I'm Dr. Ranjith Ramasamy, the Director of Reproductive Urology at the University of Miami. I'm here today to answer any questions you have about vasectomies. Ask me anything!

Submitted by ramasamymd t3_1139szh in IAmA

I am Dr. Ranjith Ramasamy, a urologist specializing in vasectomies and male reproductive health. As the Director of Reproductive Urology at the University of Miami, I have extensive experience in performing and counseling patients on vasectomies. I am here today to answer any questions you may have about this procedure. Whether you're considering a vasectomy, or simply want to learn more about it, I am here to help. So, feel free to ask me anything!

Proof: Here's my proof!

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Gutterghoul t1_j8oxkun wrote

I got my snipitty snip snip just two weeks ago. Does it really take 30 cannon fires and 90 days for all sailors to abandon ship? What makes them so stubborn/resilient?

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starwarsyeah t1_j8ryzr1 wrote

Got mine back in November, just did the semen test - still have dead sperm in there. No live ones, but they recommend continuing alternative birth control until NO sperm are present. I have FAR exceeded the suggested 30 cannon fires. Upon finding the dead sperm, they advised that I retest in a few weeks and increase my ejaculations in the meantime. Guess I'm going to twice a day.

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uncre8tv t1_j8q90ne wrote

30 in 90 days... man I'd be a different person. Microdosing no-fap. Can't even imagine it as someone who ...tends to things... at minimum twice a day.
I understand there would be tenderness and you really wouldn't want to irritate it for several days. But by week 1 I'd be looking at the least tugging options to get the job done. I remember I once went camping with family. Didn't clean the pipes for like 5 days. The night I got home I took the longest shower of any young mans life. Probably clogged a main drain somewhere. Didn't consume anything but Gatorade and Protien bars for the next 12 hours. It was an event. Doing that to my body for three months.. I'd be fucked, I'd be changed. I would probably have healthier relationships and less ruthless associates. As it is I can only hang with people who live on their own knife's edge. Maybe it's internalized bullying, maybe it's unresolved anger, maybe it's a fight in the guys head between what he know is real and what he wants to believe. But all my friends are fucked in the head too. Probably not from fap addition though. I don't rightly know.

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streim21 t1_j8p2hxa wrote

Once or twice a year I see news articles about research into alternative male contraceptives such as oral contraceptives, "birth control gel" or something else. In your opinion, are there any promising alternatives / advancements we could see being widely used in the next 5-10 years?

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ramasamymd OP t1_j8p35hi wrote

Oral contraception for men, also known as a male contraceptive pill, is still in the experimental stage and not yet widely available. There have been many efforts to develop male oral contraceptive pills that can suppress sperm production, but they are often met with an undesirable, yet prevailing, problem: testis shrinkage. While there have been reports of a potential hormonal oral pill for men, they still come with many side effects such as weight gain and loss of sex drive. A study published yesterday was proven in animals https://www.nature.com/articles/s41467-023-36119-6 but unsure how effective it will be in humans since it is short-acting

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Lanky_Relationship28 t1_j8qzhru wrote

The side effects for hormonal pills are just the same for women, why are this side effects considered acceptable for women but not for men?

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HungerMadra t1_j8rxeyu wrote

Because most female contraceptives were passed before modern safety standards were a thing and wouldn't pass today but are grandfathered in

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TylerJWhit t1_j8oxt60 wrote

Do you have any idea the physical toll, that three vasectomies have on a person?

Serious note:

  1. In your experience, is there any significant misinformation as it pertains to vasectomies that you would like to clear up?

  2. Are there substantial health benefits to vasectomies beyond birth control? Risks?

  3. Do you notice a pervasive gender inequality as it pertains to contraceptive decision making and medical research?

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ramasamymd OP t1_j8p0zu7 wrote

In general, a vasectomy is a form of birth control that prevents the release of sperm during ejaculation by cutting or blocking the vas deferens tube. This procedure does not affect a man's ability to have an erection or orgasm. Another misconception is that the procedure will decrease testosterone levels. However, since testosterone is transported through the bloodstream rather than the vas deferens, a vasectomy should not affect testosterone levels.

There are no substantial benefits to vasectomy beyond birth control.

