Socrates who said, “I drank What!?” How could I be stupid enough to be convinced to drink the kool-aid? I ineffectually get angry at myself as my eyes dim and my limbs grow numb. How could I allow myself to get into this irrevocable state?

Heloise had a tomcat. It was a large and furry tomcat. It would often bump her hand to get petted and alter his path for a quick rub against her bare leg on his way past with a pert flick of his upright tail. He was careful not to spray in the house, didn’t do much caterwauling, and stuck around her instead of prowling the neighborhood. One day Heloise decided to fix her cat, Abe Lard. That is what you should do when he gets this age, right? The vet said it was a good thing, all her cat friends said they did the same with their cats. Heloise’s cat lounges on the window sill quite a bit more now, tail over the edge of the sill, tip in perpetual motion. He mopes when she is not there to pet him. Abe bumps his head into her hand more often and is frequently underfoot, but now half the time when she reaches down to pet him her hand meets a moving mass of claws and teeth.

I laugh in my general direction.

Day One Hundred Thirty-Seven. It has been about three weeks since my last confession, in this case, longer is better. I did a seventeen-mile run. I wore my usual boxer jocks compression shorts. I know fatigue plays a part in my response, but when I stripped for a shower, I nearly sat down and cried my balls hurt so much. I really hadn’t noticed that specific pain until then. They were painfully sensitive to the slightest touch. This was worse than after the sterilization. Oh, did I say it was bad? Let me repeat. It was bad.

Thankfully, a stiff dose of ibuprofen and a night’s sleep brought everything down to a level where I didn’t have to walk triangle-legged the next day. I was able to pass it off to the uninitiated that “my legs were sore”. They weren’t; my balls hurt so badly that for several hours afterward I could not sit normally and had to sit on the edge of the chair to keep my sack from resting on a hard surface. I think an assault and battery charge would have resulted if someone had stood in front of me and proffered the BS that there are no side effects from this “minor snip”. As for the practical side of things, it appears that I will have to wear two athletic supporters to obtain the support I need to resume my active lifestyle. At least I hope that works, I don’t know what to do next except to give up that part of my life and those dreams, as meager as they are.

Day One Hundred and Eighty. I was about to report a pain free couple of weeks, but one of my testicles has started to become sensitive again. It is like having a bruise or smashed thumb. Normally you don’t notice it that much, but its noticeability is dependant upon the vigor of the movement, jogging downstairs, flopping into a chair, and unfortunately, intercourse. It is not bad enough to preclude intercourse, but enough to be disruptive to the most important sex organ, the mind.

Thankfully the “double supporter” method seems to work well enough to allow me to play sports again. It is not comfortable, but is much better than the alternative and has become a necessary piece of equipment. Spontaneously making a few layups with the kids between the car and the house on the way home from work is no longer possible; I now have to get appropriately dressed for the event.

Unfortunately, the state of events has not had a positive effect upon my emotional intimacy with my wife. She no longer asks. I don’t tell. What else is there to say which hasn’t been said already? There is a scar developing between us. I can only look at myself for the cause, yet vivisection is much more easily said than accomplished. This is compounded by every time we are physically intimate there is a physically painful reminder. Intercourse is sometimes uncomfortable or painful. Added to that is a Catch-22 even Yossarian would respect. I am sterile because of the desire to have sex, yet sex is frustratingly undesirable because of the cloud which now envelopes it. If there weren’t enough male hormones to singularly drive it forward, it wouldn’t happen. The person I most want to be intimate with is also identified with the melancholy of it all. Not everyone has this dilemma, but I do.

Day One Hundred Eighty-Nine. Did the empty deed with chagrin and submitted a sample for perusal today. It confirmed I am sterile. I need to submit another in a few weeks. Ever been in a situation when you know something is true, but you struggle to avoid hearing it officially confirmed?

As if to underscore the scaring, it took her three days before she offhandedly remembered to ask about what the results of the test were, in my melancholy I never offered to tell.

Day One Hundred Ninety-Six. We had another several hours of quiet talk. The “lack of life in your eyes” is wearing her thin; it just hasn’t come back on since I waddled out of surgery, your “spark (snap fingers) is gone”. I am finding out that, it will take a lot of long-term grunge work and focus to have that as a more permanent feature of my visage. But I shall, because this sucks. For what it is worth, she completely regrets the decision we made.

