Vasectomy cost & experience?
April 20, 2021 10:53 AM Subscribe
It's time for Ms. Nandaro to get off the pill, and since we've successfully procreated 2x, it's time for me to do my part and get snipped. I'm interested in experiences, costs and recommendations. Bonus if you are in the NYC/NJ area.
Doesn't seem like something to bargain shop for... but since I'll need to pay the full cost (we have a $2,800 unmet deductible) it would be great to hear if/how anyone managed to save some cash.
^Definitely double-check your insurance's finer print. Some Planned Parenthood health centers perform vasectomies. (Note: New York [City] requires a 30-day waiting period between consultation and getting the procedure.)
posted by Iris Gambol at 11:42 AM on April 20, 2021
posted by Iris Gambol at 11:42 AM on April 20, 2021
Good move, and good luck. Here in Ireland there has been "issues" with contraception. A pal of mine, himself a doctor, put off the snip for a long time because the only person he knew who cd/wd do the job was another GP in the village of Kilcock.
My snip-doctor, based in Ballsbridge, [ya couldn't make it up] had been at a loose end after all her children had grown and didn't want to go back to full medical practice, so set up to serve a niche market. It took two visits, one so the expert could poke [with a pencil IIRC] at the parts to assure herself that there was nothing weird down there that would need more attention. A bit like a reconnaissance to map out the paths of approach, but also so that I formally had a week to reconsider. It's not the sort of thing for an impulse buy. A week later I was on the couch getting a a local anaesthetic down there: it was remarkably similar to being in the dentist. A few minutes later:
Me: I smell burning.
She: That's you.
After removing a section of the vas deferens, efficient doctors cauterise the two open ends to make sure they don't heal up together - it has happened. Snip, snap, all done, it only took 20 minutes and £120.
Save cash? A bit of medical tourism, maybe?
posted by BobTheScientist at 11:50 AM on April 20, 2021 [10 favorites]
My snip-doctor, based in Ballsbridge, [ya couldn't make it up] had been at a loose end after all her children had grown and didn't want to go back to full medical practice, so set up to serve a niche market. It took two visits, one so the expert could poke [with a pencil IIRC] at the parts to assure herself that there was nothing weird down there that would need more attention. A bit like a reconnaissance to map out the paths of approach, but also so that I formally had a week to reconsider. It's not the sort of thing for an impulse buy. A week later I was on the couch getting a a local anaesthetic down there: it was remarkably similar to being in the dentist. A few minutes later:
Me: I smell burning.
She: That's you.
After removing a section of the vas deferens, efficient doctors cauterise the two open ends to make sure they don't heal up together - it has happened. Snip, snap, all done, it only took 20 minutes and £120.
Save cash? A bit of medical tourism, maybe?
posted by BobTheScientist at 11:50 AM on April 20, 2021 [10 favorites]
My Dr. chose to put me under general anesthesia he said I was too jumpy. I woke up and it was all done I was sore for about a week.
posted by jmsta at 12:34 PM on April 20, 2021
posted by jmsta at 12:34 PM on April 20, 2021
Insurance covered ours so I can’t speak to price. He went to one dude who was gonna put him under. He got as far as the hospital bed and there was a lot of confusion from the anesthesiologist and it was enough to spook him so he left. He contacted another dude who scoffed at the idea of anesthesia. That dude gave him a pinch and a squeeze, asked if he could handle that and he agreed, so it was done with a local. Way less an ordeal than the first time.
Asking for referrals got us a lot of “anyone can do it” so dude #2 was actually a urologist at a fertility clinic. Everything went fine (I’m not the one with the scrotum here, but it was fine.)
posted by OrangeVelour at 12:53 PM on April 20, 2021
Asking for referrals got us a lot of “anyone can do it” so dude #2 was actually a urologist at a fertility clinic. Everything went fine (I’m not the one with the scrotum here, but it was fine.)
posted by OrangeVelour at 12:53 PM on April 20, 2021
General anesthesia sounds nuts. My experience was pretty easy through Kaiser, using just the local.
My doc had done 5,000+ and was funny enough to keep me entertained through the hour or so I was there. He shaved some bits, and did a local. I didn't feel a thing for the surgery part. Instead of cauterizing the snipped ends he added teeny tiny titanium clips. The incision itself was so small that stitches weren't needed and I walked out after the procedure and took the day off. There was some soreness for a few days and the incision took about a week to completely heal, but no lasting effects physically or sexually.