The risks of vasectomy can include:
Bleeding or a blood clot (hematoma) inside the scrotum, blood in the semen, bruising of the scrotum, infection of the surgery site, mild pain or discomfort, swelling, and delayed complications such as chronic pain or sperm granuloma.
Discomfort, bruising, and swelling after surgery that usually goes away within two weeks, hematoma, bleeding under the skin that can lead to painful swelling, and infection that may require medical attention.
Pain, soreness for a few days after the procedure, and other rare complications such as infection, bleeding, and inflammation.
It is important to note that serious complications from vasectomy are rare, and most men do not experience significant side effects. However, any procedure involving surgery carries some level of risk, and it is essential to discuss the potential risks and benefits of vasectomy with a healthcare provider before making a decision.

https://theconversation.com/500k-american-men-get-vasectomies-every-year-a-specialist-explains-the-easy-and-reversible-procedure-186984

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OmenVi t1_j8rkips wrote

I had aching during orgasm for years after my vasectomy, as well as regularly frequent torsions after the procedure. After deciding we wanted more kids, I’d had a reversal, and both of these things went away. Is that normal?

Now at 5 kids, we’re definitely done. Are the risks you listed any higher chance on a second vasectomy? Is there anything I can tell the urologist to be aware of regarding the issues I had the first time?

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BigODetroit t1_j8pd4ap wrote

Had a vasectomy almost a year ago. The volume of ejaculate has gone down significantly and I believe my testicles have decreased in size. Is this all in my head?

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Hohlraum t1_j8phl4n wrote

My urologist told me that if I experienced anything like what you just described that I should contact them.

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yobboman t1_j8pstfl wrote

My libido dropped dramatically after mine

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Trpdoc t1_j8qamyr wrote

Why the hell are you guys getting this

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calllery t1_j8qdxp8 wrote

Because they don't want kids.

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Trpdoc t1_j8qjfuy wrote

Pretty low risk tho with ordinary means

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MrBohannan t1_j8xkehf wrote

All in your head. Sperm makes up around 10% of your total ejaculate volume and 70% seminal vesicles, 20% prostate. Average volume is around 5cc (tsp) but varies on person and length of time between ejaculating.

Source: Uro provider, I do this for a living.

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Mdly68 t1_j8ukbjz wrote

I believe sperm is less than 1% of ejaculate, most of the fluid comes from your prostate.

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asetupfortruth t1_j8pr7vg wrote

I got snipped about five months ago, and I still get reoccurring bruises on my sack from internal bleeding. My doc told me that as long as they're not painful it's fine, but I can't help but feel that internal bleeding- even a little bit- isn't healthy. Thoughts?

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ramasamymd OP t1_j9p70ni wrote

>I got snipped about five months ago, and I still get reoccurring bruises on my sack from internal bleeding. My doc told me that as long as they're not painful it's fine, but I can't help but feel that internal bleeding- even a little bit- isn't healthy. Thoughts?

It is not uncommon to experience some bruising and swelling after a vasectomy, but it is unusual for these symptoms to persist for five months after the procedure. It is also concerning that you are experiencing reoccurring bruises on your scrotum. In the meantime, you may take steps to reduce the risk of further injury or irritation to the affected area. This may include wearing supportive underwear, avoiding activities that put pressure on your scrotum, and applying ice to the area to reduce swelling and discomfort.

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tagwords t1_j8owpal wrote

How successful are reversals?

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ramasamymd OP t1_j8oydot wrote

the success of a vasectomy reversal can vary based on various factors such as the experience of the surgeon, the technique used, and the specific circumstances of the patient. However, with proper surgical techniques, the success rate can be high. It is best to consult with a qualified medical professional for an individual assessment of your specific case. https://pubmed.ncbi.nlm.nih.gov/21716894/

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OmenVi t1_j8rk2y9 wrote

Like the other reply to you, I also had a successful reversal, and added 2 kids. I had to go to a specialist urologist who’s been doing it for a while. Recovery was faster than the vasectomy. Cost was ~$5k out of my own pocket; I had an ancient IRA with about that in it, so I took the penalty and withdrew. The place I went through said if they couldn’t get a success out of the procedure, they’d refund everything accept $600, so we could pursue other options for having kids. If you’re in or near MN, and want to know more about where and who, dm me.