Day Two Hundred Six. As usual, the situation has gotten better after our talk. We both have been actively working on issues arising from the “damn vasectomy”. I have been working to actively suppress thinking about it, which hasn’t been easy since discomfort during intercourse has become more commonplace. But I have been fairly successful and the results have been encouraging to both of us.

Day Two Hundred Twelve. While making an “adjustment”, it came to my attention that on one side there is a very hard knot slightly smaller than a marble attached to a “stick” which is also hard. Think marble-sized lollipop on a short stick. It is not painful, but I had not noticed it like that before. I do not feel it on the other side. I assume this is part of the scaring and the body walling off the injury and metal clip.

Day Two Hundred Sixteen. I was woken up last night with sharp twinges of pain in one of my testicles. It continued for about a minute before diminishing. The occasional pulsing pain has continued into the day. When the pain comes, it is quite sharp. This is similar to what has happened at least twice before and usually lasts a few weeks before it goes into remission.

Day Two Hundred Twenty Four. I euphemistically “collected a specimen for the last time” today. Why can’t you just use a condom? It is not like they are checking for motility. Anyway, I am sure glad the “collect a specimen” time is over, I did not look forward to it. The lady at the doctor’s office called today with a twinkle in her voice to tell me I am now confirmed to be sterile. I told her that I did not consider my case to be in the success column and it was the most devastating decision my wife and I had ever made. We talked a bit. Hopefully, I now can begin to forget and can move out of my Children of Menworld.

Consummatum est.

The Humor

There was an entertaining situation where the grey-haired female nurse was given the task of giving me the generic advertisement brochure on vasectomy, two specimen cups, and then tried to indicate to me that I needed to masturbate and submit samples after the surgery. There was a decided air like my mom or grandmother was trying to tell me to masturbate. She was not comfortable with the situation, neither was I, but it was amusing and my wife thought it was funny when I told her later.

The Synopsis

1. On the whole, a root canal would probably be initially physically more painful. But the initial pain is never the primary issue; a root canal would have healed much more quickly, had a shorter recovery period, fewer recurring issues, and not have had emotional and relational ramifications.

2. The prescription pain medication was not really necessary. Tylenol would have done the trick, but Tylenol will not make you pre-surgery functional. Just because you don’t need heavy drugs doesn’t mean it isn’t painful and unpleasant.

3. I believe there is pressure and a bias for men to do this rather than a dispassionate presentation of birth control options. Additionally, the presentations do not adequately discuss orchialgia nor do they adequately address the emotional impact and instead treat it inappropriately like a wisdom tooth extraction or getting a wart burned off.

4. A vasectomy is not simply clamping an unused hose. The pipe is capped but the pump is not shut off. The Combined Gas Law still applies.

5. I would not recommend it or discourage it to a couple; it is a deeply personal decision you need to make together. It may be perfect for your situation. For us, it was a far bigger experience than we anticipated and definitely not something which is over in a few days or even weeks. The physical and emotional consequences can last a long time or even return.

6. A vasectomy terminates the primary biological purpose of your sexual organs, rendering you permanently sterile; it involves cutting on, removing, and altering the function of a part of your body which is delicate physically, symbolically, and emotionally.

7. While reading official literature on vasectomy, be aware you are reading an infomercial. Its purpose is to persuasively inform. You have to find the “Consumer Reports” information yourself. Caveat emptor.

8. Approx. 1 man out of 100 will have life-altering complications as a result of a vasectomy. It seems impossible to determine if you are in an elevated risk group before the procedure and the bones will have been rolled. 1 out of 3 will have some kind of pain after the initial healing process which they did not have in their pre-vasectomy life.

9. Do not just talk to couples who had a vasectomy, also talk to couples who decided not to have a vasectomy. Some people who get sterilized love it, others suffer because of it, others decide not to. When making your decision, do not just investigate the first group. It is well worth the risk of being in the third group to avoid being in the second group. Your doctor never sees the third group and only the worst of the second.

