When a "Routine" Vasectomy Doesn't Go as Planned

In December, I suffered a debilitating brain fart and scheduled my vasectomy on the Friday before my busiest work weekend of the year.

Traditionally, this is when the Seven Days staff produces two issues simultaneously to allow ourselves down time during the holidays. But if I postponed the procedure until January, my insurance wouldn’t immediately cover it, so I awkwardly requested the day off, offering my employers the oblique explanation that I was undergoing a “minor medical procedure.” Publisher Paula Routly immediately guessed its nature.

“Getting snipped?” she blurted in a room full of fellow staffers, letting my sterilization plan out of the bag. “Why don’t you write about it?”

Hey, no harm, no foul. I’ve published other personal stories about major milestones in my life, including my wedding [1], the birth of my daughter [2] and deciding whether to circumcise my son [3]. Saying sayonara to my sperm — or at least to their ability to swim downstream and cause trouble — seemed like just another (cough) seminal event.

Besides, as news editor Andy Bromage chimed in, “This one is right in your wheelhouse.” He didn’t specify whether he meant health reporting or testicle humor.

Unlike my son’s circumcision, my decision to get fixed wasn’t one over which I anguished. For one thing, it’s a socially responsible move. Ezra, my second child, was born last May. In the interest of zero population growth, my wife, Stacy, and I had already decided we’d stop at two.

After her first labor — a hellacious ordeal that began, prophetically, during a viewing of Apocalypse Now and ended 38 hours later in an unplanned Caesarean delivery — her physician recommended a scheduled C-section for our second child. On the plus side, it would afford the option of getting Stacy’s tubes tied. Financially, it’d be akin to replacing the timing belt on a car: While the mechanic is already under the hood, we might as well change the oil and swap out the fuel pump, too.

Shortly before her second C-section, however, when our world became very small and less certain, we had an 11th-hour change of heart. Fearing the irreversible consequences if something tragic were to happen to our newborn in the coming days or weeks, I agreed to get “fixed” instead.

The scouting report from my male friends and relatives sounded promising: A vasectomy is a short, simple and painless procedure, I was told, one that would require only a few days of postoperative lounging in my La-Z-Boy, TV remote in hand and a bag of frozen peas on my crotch. One friend assured me that he’d resumed sexual activity within a few days; another knew someone who’d gone mountain biking a week later. My only real concern was convincing my 3-year-old daughter not to hop on Pop [4].

But, as I soon discovered the hard way, even a “safe” and “routine” medical procedure is a statistical crapshoot. If 99 out of 100 men who get their grapes pruned on a Friday are back riding a mechanical bull by Monday, that leaves one unlucky lad gobbling painkillers like Skittles, and icing a plum-colored nut sack the circumference of a grapefruit (OK, a blood orange). Guess who went home with that door prize?

The morning I got clipped, Stacy drove me to the offices of Green Mountain Urology [5] in Colchester. There, Dr. Richard Grunert walked us through the procedure, using such eminently comforting phrases as “no needle” and “no scalpel.” Still, we were talking about puncturing my scrotum, now shaved as smooth as eggs, with a sharp, metallic object.

First, Grunert explained, he uses a high-pressure spray gun to deliver lidocaine through the skin to the vas deferens. The vas are the ducts that carry sperm from the epididymis to the urethra. If you think of sperm as Navy SEALs, the epididymis is where immature recruits learn to swim and storm an egg. The vas (Latin for “vessel”) is how they deploy into the Sea of Semen en route to their fertilize-or-die mission.

Grunert explained how, using a specialized tool similar to a sharpened hemostat, he cracks the nut without a cut, isolates the vas, then cauterizes the ends to solder them shut. After a few internal stitches and a packing off of my ’nads in gauze, I’d be on my way. Grunert even suggested I not take my pants off, but just leave them around my ankles for easier dressing afterward. The entire procedure would take no more than 15 minutes.

I kissed Stacy good-bye, dropped trou and lay back on the operating table. As Grunert shot me up with a mild sedative, my vision went slightly askew and I felt the warm embrace of an intravenous opiate hitting my bloodstream. I reclined, closed my eyes and felt not a trace of worry, even as I caught a whiff of cauterized flesh emanating from my nether region. I’ve had visits to the dentist far less pleasant.