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LilyWhitesN17 t1_j8poh98 wrote

2 kids later, it was a huge success. However, I did have to see a specialist.

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Mrs-O-Meurs t1_j8q6mxx wrote

I've had 9 pregnancies 7 miscarriages. One success and currently pregnant. I'm sure this is going to be my 7th miscarriage in a row cos I'm already bleeding. I'm exhausted and in pain and 40 yrs old. I'm done but my husband doesn't want a vasectomy. Any tips to get him over the line?

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Racechick20 t1_j8s3r8p wrote

Go get the pre-op for your tubal ligation.

After my spouse heard what it all entailed and how long I'd be down, he took one for the team and got it done.

However, he's a science/reason guy. I don't want to read into your situation, but my husband would take a little pain to keep me out of a lot of it.

There's also the option where you don't consent to sex.

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VoxClarus t1_j9lkrve wrote

Yeah. I get that there's no context here, but it seems like 10 painful pregnancies don't indicate a lot of respect for her wellbeing. Time to buy some condoms. Or pills. Or an IUD. Literally anything has to be better than that?

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Drunk_Histories t1_j9hx7go wrote

His body, his choice. Your body, your choice. Abstain from sex OR tell him to put a condom on. Least amount of effort for everyone, though I promise you he won't do that condom shit for very long.

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Reader532 t1_j8oy881 wrote

~15 years ago, there was research that there was a link between vasectomies and aphasia/dementia.

What is the current theory about this link?

https://www.webmd.com/men/news/20070222/study-suggests-vasectomy-dementia-link

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ramasamymd OP t1_j8ozl66 wrote

One study conducted by researchers at Northwestern University found that men with PPA were more likely to have undergone vasectomy than cognitively normal men of the same age, with 40% of men with PPA having had a vasectomy compared to 16% of others. However, it's important to note that this study only showed a correlation and not causation. Further research is needed to determine whether there is a causal relationship between vasectomy and PPA or other forms of dementia. It's also worth mentioning that the vast majority of men who have undergone a vasectomy do not experience any negative effects on their cognitive abilities.

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Reader532 t1_j8p19vp wrote

It's .. irksome that after 15 years, this is still filed under "needs more research." Aphasia and PPA are no joke.

My father had severe aphasia in his final years, and this link was enough for me to deny having a vasectomy years ago.

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ramasamymd OP t1_j8p2ob1 wrote

Unfortunately, negative studies (studies that do not show an association) do not get published due to publication bias. I am confident that it was a statistical association without a biological explanation.

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Obi_Vayne_Kenobi t1_j8r1ewr wrote

That's a very weird way to do the statistics on this. Only few men get PPA and only very few men get a vasectomy. How do the numbers look like when we're instead asking "how high is the chance for a man who hasn't got a vasectomy to get aphasia, and how high is the chance for a man who has?"

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VoxClarus t1_j8ozcxt wrote

There are (rare) chronic pain complications involved with vasectomies, but when looking into this as a layman it's not clear at all how much of a concern this should be to men considering the surgery. Cleveland and Mayo Clinic present it as kind of a medical mystery and both suggest it's difficult to treat. And yet they both also note that it's *extremely* unlikely to develop.

I'm wondering about your general sense of the issue: Is it something you see being seriously studied? Would it cause you to hesitate in receiving or recommending the procedure or is it more of a "cost of doing business" kind of outcome?

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ramasamymd OP t1_j8p1a0f wrote

Post-vasectomy pain syndrome (PVPS) is a possible complication of a vasectomy that involves chronic pain in one or both testicles that persists for three or more months after the procedure. PVPS is a rare complication, and the risk of developing PVPS after a vasectomy is low. The pain can range from a rare, dull ache to sharp, constant pain that can interfere with daily life. Possible treatments for PVPS include medication, a vasectomy reversal, or surgery to remove the epididymis or the spermatic cord, although these options may not always be effective

https://pubmed.ncbi.nlm.nih.gov/28725617/

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ramasamymd OP t1_j8p1rtk wrote

post-vasectomy pain syndrome (PVPS) is a possible complication of a vasectomy that involves chronic pain in one or both testicles that persists for three or more months after the procedure. PVPS is a rare complication, and the risk of developing PVPS after a vasectomy is low. The pain can range from a rare, dull ache to sharp, constant pain that can interfere with daily life. Possible treatments for PVPS include medication, a vasectomy reversal, or surgery to remove the epididymis or the spermatic cord, although these options may not always be effective.

