There's a widespread (if unverified) belief that vasectomies increase substantially during March Madness. If you're going to be stuck at home icing your testicles, the thinking goes, why not schedule it around a week you're already blowing off work for the tournament?
Now, the American Urologic Society doesn't have data showing a link between March Madness and the number of vasectomies performed, so the connection is driven by anecdotal reports from practicing urologists, who find themselves much busier this time of year. The chairman of the Department of Urology at the Cleveland Clinic, Dr. Ed Sabanegh, recently said, "We do have (in March) typically about 50% more vasectomies than in other months" and other urologists have reported patients jockeying for coveted time slots just before and during the NCAA men's basketball tournament. At the Oregon Urology Clinic, the motto this month is "Snip City: Lower Your Seed." Other clinics even offer discounts or throw in a free pizza.
But forget for a moment how strange and utterly fantastic it would be if this perception turns out to be true. Instead—since at least some of you inseminating sports fans bit on these offers, or are now penciling it into next March—let's take this opportunity to find out what you're in for.
First things first: This hurts, right?
The first, completely reasonable question that invariably pops up is, How bad does it hurt? The answer is a little complicated.
One person I spoke with, a father of two who recently underwent the procedure, described it as, "five seconds of agony in exchange for forty years of relief." After the procedure, your doctor will instruct you to lie down for a couple of hours with an ice pack placed on your testicles (to avoid frost bite, do not place the ice directly on your scrotal skin). Raise your testicles slightly by putting a rolled-up washcloth under your scrotum. Place an ice pack rolled in another towel on top of your scrotum. Keep your jockstrap on and place the ice pack outside of it.You may have some testicular bruising after the vasectomy, but the bruises should slowly lighten and be gone in about two weeks. However.
If you survive that brief, sharp, searing pain and the ensuing bruising, there's another condition you have to look out for: post-vasectomy pain syndrome. The condition may develop months or even years after the procedure and can result in chronic groin discomfort as well as pain while achieving an erection or during ejaculation. The good news is that it's rare; most vasectomies go off without a hitch. The bad news is that you're adding "chronic groin discomfort" to your list of worries in life.
Once the pain issue has been discussed, patients usually want to know how effective the procedure is. The success rate exceeds 98%, but will vary slightly based on the experience of the practitioner as well as the method that's used.
OK. Fine. So what is a vasectomy?
As a refresher, a vasectomy involves interruption or occlusion of the vas deferens—the foot-long tube that transports sperm from the testicles to the ejaculatory ducts—and it's typically performed by a urologist in an outpatient (you go home!) setting under local anesthesia (you're awake!).
The traditional approach—which is rarely used now and causes most men to wince when they think about it—involves bilateral scrotal incisions to remove a small section of the vas deferens. The resulting ends are then sealed off by electrocautery, which involves burning a part of the body to close it off. Yikes.
But scalpels aren't always necessary. To make the procedure more palatable, physicians have designed no-needle anesthesia, which uses a jet injection device to deliver high-pressure anesthetic spray through intact skin. (You can view a VERY NSFW video here). And doctors have nearly perfected the no-scalpel vasectomy, which uses a sharp, pointed hemostat to create a tiny skin puncture in the testicles. In some cases, chemicals can be injected directly into the vas deferens to cause temporary or permanent occlusion. And the whole thing can be done in half an hour.
So what happens after it? Can we just, uh, you know?
Sexual intercourse can usually be resumed in about a week (depending on recovery); however, pregnancy is still possible as long as the sperm count is above zero. That's why most doctors recommend a semen analysis three or four months out, to confirm infertility.
If you dig around the internet, you may read that vasectomies have been linked to kidney stone formation, cardiovascular disease, cancer of the prostate or testes, or immune disorders, but there is no evidence to support any of this. It's a safe procedure, and the complications are minimal (a small amount of bleeding or infection are possible, as with any invasive procedure).
Plus! If you change your mind, it's good to know that successful vasectomy reversal has been reported in fifty to seventy percent of men, but success rates decline the longer you wait. So if you're going to change your mind, do it quickly.
Am I going to regret this?
OK, so a lot of guys make their dumb jokes about this being the perfect month to get their tubes snipped. But who should actually do it? It appears that men over the age of thirty in stable, committed relationships are the best candidates for the procedure. In one retrospective study of 365 men who underwent vasectomy, patients in their twenties were 12.5 times more likely to request vasectomy reversal compared with men over thirty years old. In that study, men whose wives worked outside of the home were twice as likely to seek reversal as men with wives who stayed at home. And somewhat surprisingly, men with children requested reversal more frequently than men without children.
While we're at it: Although women will make up a large chunk of the NCAA Tournament's viewers, we haven't yet heard reports of them opting to sterilize themselves in conjunction with March Madness. There are probably a number of things that account for this, not least of which is that the surgical procedure, called tubal ligation, is more invasive. The woman's fallopian tubes are clamped and blocked—or severed and sealed—to prevent eggs from reaching the uterus for fertilization and it's more difficult to reverse. But women do, on occasion, get pregnant after tubal ligation. Just this week, ABCnews.com reported that an Illinois woman who became pregnant six months after the procedure had sued her doctor for "wrongful pregnancy."
Rendering yourself infertile and scheduling it around an amateur basketball tournament may seem like an odd thing to do (it is a very odd thing to do), but people do it. March Madness means different things to different people, but it's clear that basketball nets won't be the only things getting snipped this time of year.
Matt McCarthy is board-certified in internal medicine. You can follow him on Twitter here.
Image by Sam Woolley