Everett Herald

In the news: Procedure keeps little soldiers in their fort

Monday, April 18, 2016

Everett Clinic Family Medicine physician, Dr. John Benedict Abaño, was featured in the Herald’s feature, “Procedure keeps little soldiers in their fort.”

There’s no shortage of sperm in this world.

A healthy scrotum never runs out of reproductive fluid, so most men can remain forever fertile.

Most men also want to call it quits after a couple of kids. Sure, you and your partner can use protection, but what you learned in health class is still true: sperm can find a way through. A vasectomy is the only way to give a 21-gun salute to your soldiers.

“Vas” refers to the vas deferens, a pair of tubes that shuttle northbound sperm out of the testicles. A vasectomy closes down the stations for good.
Men have a vas on each side of their scrotum. Looking for yours? It feels like an al dente spaghetti noodle.

Women get their tubes tied. Men get theirs snipped.

“It’s the same concept: interrupt the tubes and prevent them from re-forming,” said Dr. John Abaño, who performs vasectomies at Everett Clinic in Silver Lake.

The difference is how the reproductive system works. With women, you’re interrupting a monthly pattern. There’s no pattern for men. “We have troops ready 24/7,” Abaño said.

Vasectomy patients tend to be in their 30s and 40s with female partners under 50 years old. If your partner is older than that or has had a hysterectomy, the likelihood of pregnancy is low.

If you’re the type of man who avoids the doctor’s office — in other words, if you’re a man — a vasectomist can seem like a worst nightmare. Start with a general visit or a phone call to voice your concerns.

Pain is often a big one. However, less than 1 percent of patients experience chronic symptoms. Equally rare is bleeding or infection.

You won’t feel anything during the procedure thanks to a local anesthetic. Abaño uses a device called a Madajet, which penetrates the skin with pressure instead of a scalpel or a needle.

Worried about your, ahem, fluids? “The sperm is about 10 to 20 percent of the ejaculate fluid,” Abaño said. “You will still have ejaculation.”

As for overall sex drive, a vasectomy won’t spoil that. You still have sperm, they just can’t get out. Some studies even show an increased libido in vasectomy patients. That’s probably more mental than physical: sex without consequences may make things more pleasurable for both the man and the woman.

Your mental state also matters before the surgery. Abaño screens patients for red flags. That could include, say, a 45-year-old who never had children and just had a terrible breakup. Or a 20-year-old who thinks kids are annoying and never wants any.

“I counsel heavy,” Abaño said. “For me, the procedure is easy. But part of the job is guiding patients to make the right decisions. We’re in the business of long-term patient care.”

Unlike abstinence vows and condoms, a vasectomy can’t be broken. It can, however, be reversed. Vasectomies are permanent in the way that tattoos last forever. Repairing your tubes can be a long, expensive procedure, and success isn’t a guarantee.

Do the doctor a favor and shave your scrotum before the procedure. That’s the preference of over 90 percent of physicians, and understandably so. The appointment takes about half an hour. Sit back and try to relax as the doctor seals your doors for good.

Most patients walk out needing only an ice pack and ibuprofen. Take the day off from work and catch up on “Better Call Saul.” Don’t strain or walk around for 24 hours, and avoid the gym or any sort of heavy lifting for a week.

Move around a little the next day, but pace yourself. The skin of the scrotum has to close on its own. Nobody wants an open scrotum.

As for the question you’ve been waiting for: Wait two days to have intercourse, and only do it if it’s not painful. Oh, and don’t throw out that birth control yet: you’ll return to the doctor in three months to see if any sperm are sneaking through.

The failure rate is about 5 percent, and even if it’s is done right, there’s always a small chance the tubes can heal back together on their own.

A vasectomy is a much simpler procedure than its female counterpart, called tubal ligation. That’s why Abaño encourages men to get it done instead of their wives. Women undergo general anesthesia instead of simple numbing, and recovery entails more downtime and more pain. There’s also no way to test if it actually worked.

And in general, Abaño believes it’s part of being a modern father.

“It’s not just the woman’s job to handle reproductive planning,” he said. “It’s also the man’s job.”

 Originally Published with The Everett herald on April 18, 2016, Living Section


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