https://pubmed.ncbi.nlm.nih.gov/28725617/

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CattleAndLoveplay t1_j96pzr5 wrote

This should be higher up and have better visibility. A relative of mine had the procedure and developed severe chronic pain. His pain was minimized and hand-waved by doctors and relatives, and it was just generally shitty to watch him go through that. There are always risks and complications when it comes to surgery, I’m not sure I’d be willing to take a 1 in 1000 or greater chance of developing a complication like that instead of using other contraceptive methods in conjunction with birth control if my partner can be on it.

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VoxClarus t1_j9lka6c wrote

This is the exact debate I'm having. I want to take the lead on this because I know I never want children and don't want to ask future partners to bear the burden of it, but some of the chronic pain stories are debilitating.

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Free2fu-q-up t1_j8owt9p wrote

What are the chances of the V not taking and a pregnancy slipping through?

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ramasamymd OP t1_j8p0anj wrote

According to the sources, the failure rate for vasectomies is very low, with only one to two in 1,000 men experiencing a failed vasectomy. However, in rare cases, a vasectomy can fail if the doctor misses the vas deferens during the procedure, and the tube can regrow, though this is very uncommon. Another possible cause of failure is having sex too soon after the surgery, without using an alternate form of birth control.

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BuenosDias8 t1_j8p0ecb wrote

How long does a vasectomy take, and how soon after can one resume sexual intercourse?

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ramasamymd OP t1_j8p1guh wrote

15 minutes on average. 1 week after vasectomy

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xYxTwitchyxYx t1_j8rht09 wrote

Yeah I was told 1 month after my surgery. 1 week?

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m0bscenity t1_j942z40 wrote

I was told a week to 10 days. I was still in a considerable amount of pain after 10 days tho and opted out for a little while after that, even.

1

Stibber t1_j8p5f2g wrote

Given the vas deferens are cut/tied what happens to the sperm that continues to be produced ? Do they leak into the surrounding cavity or get re absorbed somehow?

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ramasamymd OP t1_j8p6xha wrote

When a vasectomy is performed, the vas deferens, the tubes that carry sperm from the testicles to the urethra, are cut, tied, or blocked [1]. After this procedure, the testes continue to produce sperm, but the sperm cannot reach the semen or be ejaculated out of the body. According to Johns Hopkins Medicine, the sperm that are produced after a vasectomy die and are absorbed by the body. The ends of the vas deferens that have been cut are sealed off, and the sperm cannot leak into the surrounding cavity. The absorption of the sperm by the body is a natural process that happens over time, and it does not pose any harm to the body. Therefore, there is no need to worry about the presence of excess sperm in the body after a vasectomy.

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OmenVi t1_j8rkq3r wrote

To add to the OP reply, mine were cut, tied, and cauterized. And I was still able to get a reversal. But plan on another vasectomy, now…

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Swedish-Butt-Whistle t1_j8p1jyi wrote

Had a vasectomy over a year ago, and now feeling a firm nodule on one side approximately where the doctor cut the vas defrens. Could that be a sperm granuloma? There is no pain. Should I get it looked at?

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ramasamymd OP t1_j8p2ezj wrote

A sperm granuloma is a small mass or lump that may develop following a vasectomy. This lump is an inflammation created by extravasated sperm which leaks or is forced out of the cut end of the vas deferens during surgery. These granulomas can vary in size and are usually about the size of a pea. They can be encapsulated in a lump of scar tissue. Sperm granulomas are not life-threatening or cancerous. They do not cause any harm but may cause pain and discomfort in some cases. If no pain or discomfort, not to worry

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Reviewingremy t1_j8owx4x wrote

What painkillers do you get during/ before hand?

How likely are they to spontaneously reverse/be unsuccessful?