That feeling of peace and tranquility lasted all of one hour. The sedative wore off in the Colchester Rite Aid parking lot as I waited in the car for Stacy to pick up my prescription painkillers and about a thousand other items. As I began to double over in pain, I turned on the radio in search of a mild distraction.

National Public Radio was reporting that, two hours earlier, a man with an assault rifle had entered an elementary school in Newtown, Conn., and mowed down 20 first graders and six adults before killing himself. That dull but growing ache in my genitals — which would last not days but weeks — was now joined by a sinking feeling in the pit of my stomach. In an instant, the full weight of my decision never again to father a child landed in my lap like a swift kick in the groin.

The history of male sterilization, like that of most medical procedures, is longer and more sordid than I had previously imagined. As I learned later from David Brown, founder and webmaster of vasectomy-information.com [6], who lives in the south of England and is something of a vasectomy expert — a vasectorian, if you will — the vas deferens were first identified and named by Berengarius of Carpi in the 15th century.

The more invasive practice of castration, or full removal of the testes — performed as both therapy and punishment — predates written history and is probably as old as flint knapping and alpha males. But it wasn’t until 1830 that Sir Ashley Cooper performed the first successful vasectomy — on his dog. Man’s best friend, indeed.

For another 100 years, physicians and medical quacks offered up an array of unproven and occasionally bizarre theories on the presumed benefits of getting a vasectomy. These included the belief that cutting off the flow of sperm could cure tuberculosis, reduce an enlarged prostate, rejuvenate the soul and even cure “deviants” of their excessive masturbation habits.

More disturbing is the tragic history, in the United States and abroad, of the eugenics movement and its advocacy for sterilization of the poor, people of color, the mentally ill and the developmentally disabled. According to the University of Vermont’s web-based “Vermont Eugenics: A Documentary History,” [7] governor John Mead, who was also a physician, first recommended in 1912 that the Vermont Legislature adopt a sterilization law to cleanse the Green Mountain gene pool of those deemed genetically “unfit” and “undesirable.” Fortuitously, his successor, Allen Fletcher, shit-canned that bill.

Nonetheless, Vermont later adopted a voluntary sexual sterilization law in 1931 to “prevent [the] procreation of idiots, imbeciles, feebleminded or insane persons.” One can only imagine just how “voluntary” those procedures were and how informed, if at all, was the subjects’ consent. Shockingly, it wasn’t until 1987 — the year I graduated from college — that Vermont rewrote its statute [8] that had allowed the “voluntary and involuntary sterilizations of mentally retarded adults.”

Despite such misguided applications, the history of vasectomies isn’t a total bummer. In 1971, Brown reports, a “family planning festival” in Kerala, India, which included cash-for-clip incentives, resulted in 62,913 vasectomies being performed in just one month. By 1973, more than 7 million vasectomies had been performed nationwide in India as a part of a trend later dubbed “vasectomania.”

It wasn’t until 1985 that the first no-scalpel vasectomy was done at New York Presbyterian Hospital/Weill Cornell Medical Center; the no-needle vasectomy, along with the “hypospray” anesthesia injector, came along in 1999.

Today, an estimated half million vasectomies are performed in the United States each year. According to the American Academy of Family Physicians, it’s still the safest and cheapest form of permanent sterilization. The incidence of complications is low compared with that of most elective surgeries, and the failure (i.e., knock-up) rate is only one in 2000.

Alas, even the absence of needles and scalpels didn’t keep my pain at bay. My doctor later described the complication as an acute immunological reaction to my own sperm. In laymen’s terms, my swimmers got irate that I cut off their only escape route to open water and launched a rebellion. In response, my immune system, now viewing my sperm as insurgents, mounted a counterattack.

A prescription anti-inflammatory drug is expected to quell the hostilities shortly — though, a month after the procedure, I’m still dealing with the occasional terrorist attack that stops me in my tracks. Nevertheless, my doctor insists this isn’t a precursor to post-vasectomy pain syndrome — a rare condition that I made the mistake of reading about online on Christmas Day. Post-vasectomy pain syndrome can occur months or even years later, causing chronic and occasionally debilitating pain.

While I await a full recovery, I’ve been enjoying the only biological children I will ever have. As for any lingering soreness or Quasimodo-like shuffling, I just chalk it up to the teenage rebellion of might-have-been kids I’ll never know — and remind myself that at least they’ll never raid my liquor cabinet or wreck the car.

The print version of this article was headlined "Hitting the Sack".