For Vasectomy Patients

Congratulations! You have decided to take control of your reproductive health. We are happy that you have chosen Top Gun NW Expert Vasectomy and we are ready to get you started.

How does it work?

The no-scalpel, no-needle vasectomy technique is achieved by isolating and separating both tubes of the vas deferens (sperm highway).

Sterility, Safety, and Comfort are our top most priority.

We numb up the area using a Madajet, which uses a pressure chamber to apply the anesthetic around the vas deferens. The application feels like a flick vs a sharp needle to the skin. Most patients say that the application was significantly less painful than a needle and helped them overcome their fear of having the procedure done.

Once skin is numbed, a small puncture is done which allows us access to the vas deferens.

To further decrease risk of reconnecting, the abdominal end of the vas deferens is then covered with fat and soft tissue so the two ends don’t meet again. The procedure takes approximately 30 minutes in the clinic. You can return to sedentary work three days after the operation. Usually, it takes three months AND approximately 20 ejaculations post-operation before all remaining sperm on the other end of the vas deferens are cleared and permanent contraception is achieved.

What are the risks?

There are currently no proven long-term health risks associated with vasectomy. In rare instances, the following risks have been observed.

Vasectomy provides the most effective, permanent means of surgical contraception. When compared with other contraceptives, it has one of the lowest incidences of side effects.
Minor side effects immediately following vasectomy may include discomfort, swelling and/or bruising of the scrotal skin, all of which usually disappear without treatment. Some men (about 1 in 20) will experience swelling and a low-grade ache in one or both testes anywhere from three days to six months after the procedure. This is probably due to an exaggerated form of the body’s natural response to the obstruction caused by the vasectomy. It usually responds nicely to an anti-inflammatory drug (such as ibuprofen) 400-600 mg 3 times per day and almost never lasts for more than a week or two but for rare patients, fewer than 1 in 100, swelling and discomfort will occur more than once and/or will be severe enough to require prescription pain medications, stronger anti-inflammatory drugs, and one or more days off from work. Other side effects and possible adverse outcomes include:
1) Failure
Vasectomy is not considered successful until you have been given the all clear after a post-vasectomy semen analysis performed by this Clinic. This analysis must be performed 12 weeks AND 20 ejaculations after your procedure.
2) Permanent
Vasectomy is considered a form of permanent birth control. If you feel there is any chance at all you may want to have (any more) children then vasectomy is not a good choice for you. While vasectomy reversal l is possible it is expensive and is not 100% effective. You should not rely on having a reversal. There are other relatively safe and effective forms of reversible birth control such as: barrier and hormonal methods and devices such as IUD and Nexplanon which are implanted in a woman. See some options below. Because of the permanent nature of a vasectomy you should consider sperm storage as a potential option prior to your vasectomy if you are concerned. We would be happy to give you referral information upon your request.
3) No driving after vasectomy
Some men become light headed during or after the vasectomy procedure. This can make driving unsafe for you and others. It is strongly recommended that you do not drive for the remainder of the day following your vasectomy. For those taking mild sedative, having designated driver other than patient is mandatory prior to proceeding with procedure.
4) Chance for Infection
Any medical procedure has some risk of infection. Every effort is made to prevent this from this happening and the risk is very low; however, the risk is not zero. If you think you may be developing an infection, contact this Clinic immediately so we are able to have you come in and examine you. Most infections can be easily treated with antibiotics. However, in rare instances, some infections may require additional surgical intervention.
5) Bleeding
There is always some risk of bleeding. The use of the no-scalpel vasectomy technique significantly reduces the risk of bleeding. If you think you may have a problem with bleeding contact this Clinic immediately. Most post-procedure bleeding is minor and can be treated with jock-band support and rest. However, in rare instances, some bleeding may require additional surgical intervention.
6) Sperm Granuloma
You will likely form a small pea-like nodule along your vas deferens at some point in the next several weeks after your vasectomy. When this happens, it is due to some associated inflammation that can cause some achiness. The achiness is usually managed without any long-term discomfort with a few days of NSAIDs (E.g., aspirin, ibuprofen or naproxen) and jock-band support.
7) Post Vasectomy Pain
Some men experience discomfort after the vasectomy. The vast majority of the time the pain is easily managed with NSAIDs and supportive underwear. However, there is a very small percentage of men who go on to have a chronic pain syndrome that is not fully understood. This potentially could have a significant impact on your quality of life. Treatment of the pain could require further surgical interventions such as steroid injections, removal of the epididymis, or even vasectomy reversal.
8) Loss of Testicle
In very rare instances, the artery to the testicles can be injured. The effect of that injury can be impaired blood flow that causes loss of a testicle. This may require additional surgery.
9) Emotional Reactions
Both patients and their partners can sometimes have unexpected emotional reactions to a vasectomy. This can potentially impair sexual function and effect relationships. However, most men have increased sexual function after a vasectomy.
10) The Unforeseen
Vasectomy is a very low risk procedure with minimal side effects. However, receipt of healthcare services is not without risk. Every procedure, intervention and medication can have unforeseen and unpredictable effects. Each body is different and human physiology is only partially understood by even the most expert medical providers. There will always remain the risk of unforeseen consequences of each intervention and every medical procedure.

