Most casual observers will think of the North Star as the brightest star, in fact it is Sirius. (The North Star is known for its dependable location in the sky, not its brightness.)
According to Greek mythology, Sirius was the dog of the hunter Orion, and the ancient Romans placed the star in the constellation Canis Major (Latin for “Greater Dog”). The Romans thus referred to the sweltering period when the rising of the sun and Sirius converged as the “dies caniculares” or “days of the dog star.”
By the 1500s, the English world began to call the same summertime point on the astronomical calendar as the “dog days.”
You have had your vasectomy…here are some “after the procedure” instructions and a heads up on potential issues that are peculiar to having a vasectomy.
The small opening at the midline of the upper strotum does not have a suture and will close on its own. A thin film of Neosporin ointment daily is recommended. Any spotting/oozing is usually corrected with pressure to the incision site for 30 minutes.
You can shower the day after the procedure, but don’t let water hit the procedure site directly.
Ice to the scrotum after the procedure helps with swelling and with discomfort. (Lidocaine is used at the opening and along the course of the vas tubes so there is anesthesia for an hour or so after the procedure.)
You’ll be given something for pain, this is to be used in an “as needed fashion.” If you don’t have pain, don’t take it or use Advil or Aleve. Taking a half a pill is acceptable.
Try to be off your feet with the scrotum elevated strictly for the first 24 hours and then as much as possible for the next two days. Most patient who have the procedure on a Thursday or Friday take it easy over the weekend and return to work on Monday. If you have a strenuous job, you may want to gradually get back into your routine.
For the first week after the vasectomy, compression underwear to stabilize the scrotum and elevation of the scrotum with a rolled sheet when sitting can reduce any swelling.
No sexual activity for one week.
No unprotected sexual activity until we have evaluated two negative specimens. It takes approximately 25 ejaculations to clear the tube beyond the vasectomy site. (A couple can achieve pregnancy if there is unprotected sexual activity before the sperm has completely cleared.) We recommend evaluation of specimens as a rule at 6-8 weeks. It is not about the time since the vasectomy, it is about the number of ejaculations.
Even though the opening is in the middle of the upper scrotum, the vasectomy sites are on the left and right underneath the skin. Discomfort, bruising or asymmetrical swelling is not uncommon, but should slowly improve over several days.
Each patient is given two specimen containers after the procedure and there are several options regarding checking the post-vasectomy specimen. Dr. McHugh examines semen specimens with a microscope at no expense. (The best days for dropping off the specimen is Monday, Wednesday and Friday-but it best to call to be sure he is available to examine.) For out of town patients, specimens can be taken to a local hospital for a “post vasectomy” semen analysis (we can fax an order) or use online test kits such as spermcheck.com.
It is not unusual, maybe 5-10% of specimens, will have a rare sperm. This just means that more time/ejaculations are necessary to completely clear all of the sperm. We will require two consecutive completely negative evaluations.
There are no special instructions about the specimen. If you obtain the specimen in the morning and drop off later in the day, this is not a problem. We are not doing a formal count, only the presence of absence of sperm. We will call you back with the results that day.
Concerns you may have after the procedure-How to contact us.
If any issues arise that you have questions about, feel free to contact us using the form below.
We will be happy to speak to you (770) 535-0000 or if you feel it is necessary, we will arrange for an examination in the office at no expense to you.
Our email: email@example.com (Dr. McHugh replies on weekends!)
You also can utilize our text to email option. (You text your comment/concern and it comes immediately to our email. We check our email numerous times a day and on weekends.) The response comes back to you as a text. Here’s the number: 770-376-5616
Thank you for allowing us to participate in your care.
A common question asked is whether the reversal will be harder if clips were used or if the patient was told by the urologist “I took out a section and burned it.”
In the vast majority of cases this has no influence on the microscopic vasectomy procedure.
The procedure is harder if both sides of the vasectomy were done in the vas deferens closest to the testicle-the convoluted vas. This area is smaller in diameter and not straight (convoluted) and this makes the repair a little harder.
Whether clips or burned, there is not difference in how difficult the reversal will be. Having had clips makes the area of the vasectomy easier to locate.
The amount of vas tube removed is usually not an issue unless there is a very large segment removed and this is customarily not done.
Of note, if you have had two vasectomies done, this could be an issue. If you had a complication after the vasectomy, say a large hematoma or infection that had to resolve or be operated on, these may affect the repair. On all unusual issues, be sure to make the reversal doctor aware.
A vasectomy takes about 15 minutes and I do them through a single “size of a grain of rice” opening.
A reversal, in my hands, takes about two hours and more commonly uses two incisions (3/4 inch on each side of the upper scrotum over the course of the vas deferens) and requires an operating microscope and microscopic suture.
I tell patients that it is a minor procedure, minimal blood loss or other complications, but it does take two hours to do. Bruising and some scrotal swelling is more common and there is a longer recovery period.
So…to the question…same structure (the vas deferens) different procedure.
As sole Roman ruler, Caesar launched ambitious programs of reform within the empire.
The most lasting of these was his establishment of the Julian calendar, which, with the exception of a slight modification and adjustment in the 16th century, remains in use today.
He also planned new imperial expansions in central Europe and to the east. In the midst of these vast designs, he was assassinated on March 15, 44 B.C., by a group of conspirators who believed that his death would lead to the restoration of the Roman Republic. However, the result of the “Ides of March” was to plunge Rome into a fresh round of civil wars, out of which Octavian, Caesar’s grand-nephew, would emerge as Augustus, the first Roman emperor, destroying the republic forever.
A handful of studies have tried to pinpoint a number of children that maximizes parents’ happiness. One study from the mid-2000s indicated that a second child or a third didn’t make parents happier. “If you want to maximize your subjective well-being, you should stop at one child,” the study’s author told Psychology Today. A more recent study, from Europe, found that two was the magic number; having more children didn’t bring parents more joy.
In the United States, nearly half of adults consider two to be the ideal number of children, according to Gallup polls, with three as the next most popular option, preferred by 26 percent. Two is the favorite across Europe, too.
Ashley Larsen Gibby, a Ph.D. student in sociology and demography at Penn State, notes that these numbers come with some disclaimers. “While a lot of [the] evidence points to two children being optimal, I would be hesitant to make that claim or generalize it past Western populations,” she wrote to me in an email. “Having the ‘normative’ number of children is likely met with more support both socially and institutionally. Therefore, perhaps two is optimal in places where two is considered the norm. However, if the norm changed, I think the answer to your question would change as well.”
About 500,000 vasectomies are performed each year in the U.S. Although the procedure is cheaper, faster, safer, and more reliable than female sterilization (1 pregnancy in 100), only 9% of sexually active men in the United States get vasectomies, while 27% of women get tubal ligations.