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ramasamymd OP t1_j8ozy3y wrote

According to the sources, the failure rate for vasectomies is very low, with only one to two in 1,000 men experiencing a failed vasectomy. However, in rare cases, a vasectomy can fail if the doctor misses the vas deferens during the procedure, and the tube can regrow, though this is very uncommon. Another possible cause of failure is having sex too soon after the surgery, without using an alternate form of birth control.

​

I typically dont prescribe pain killers either before or after the procedure beyond just the local anesthesia.

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ramasamymd OP t1_j8p09fy wrote

According to the sources, the failure rate for vasectomies is very low, with only one to two in 1,000 men experiencing a failed vasectomy. However, in rare cases, a vasectomy can fail if the doctor misses the vas deferens during the procedure, and the tube can regrow, though this is very uncommon. Another possible cause of failure is having sex too soon after the surgery, without using an alternate form of birth control.

I typically dont use pain killers before or after vasectomy. Just local anesthesia.

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Ok-Feedback5604 t1_j8p20vx wrote

Are there some ideas to reduce vasectomy's cost?

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ramasamymd OP t1_j8p3fl1 wrote

  1. Check with your insurance provider to determine whether vasectomy is covered and what expenses are included. Most insurance companies cover vasectomy
  2. Consider low-cost providers: Planned Parenthood may offer vasectomy for low cost. It may be worth checking with low-cost providers in your area to find the best option.
  3. Negotiate with providers: If the cost of vasectomy is prohibitive, some providers may be open to negotiation. Discuss the cost with the provider and explore whether there are any options to reduce the price.
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RedRos3s t1_j8p0prp wrote

How is a vasectomy actually done and what is being removed or cut during the procedure?

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ramasamymd OP t1_j8p1nvg wrote

A vasectomy is a surgical procedure in which the vas deferens, the tubes that carry sperm from the testicles to the urethra, are cut, tied, or sealed to prevent the release of sperm during ejaculation. The procedure is usually performed at a doctor's office or surgery center under local anesthesia. During the surgery, a small section of the vas deferens is cut out and removed. The vas deferens is cut and sealed in order to prevent sperm from mixing with the semen and being released from the body during ejaculation. The procedure usually takes about 10 minutes and can be performed on both testicles during the same visit.

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nudistmike t1_j8p3rgh wrote

How important is choosing the right doctor when it comes to the success, technique, and pain? Or is it pretty much all the same at this point?

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ramasamymd OP t1_j8p4lh5 wrote

Choosing the right doctor is important when it comes to the success, technique, and pain for vasectomy. It is recommended to ask family, friends, and healthcare providers for recommendations when searching for the right doctor. In addition, some experts suggest that starting with a good old-fashioned word of mouth can be helpful. When choosing a doctor for vasectomy, patients should consider factors such as the doctor's experience with the procedure, their approach to pain management, and their success rates with the procedure. Patients should also feel comfortable asking their doctor about their experience and training, and how they manage pain during and after the procedure. A well-informed patient who chooses the right doctor is more likely to have a successful and comfortable vasectomy procedure.

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fairygodmotherfckr t1_j8p58cy wrote

I read that there was an upsurge of interest in getting vasectomies in the United States following the reversal of Roe vs. Wade.

I wondered if you could give some comment on that. Have you noticed more interest or procedures since the reversal?

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ramasamymd OP t1_j8p76g8 wrote

There does appear to be an upsurge of interest in getting vasectomies in the United States following the reversal of Roe vs. Wade in my practice. News sources report that interest in vasectomies has spiked since the Supreme Court's ruling to overturn Roe v. Wade. The news also suggests that the procedure is becoming increasingly popular as a form of permanent sterilization, and that more men are seeking vasectomies in response to the current political climate.

https://pubmed.ncbi.nlm.nih.gov/36420253/

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cheap_as_chips t1_j8p5x05 wrote

Should I get a fertility test every few months to verify my vasectomy is 100%, or am I being paranoid?