10. Do not fantasize that this is a method of increasing the frequency of your sex life. The unvarnished reality of the situation is that a year after you get cut she will be just as tired and distracted after working or dealing with the kids as she is now. No matter what the insinuations are, it is not an aphrodisiac.

11. Sexuality is not something to be trifled with. I have much more respect for it than before. It is truly serious business. You may think you are prepared to take the physical and emotional risks, but you are not prepared for the consequences if your number comes up.

12. If you have physical problems as a result of a vasectomy, say pain during intercourse, or simply “touchy balls”, the side effects will only start there. The more critical ones will follow. The physical side effects eventually will affect you emotionally and have negative effects on your most important relationship.

The Tips

1. Exercise hard beforehand. Under Armour boxer jocks or similar. A loving wife who will put up with you and support you through both the physical and emotional effects.

2. Do not underestimate the emotional fallout. It is a cunning and frightful beast. Be aware the emotional beast may not strike you, but your wife.

3. Expect to move like an old cowboy for (at least) a week and for random periods of time after that.

4. Women: your man is not just worried about the pain of receiving the initial injury of surgery, but is additionally worried about the injury done to a part of his body for which you do not have a physical or emotional counterpart and what longer-term consequences it will have for him. He is not just being a wuss similar to not wanting to give blood, get a shot, or go to the dentist. You are asking him to allow someone takes a knife to an intimate part of his body which he has spent considerable effort protecting since he figured out he didn’t look like his sister, which is integral in activities he thinks about more often than you would want to know, which he has verbally preened and strutted over with others of his gender, which is physically extremely sensitive and delicate and are actively involved during intercourse, are necessary for the biological reason he exists and which symbolizes his differences from you. To refer to this as “a Little Snip” is so diametrically opposed to reality and so contrary to his point of view they are offensive. Short version: if you have referred to this as “A Little Snip” you do not understand your man as well as you thought you did.

5. Both of you do thorough research on all options. Share sources so you will have read the same things. This must not be another “Battle of the Sexes”.

6. Never consider sterilization while under any sort of duress. Unfortunately, this is an impossible condition. A corollary, do NOT get sterilized unless you came up with the idea by yourself and liked it. E.g. the word vasectomy did not come out of her mouth until after the concept of Sterility has seductively sashayed through your head, you made eye contact, you walked across the room, you planted a kiss on Sterility’s lips and the words “’til death do us part” make you tingle with anticipation. The courtship must be long and amorous, and you must with desire look at Sterility unadorned the morning after the consummation – and every other morning and evening for the rest of your life. The corollary, as a general rule (of course there are exceptions), whoever suggests sterilization first should be the one to get sterilized. This should be a standard filter question in every doctor’s office. The corollary, if you find yourself in a position such that one is working on convincing the other, do not concede. You are the high-risk group. You both will regret it.

7. Discuss your sex life and sterilization with your wife thoroughly, repeatedly, with mutual understanding, over a long period of time, and without an agenda. If you accomplish this, try walking on water, you might surprise yourself. Understand and accept the processes which your body will go through to compensate for the injury of vasectomy. Look at the risks you are taking in the eye and invite them into your bedroom and home because that is where they will reside. Remember, someone just like you was that 1 in X.

8. Find a doctor who performs lots of them, frequently does the method you chose, and will treat your nuts like they were his and not an appointment before his tee time. Meditate on this thought: a vasectomy is not a root canal, it is not an appendectomy; it is sterilization.

The (not so) Deep Thoughts A statement like “being young is a state of mind” is noticeable because of its incongruity. It is wordplay. The fundamental definition of ‘young’ deals with the number of years since birth, not vivaciousness. Here is another one for all those anal-retentive balderdash lovers: Strictly speaking the word “virility” does indeed have a procreation aspect. Rather than trying to bend the definition to what you would like the word to mean and since you will doubt me, go look virility up on 3 of the 6 dictionary sources, specifically mention procreation. All of them have potency or “ability to perform the function of a male in copulation”. So the next time someone blithely states that a vasectomy does not affect virility, remember the Spaniard, “You keep using that word. I do not think it means what you think it means”. They are narrowing the standard definition of the word to something which suits them better. I guess that if American presidents do it, then others will try it too, but at least they should be aware of the reputation of the company that they keep.