No doubt this option was much easier than what my partner would have to endure and contraceptives for either of us were a drag. Would recommend!
posted by homesickness at 1:22 PM on April 20, 2021
My doc had done 5,000+ and was funny enough to keep me entertained through the hour or so I was there. He shaved some bits, and did a local. I didn't feel a thing for the surgery part. Instead of cauterizing the snipped ends he added teeny tiny titanium clips. The incision itself was so small that stitches weren't needed and I walked out after the procedure and took the day off. There was some soreness for a few days and the incision took about a week to completely heal, but no lasting effects physically or sexually.
No doubt this option was much easier than what my partner would have to endure and contraceptives for either of us were a drag. Would recommend!
posted by homesickness at 1:22 PM on April 20, 2021
Two bits of info from my experience:
1) BUY THE JOCK STRAP FOR RECOVERY. It was recommended to purchase one to keep things from jostling post-surgery. I thought it a waste of money, as I knew I'd be couch/bed ridden for a few days and would then be fine. Yeah, not fine when the slightest movement meant shooting pain. Plan to keep things as tightly wrapped as comfortable and move gingerly (no Rocky jump rope montages).
2) Beware a pun when the procedure is over. I was numbed but awake and the doctor said "Welp, I guess we're done here since it's IN THE BAG" as he tucked my vas deferens back in.
Hope all goes well!
posted by Twicketface at 1:22 PM on April 20, 2021 [1 favorite]
1) BUY THE JOCK STRAP FOR RECOVERY. It was recommended to purchase one to keep things from jostling post-surgery. I thought it a waste of money, as I knew I'd be couch/bed ridden for a few days and would then be fine. Yeah, not fine when the slightest movement meant shooting pain. Plan to keep things as tightly wrapped as comfortable and move gingerly (no Rocky jump rope montages).
2) Beware a pun when the procedure is over. I was numbed but awake and the doctor said "Welp, I guess we're done here since it's IN THE BAG" as he tucked my vas deferens back in.
Hope all goes well!
posted by Twicketface at 1:22 PM on April 20, 2021 [1 favorite]
Seconding Iris Gambol - check in with your local Planned Parenthood. The scheduling staff can likely give you an idea of the full cost.
As for the procedure itself, I actually used to assist the procedure at a Planned Parenthood clinic years ago. Methods may have changed, but here's what it looked like in the 2000s:
A patient first needs an initial consult to confirm that they are a good candidate (e.g. you understand the procedure, and don't have risk factors that would make it dangerous as an outpatient visit). If you're a good candidate, you'll then be allowed to schedule the vasectomy itself.
At the procedure appointment, nervous patients who had a ride home were offered a Valium. The procedure itself is fast. We used a "scalpel-free" method that involves, like, a tiny hole-punch to the scrotum. The surgeon pulls the vas deferens out of the hole, one at at time, to cut and cauterize them. The cauterized ends get tucked back in under different layers so they are less likely to try to grow back together. After that's complete, the tiny hole is left open - it might drain a little as swelling goes down over the next couple days, and it will close up by itself as you heal.
You might want a soft ice pack (or frozen peas!) handy for the first day or two, and you'll want to follow aftercare instructions about activity (e.g. no running for a few days).
You'll need to come back for a follow-up appointment a few weeks after your vasectomy to make sure it worked. The appointment needs to be after either a certain number of days, or a certain number of ejaculates - whichever comes last. At that appointment, you'll provide a semen sample which will be sent out for analysis to ensure the procedure was effective. Once those results come back showing a successful vasectomy, that's it!
posted by girlstyle at 1:28 PM on April 20, 2021 [4 favorites]
As for the procedure itself, I actually used to assist the procedure at a Planned Parenthood clinic years ago. Methods may have changed, but here's what it looked like in the 2000s:
A patient first needs an initial consult to confirm that they are a good candidate (e.g. you understand the procedure, and don't have risk factors that would make it dangerous as an outpatient visit). If you're a good candidate, you'll then be allowed to schedule the vasectomy itself.
At the procedure appointment, nervous patients who had a ride home were offered a Valium. The procedure itself is fast. We used a "scalpel-free" method that involves, like, a tiny hole-punch to the scrotum. The surgeon pulls the vas deferens out of the hole, one at at time, to cut and cauterize them. The cauterized ends get tucked back in under different layers so they are less likely to try to grow back together. After that's complete, the tiny hole is left open - it might drain a little as swelling goes down over the next couple days, and it will close up by itself as you heal.
You might want a soft ice pack (or frozen peas!) handy for the first day or two, and you'll want to follow aftercare instructions about activity (e.g. no running for a few days).