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ramasamymd OP t1_j8p6rje wrote

As for the frequency of fertility testing to verify a successful vasectomy, there is no clear consensus on this matter. It is generally recommended to wait three months after the vasectomy before undergoing a semen analysis to allow all sperm to clear the system. Depending on the results, a repeat test may be needed to ensure that the sperm count has remained at zero. After this initial test, your doctor can advise on when you should undergo subsequent testing to ensure that the vasectomy remains effective. If you have any concerns or questions, it is best to speak with your doctor, who can provide personalized recommendations based on your individual circumstances.

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karma_dumpster t1_j8p7j1x wrote

What are your thoughts on no scalpel or clamp vasectomies?

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ramasamymd OP t1_j8p7wdz wrote

No-scalpel or no-clamp vasectomies appear to be a favorable option for individuals considering vasectomy. These procedures offer several benefits over traditional vasectomy, including less bleeding and infections and faster recovery time, and fewer complications such as infections and hematomas.

No-scalpel vasectomies involve a specialized tool that creates a small hole in the scrotum without the need for a scalpel. The vas deferens is then accessed and sealed, blocking the flow of sperm. The no-clamp vasectomy method involves holding the vas deferens in place using a special clamp, rather than a traditional scalpel, while the procedure is performed.

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huh_phd t1_j8p7qp4 wrote

Of all the specialties you chose this one, why?

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ramasamymd OP t1_j8p8jcf wrote

Reproductive urology is a sub-specialty of urology that focuses on treating conditions related to the male reproductive system. Patients who suffer from problems like infertility, urinary incontinence, prostate issues, and sexually transmitted infections may benefit from seeing a reproductive urologist. Urologists are also skilled in performing surgical procedures on the male reproductive system, such as vasectomies and vasectomy reversals. Overall, I wanted to help patients who need specialized care in these areas and improve their quality of life

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bubba-yo t1_j8pcrnm wrote

Given the legislative direction Florida has taken lately, are you concerned about efforts to limit access to contraception, from funding support through mechanisms like Medicaid to other measures? Or do you think the intent is to only target women reproductive access? Does the medical community have a responsibility to speak about these issues to government leaders?

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ramasamymd OP t1_j8pdeyj wrote

it is unclear whether there are any recent legislative efforts in Florida to limit access to contraception. However, it is worth noting that the state's political climate has been largely dominated by conservative lawmakers, and reproductive health has been a contentious issue in the state's legislature.

If there are any efforts to limit access to contraception in Florida, it would be important for the medical community to speak out and advocate for reproductive rights. While it is unclear whether the intent of any such efforts would be to only target women's reproductive access, it is important to ensure that all individuals have access to the health care services they need. The medical community has a responsibility to advocate for their patients and ensure that lawmakers are aware of the potential consequences of their actions on public health.

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ZaxLofful t1_j8poyb4 wrote

How effective is artificial insemination after a vasectomy (use needle to get sperm from testicles)?

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ramasamymd OP t1_j8pudqk wrote

Thank you all for the great questions. I'll return soon for any new questions!

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brianthebloomfield t1_j8pus2g wrote

My wife is convinced that my V will spontaneously reverse itself and we're going to have a baby in our 40s. How can I put her mind at ease?

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zoofro t1_j8q3g2n wrote

How often have you had patients experience recanalization post vasectomy? I am one of the lucky individuals who had an unsuccessful first vasectomy due to this so had to have a second vasectomy that was successful. My doctor said I was his second patient in 30 years after thousands of no scalpel vasectomies.

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LoftyWalrus t1_j8q801r wrote

I had mild pain in my scrotum for 9 months after my vasectomy, and it was most painful when I had an erection. I went back to my urologist at about the 6 month mark and all she could offer me was exploratory surgery to see what was up. I decided to just wait and the pain eventually went away.

How common is this and what do you think could have been the problem? I'm fine now, but I still wonder about it.

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_BlueFire_ t1_j8qtdix wrote

Is there any significative hormonal change after a vasectomy? I'm seeing different answers all around and even being a pharm chemist I can get which ones are right. We don't really go deep on biology...

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ramasamymd OP t1_j8rjt16 wrote

Multiple studies have measured hormone levels, especially testosterone, before and after the procedure and found no significant change in hormone levels. While changes in sexual desire are rare after a vasectomy, they are not related to hormonal changes, as a vasectomy does not affect testosterone, the hormone that fuels sex drive

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IAmAModBot t1_j8ozcb2 wrote

For more AMAs on this topic, subscribe to r/IAmA_Medical, and check out our other topic-specific AMA subreddits here.