And while we have the dusty dictionary out, check out the word “impotent”. The word has several definitions but there are two specific definitions that apply directly in our case. One is “Incapable of sexual intercourse, often because of an inability to achieve or sustain an erection.” But there is another part of that definition: “Sterile. Used of males.” and “Want of procreative power; inability to copulate, or beget children; also, sometimes, sterility; barrenness.” (Webster’s Revised Unabridged Dictionary) So you tell me. Is this a completely true statement? “Vasectomy does not make you impotent.”

A vasectomy is “birth control” only in a public policy sense. To the pig, bacon is not a commoditized breakfast food. For the individual, a vasectomy is not birth control; it is personal sterilization. It is control like the “control” Alex has over violence because of the Ludovico technique in A Clockwork Orange. The ability has been removed. The individual no longer has “control” over conception; he now has an inability to conceive.

Doctors who promote a specific medical treatment with an intent to persuade instead of educating should have their medical license revoked. Titles like “Attracting men to Vasectomy” or “Operations research on promoting vasectomy in three Latin American countries” and articles that didn’t have such an obvious title but should have were not hard to find. This is an ethical travesty that makes it difficult for the individual to make informed and free medical decisions. As a rule, surgery should be last on the list of treatments.

A note to the women who may be reading (and your husband thanks you, I wish my wife had done what you are doing), if your man does have a vasectomy for you, be excited, be happy, empathize, and might I say, be thankful past the frissons of the first 2 weeks. Quid pro quo is going a bit too far, but to get sterilized and then have a declining or stagnated sex life would be frustrating and futile. The whole purpose of birth control is, well, to have hot recreational sex! So if frequent recreational sex is not something you are excited about or if you find that you spend effort trying to get out of sex rather than trying hop in the sack, don’t work on him to get a vasectomy. The sex life your spouse has with you is the only legitimate one they have, what are you doing to make it the best one possible?! this goes both ways? (Charla Muller at least gets that part right.) Please remember this and use it as an opportunity to increase intimacy (not just sexual) and have fewer “headaches”, even years later. And yes, this was meant in the best loving-husband-horny-for-only-you-remember-why-you-had-the-hots-for-me-and-married-me-male-chauvinist-pig way. 😀

A bit of philosophical and incomplete introspection is in order on the male response of “Congratulations!”, a hearty handshake, and backslapping to a pregnancy announcement. The act is multifaceted. It is a celebration of life, of the creation of life, of the pleasure and allure of Sex, of Fatherhood, of a successful seduction, of having a partnership with your spouse in a project whose outcome will last long after you both are dead. It is a public affirmation of your mutual love, your masculinity, virility, sexual potency and prowess, ability to attract and keep a mate, and physical and emotional intimacy with your spouse. An open acknowledgment that your biological genes will continue, that she wanted you to have sexual intercourse with her, that she chose you to make babies with her. In other words, “you da man”. This is not the only role of a Man but is a role of a Man and only a Man can perform it. Although not sufficient, a Man is necessary. In this socially important ritual, another male in the community is acknowledging and affirming this and more. In juxtaposition, walk up to your buddy and say, “I am sterile.”

Submitted by “Ganymedes”

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  1. Thank you so much for taking the time to write this and sharing. I am so sorry to hear how much you have suffered physically and emotionally from having a vasectomy.

    I am reading your review from the female perspective, having supported my husband through his vasectomy a year ago. He was not in as much discomfort as you and appears emotionally resilient to the procedure. I, on the other hand, feel like I have been hit hard by the emotional impact of my husband now being sterile. I clearly did not think this through and should have tried harder to dissuade him but I assumed he wanted it and knew what he was doing. I feel I have been in a state of grief now since the procedure and his sterility has proven a big turn off. Which sort of defeats the point.

    Reading your review has made me understand I need to talk to him about this but I have been so worried about upsetting him that I have avoided bringing up the subject. I really admire how open you and your wife are and wish I had that emotional intimacy in my relationship. What an awful surprise this vasectomy has been on our marriage of 10 years. Writing from the UK it appears things aren’t that different on the other side of the pond! But, thank you! You have made me understand my feelings are legitimate and important and given me the confidence to approach my husband about the subject.


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