You'll need to come back for a follow-up appointment a few weeks after your vasectomy to make sure it worked. The appointment needs to be after either a certain number of days, or a certain number of ejaculates - whichever comes last. At that appointment, you'll provide a semen sample which will be sent out for analysis to ensure the procedure was effective. Once those results come back showing a successful vasectomy, that's it!
posted by girlstyle at 1:28 PM on April 20, 2021 [4 favorites]
Mine was 35+ years ago, so I have nothing current to recommend, but I will say that if/when they tell you to take it very easy for [x] days, do it. I felt 100% the day after and proceeded to have a mostly normal, fairly active long weekend. And, as a result, ended up with what I was told was likely some minor bleeding in there that led to very-very-very-much-NOT-minor pain for a few days. No further consequences of my actions, thank goodness, but that was more than enough. Learn from my foolishness and my suffering.
posted by ClingClang at 1:43 PM on April 20, 2021
posted by ClingClang at 1:43 PM on April 20, 2021
Spouse had a no needle no scalpel procedure years ago. They use an air jet injector for numbing and a small punch hole for the procedure. It was about 20 mins in the office and sore for a week or two. He didn’t like tight underwear but needed ice packs. Should have done it years earlier.
Some people don’t realize : you have to use a backup method for a number of weeks until you get follow up labs to confirm the procedure is complete and any sperm have cleared out.
We had not so great insurance in UT and it was around $500. Call the urologists and ask. They can give you a quote and you can ask about payment plans. Some places may also take Care Credit. And only certain Planned Parenthood locations / doctors do vasectomy so double check on that.
posted by Crystalinne at 1:45 PM on April 20, 2021 [2 favorites]
Some people don’t realize : you have to use a backup method for a number of weeks until you get follow up labs to confirm the procedure is complete and any sperm have cleared out.
We had not so great insurance in UT and it was around $500. Call the urologists and ask. They can give you a quote and you can ask about payment plans. Some places may also take Care Credit. And only certain Planned Parenthood locations / doctors do vasectomy so double check on that.
posted by Crystalinne at 1:45 PM on April 20, 2021 [2 favorites]
Check to see if it's covered differently than other procedures. Things that prevent pregnancy & birth save health insurance dollars and may be covered.
posted by theora55 at 2:57 PM on April 20, 2021
posted by theora55 at 2:57 PM on April 20, 2021
Doesn't seem like something to bargain shop for
I mean, I think just going for people who have done a lot of them is what you're after. My partner got one maybe 12 years ago? The kind with the no scalpel and the titanium clips (you can still feel 'em, it's weird!). His was covered nearly entirely by insurance so can't help with $$ stuff. The things that I think were helpful that I didn't know at the time
- the bruising can be impressive but this doesn't mean there's anything wrong
- I went with my guy to get it and it was pretty quick and then he took the bus home. Was out of commission for a few days, just sore, icepack and good tightish underwear helped, and then basically okay.
- YES to using a backup method, and it can be fiddly knowing when you have the all clear. We got a "You're good" call from his lab which was then followed up with a "Uh, no you're not...." call a day or two later. Deeply aggravating but just assume it might be a month or more before you're totally vasectomized and you'll have at least one follow up appointment to check.
posted by jessamyn at 3:52 PM on April 20, 2021
I mean, I think just going for people who have done a lot of them is what you're after. My partner got one maybe 12 years ago? The kind with the no scalpel and the titanium clips (you can still feel 'em, it's weird!). His was covered nearly entirely by insurance so can't help with $$ stuff. The things that I think were helpful that I didn't know at the time
- the bruising can be impressive but this doesn't mean there's anything wrong
- I went with my guy to get it and it was pretty quick and then he took the bus home. Was out of commission for a few days, just sore, icepack and good tightish underwear helped, and then basically okay.
- YES to using a backup method, and it can be fiddly knowing when you have the all clear. We got a "You're good" call from his lab which was then followed up with a "Uh, no you're not...." call a day or two later. Deeply aggravating but just assume it might be a month or more before you're totally vasectomized and you'll have at least one follow up appointment to check.
posted by jessamyn at 3:52 PM on April 20, 2021
- Had "no scalpel" procedure, but no inserts, about 20 years ago (holy shit time flies).
- Local anaesthetic, stared at the ceiling and tried to ignore what they were doing.
- Maybe 20 minutes? Spray-on bandage substance left on for several days.
- Giant swelling and bruising for some days. Rest & do nothing vigorous.
- Notable soreness for weeks, off-and-on for months; permanently more-sensitive.
- Spend money on supportive underwear. Bonus: tends to be nicer fabric.
- Absolutely worthwhile.
posted by ead at 5:23 PM on April 20, 2021
- Local anaesthetic, stared at the ceiling and tried to ignore what they were doing.
- Maybe 20 minutes? Spray-on bandage substance left on for several days.
- Giant swelling and bruising for some days. Rest & do nothing vigorous.