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PT_Clownshow t1_j8p6zw1 wrote

Dr, what is your experience with patients who have horseshoe kidneys? Are surgeries to move the urinary tract generally successful or no?

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ramasamymd OP t1_j8p7ncg wrote

Horseshoe kidney is a rare condition where the two kidneys are fused together at the lower end forming a U-shape. People with horseshoe kidney are more prone to developing various conditions including vesicoureteral reflux (VUR), ureteropelvic junction (UPJ) obstruction, and hydronephrosis, which makes the kidneys swell. Children with horseshoe kidneys may have symptoms such as belly pain, nausea, urinary tract infections, and kidney stones.

As for surgery to move the urinary tract, there is no information in the provided search results about such surgery for horseshoe kidney. Treatment for horseshoe kidney depends on the symptoms and complications. In some cases, surgery may be needed to correct complications such as obstruction or reflux. Surgery for horseshoe kidney may be challenging and involves a high risk of complications. Therefore, the decision to undergo surgery should be based on careful consideration of the risks and benefits. It is important to consult a medical professional with expertise (that I do not possess) for individualized advice regarding the management of horseshoe kidney.

References: [1] https://my.clevelandclinic.org/health/diseases/21745-horseshoe-kidney-renal-fusion [2] https://www.massgeneral.org/children/horseshoe-kidney [3] https://www.ncbi.nlm.nih.gov/books/NBK431105/

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scienide t1_j8p7qly wrote

Any thoughts on the Vasalgel contraceptive? Seems like a game changer but it’s been in development for years.

1

ramasamymd OP t1_j8p861p wrote

According to a recent study, Vasalgel is a promising new form of male contraceptive [3]. Vasalgel works by blocking the vas deferens, which is the tube that carries sperm from the testicles to the urethra. The procedure is minimally invasive and reversible, and does not affect hormone levels. However, it should be noted that the product is still in clinical trials and not yet available for widespread use [3].
Compared to other contraceptive methods, Vasalgel has some unique advantages. Since it is a non-hormonal method, it does not cause hormonal side effects, such as mood changes, weight gain, or decreased sex drive. Unlike condoms or other barrier methods, it does not interfere with sexual pleasure or require frequent use.
It is important to note that Vasalgel, like all contraceptive methods, is not 100% effective. The gel is designed to be more than 99% effective in preventing pregnancy, but some failures may occur. It is also important to use contraception consistently and correctly in order to maximize its effectiveness.
In conclusion, Vasalgel has the potential to be a promising new contraceptive option for men, but more research is needed to evaluate its safety and efficacy.

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Tight_Vegetable_2113 t1_j8p8u4o wrote

How do I get insurance to ay for a vasectomy?

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ramasamymd OP t1_j8p9tpj wrote

Its a good idea to check with / call your specific insurance provider and state to see if you are eligible for coverage. If your insurance does not cover the procedure, you may be able to work out a payment plan or sliding cost scale with your doctor. Overall, while the upfront cost of a vasectomy may be more than other forms of birth control, the long-term benefits and cost savings can make it a worthwhile investment.

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RolandOfEld33 t1_j8pko6l wrote

What new findings have occurred related to vasectomies and prostate cancer risk?

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ramasamymd OP t1_j8pmu1f wrote

New findings suggest that there may be a slight increase in the risk of prostate cancer associated with vasectomy, although the absolute risk remains relatively small. It is essential to discuss the potential risks and benefits of vasectomy with a healthcare provider before making a decision.

https://pubmed.ncbi.nlm.nih.gov/32772072/

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IamBmeTammy t1_j8pl3d1 wrote

If someone has a pre-existing autoimmune disease, does that increase their chances of having an autoimmune response to sperm after vasectomy or is the rate of occurrence similar to someone without underlying autoimmune disease?

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ramasamymd OP t1_j8pn5yk wrote

There is no direct information on whether pre-existing autoimmune disease increases the chances of having an autoimmune response to sperm after vasectomy.