Before your vasectomy

Please follow the following instructions before your vasectomy procedure. If you have any questions, feel free to call our office: 206-687-7638

1. Please shave the underside of the penis and the front wall of the scrotum the evening before your vasectomy. A small amount of alcohol/chlorhexidine is used to clean the skin before the use of the MadaJet and it may sting slightly after a fresh shave if the skin is chafed.

2. Do not use powder or deodorant in the general area on the day of your procedure.

3. An athletic supporter (jockstrap) will be provided.

4. Driving home: It is not required but if possible, arrange to have someone drive you home. It is not uncommon for patients to pass out during or minutes after their vasectomies. If you must drive yourself, drive in the right lane, so that you can pull over at the slightest hint of delayed lightheadedness. Also, a flat tire or fender bender could lead to complications.

5. If you are requiring a mild sedative prior to procedure, Please call the office so we can discuss options and have a designated driver on day of procedure. This is required prior to proceeding with procedure.

6. Plan to do nothing but recline at home the evening of the vasectomy. We recommend catching up on a favorite TV series or movies.

7. IF you are on blood thinners (Coumadin, Warfarin, Aspirin, Plavix, Clopidogrel, Xarelto, Dabigatran, etc), please call us at (206) 687 7638 prior to procedure or notify our nurse at time of scheduling.

8. If your insurance company or HMO requires authorization, please make sure to bring a copy the day of your procedure.

9. Please EAT a light meal 2-3 hours before your procedure. A normal breakfast or lunch but don’t over eat. Nervous men who do not eat beforehand are more likely to become light headed during and or after their procedure.

  • We require a $100 deposit to schedule. This will be refunded if insurance covers the procedure, or deducted from your final fee if you are paying out of pocket. At the time of service, a co-payment and/or contracted fee will be required of insured men who have not met their deductibles. If you have any questions, please feel free to give us a call at (206) 6877638

After your vasectomy

1. Spend a quiet evening at home, reclining in bed or on a sofa. Minimize activity. Some men have no pain at all after vasectomy. Many have mild discomfort that does not require pain pills. Sometimes the discomfort is in the groins or abdomen. Call the after hours phone below if pain is worsening or if you have concerns regarding this.

2. Avoid aspirin based products for 2 days after the vasectomy. You may take acetaminophen (Tylenol or generic) if you have any discomfort. Ibuprofen (Motrin), Advil (or generic) and Naproxen (Aleve) are both pain medications and anti-inflammatory drugs. For the first few days after a procedure, inflammation may be a normal component of the healing process, and I prefer not to stifle it, so Tylenol is preferred. Pain beyond 3 days, especially if accompanied by some swelling of the vasectomy sites above the testes, may signify excessive inflammation and then ibuprofen and naproxen are good choices. Some men will have more discomfort or tenderness 3-5 days after the vasectomy than they do for the first few days after their vasectomies. That’s because the body goes through a series of steps in responding to the new arrangement, and sometimes the later steps are more noticeable than the earlier steps. Usually no reason for concern.

3. Application of an ice pack may be used to provide comfort however, it is not required.

4. You may remove the scrotal support and take a daily shower starting the morning after the procedure. Replace the scrotal support and wear it whenever you are up and around for the next two (2) days, and during exercise for the next 7 days.

5. Three days after the procedure, you may return to regular activities wearing your scrotal support. When pain is gone and tenderness is minimal, you may return to the gym or to running, but on the first day back, do half (½) of your usual workout: half the weight, half the reps, half the speed, half the distance, etc. If pain does not return, you may do your regular workout the next day.

6. When you no longer have any pain or tenderness, you may ejaculate. I have always recommended waiting at least three (3) days to resume gentle sexual activities, but the American Urological Association Vasectomy Guidelines recommend that men wait a week. It is unclear whether sooner ejaculation prolongs discomfort. Blood in the semen within the first month or two after the vasectomy occurs in some men, but also no reason for concern.

7. Since no incision is made, no follow-up visit is required. You can call Dr. Abano on his cell at (206) 906-9956 after hours for any questions or concerns. During regular work hours, please call (206) 687-7638.

8. It is normal to have some discoloration of the skin (black and blue) around the puncture site a day or two after the vasectomy. Some men will develop considerable discoloration of the scrotum about four (4) days after the vasectomy and resolve within a few weeks.

9. Twelve (12) weeks AND 20 ejaculations after your vasectomy, have your semen tested to be sure that it no longer contains sperm and that it is thereby safe to stop other forms of contraception (number of ejaculations and number of weeks are both important). A tube will be provided for specimens being mailed. It contains a small amount of antibiotic so that the sample does not grow bacteria (do not wash tube). A cup provided for those physically bringing in a specimen sample will not have antibiotic powder.

Since no incision is made, no follow-up visit is required. Please expect us to call you within 24-48 hours to asses how you are doing. Dr. Abano will provide you with his cellphone number for any after-hours questions or concerns after the procedure. If you have questions during regular work hours, please call the office (206) 687-7638.

Finally, we would sincerely appreciate a good review at google or yelp. We hope we were able to provide you the best vasectomy experience possible.


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