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1tir3dgrl t1_j8puul8 wrote

My SO, 41m had a vasectomy in 2014. He has said he does have the same complete satisfaction after ejaculation since having the procedure. He also experienced a bloody ejaculation about 4 weeks post-op, and has had episodes of heaviness and pain in one of his testicles. He has seen his provider (USAF with referral to an ultrasound for the pain), but no answers and dismissal when trying to sort it out. My question being, is decreased satisfaction a known thing or is it just a one off kind of occurrence?

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Dragoness42 t1_j8q2vrc wrote

What is the actual incidence of lasting complications of the procedure, such as pain or decreased libido or sexual satisfaction? We're at the point of deciding who's getting snipped in our marriage for permanent control, and I'm concerned about the possible side effects if my husband gets it done. He has a lower pain tolerance than I do, and a very high libido, and I'd feel awful if he ended up with pain or decreased satisfaction just to avoid condom use. We've already established that hormonal BC for me has side effects we don't want.

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mom_with_an_attitude t1_j8q6tb1 wrote

In a married couple, who should make the decision to get a vasectomy? The husband alone; the wife alone; or should it be a mutually agreed upon decision?

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Thugmeet t1_j8q7y2f wrote

I’ve heard rhetoric that vasectomies are easily reversible. How true is that?

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TheRealBrewballs t1_j8q7ynz wrote

Hello Dr! I had a vasectomy about 3 years ago. After the procedure I tested without sperm in samples. What is the likelihood of healing vas deferens?

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Additional_Writing49 t1_j8qf88m wrote

BiL got a tube cut vasectomy I assume the tubes that connect balls to the pre ejaculated storing sack. Got married again, they did a reversal after 8 years but now they struggle to conceive. Is reversal that touch and go on a guy?

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drumscrubby t1_j8uj9mi wrote

Post procedure (years ago; after twins :) my orgasms sometimes sting. Why?

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maurihamm t1_j8uk409 wrote

Can finasteride 1 mg per day cause any kind of damage in the long term?

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8ngryW0lf999 t1_j8ul1rv wrote

Some non-urology (but medical still) questions. And you can combine the responses however you want.

  1. Is becoming a MD in America still a matter of meritocracy? Or do you think it favors students with connections and means?

I've seen many MDs who come from medical families and I feel they have a huge "advantage" over working class students when applying for med school.

  1. Is getting the slots to the best residency / fellowship programs a matter of work performance or connections?

  2. What's your opinion on America's research prowess on urology today?

  3. What do you think of the direction America is headed in terms of medical access and costs of service? Should we remain optimistic?

  4. What's the best way for patients to prepare for their first visit to a specialist? I've visited docs armed with a one - page summary of my medical history and purpose of my visit and many of them barely look at it.

  5. Do you have a favorite Bollywood movie? :)

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Cheap_Banana_4356 t1_j8v9tga wrote

Why is this procedure not 100% covered on insurance? On our current insurance, they won’t cover at all.

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charleswj t1_j93vo4p wrote

Because the ACA authors didn't bother to consider that men may want sterilization or contraception. Female procedures are 100% covered.

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Cheap_Banana_4356 t1_j942vqh wrote

What insurance covers women’s procedures 100%? A tubal or partial hysterectomy is consider elective unless it’s medically necessary/life threatening. My insurance won’t cover it.

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Unsimulated t1_j8wz5ik wrote

Is there any way a vasectomay could lead to development of a spermatocoele?

Happened to me, and I don't know if they are related.

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felixdalion t1_j95feg7 wrote

Is a vasectomy always successful. E.g. is there a chance that it's not complete in some way and the person who had the vasectomy could still get a sexual partner pregnant. And conversely is a vasectomy always reversible. E.g. is there a chance that once you have a vasectomy, you might not be able to reverse it? Asking for a friend..

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felixdalion t1_j95fklr wrote

Also, I just posted. But a totally different question after reading some other posts. From my limited understanding, testicles are in some way responsible for producing hormones. Is there any data suggesting that undergoing a vasectomy could reduce testosterone?

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young_Handsome_MF t1_j8qdsy0 wrote

How did you know you wanted to become a professional peter gazer?

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bombchron t1_j8pv1g7 wrote

do u touch pp?

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