- Notable soreness for weeks, off-and-on for months; permanently more-sensitive.
- Spend money on supportive underwear. Bonus: tends to be nicer fabric.
- Absolutely worthwhile.
posted by ead at 5:23 PM on April 20, 2021
In Washington state, they had the Take Charge program, which Planned Parenthood let me know about and helped me sign up for, and which covered the entire cost of the procedure, if I remember correctly. I’m not sure if there is a similar program in your area, or if you would qualify for it, but your local Planned Parenthood will know about it if there is.
Contrary to the general consensus, I was back at work the following day with no pain, doing everything short of moving kegs around at the bar.
posted by Jawn at 9:19 PM on April 20, 2021
Contrary to the general consensus, I was back at work the following day with no pain, doing everything short of moving kegs around at the bar.
posted by Jawn at 9:19 PM on April 20, 2021
Homesickness: General anesthesia sounds nuts. My experience was pretty easy through Kaiser, using just the local.
I misread this as Keister and was reminded of joke:
Middle class parent receives bill for school fees with typo "€5,000 per anum" and says "Thanks but I'd rather pay through the nose as usual".
Eeeee, I'd forgotten the post-op sperm-count protocols; it's been a while.
posted by BobTheScientist at 11:17 PM on April 20, 2021
I misread this as Keister and was reminded of joke:
Middle class parent receives bill for school fees with typo "€5,000 per anum" and says "Thanks but I'd rather pay through the nose as usual".
Eeeee, I'd forgotten the post-op sperm-count protocols; it's been a while.
posted by BobTheScientist at 11:17 PM on April 20, 2021
I got my no scalpel vasectomy in 1999 at the age of 22. It was covered by my insurance at the time; I seem to recall that the amount that was covered seemed surprisingly low to me. Like under a $1k (20+ years ago in Seattle, WA). Because of my age, and not having had any kids, I did have to do a consult with a nurse, but I coolly expressed my thoughts to not want to breed. I also was able to clearly describe what I was expecting to occur, and my levelheadedness+knowledge was enough to get my OK'ed.
It was done with local anaesthetic. I had previously bought a few bags of frozen peas to use as ice bags, and had bought "briefs" style underwear when I was a boxers guy at the time. I shaved the area myself the day before was requested and did a good enough job that no touchup was needed as the nurse checked before hand (and I think delivered local?). I was in about 20 minutes before the procedure was to start so that prep could be assured to be done correctly.
The procedure was ~10 minutes of time of the doctor in the room, who I met the first time < 60 seconds before the procedure began. My doc said that I was about his 2200'th vasectomy. I felt no pain, but could occasionally feel tugging/pressure in the area. There was small amounts of talk during the procedure. It mentally felt like being at the dentist getting a cleaning, except obviously it being easier to talk with nothing in my mouth. I could smell the cauterizing and could see how some might be disturbed by that. I got to keep the cauterizing iron they used which was a cool souvenir (it was a plastic container around the battery, so it couldn't be autoclaved/sterilized).
I drove myself home with mild discomfort; I seem to recall that I had taken ibuprofen 30 minutes before the procedure started, but that memory feels suspect, and more likely I took some shortly after, or a few hours later. I definitely used the frozen bags of peas that night, but by the next day I didn't bother and was fine with just taking it easy. There was no bruising and my girlfriend at the time visited about 24 hours after the procedure, and was amazed at how she could hardly see anything had been done. Relatedly I ended up failing at the 7 days you're supposed to refrain from orgasm, but kept to it excepting that night and next day. There was no pain, and it ended up not interfering with the operation, but obviously not advisable.
30 day sperm count was 0, same for a year later. I also had another sperm count done a few years later; that office the person giving the results wasn't immediately aware I had the vasectomy so was initially approaching it as "are you sure you gave a fresh/correct sample" and trying to soften the news of infertility.
It's now 20+ years later, and I and my wife and both happy to not have to give any considerations to birth control. No pain/oddities. A++, would recommend for everyone.
posted by nobeagle at 7:07 AM on April 21, 2021
It was done with local anaesthetic. I had previously bought a few bags of frozen peas to use as ice bags, and had bought "briefs" style underwear when I was a boxers guy at the time. I shaved the area myself the day before was requested and did a good enough job that no touchup was needed as the nurse checked before hand (and I think delivered local?). I was in about 20 minutes before the procedure was to start so that prep could be assured to be done correctly.
The procedure was ~10 minutes of time of the doctor in the room, who I met the first time < 60 seconds before the procedure began. My doc said that I was about his 2200'th vasectomy. I felt no pain, but could occasionally feel tugging/pressure in the area. There was small amounts of talk during the procedure. It mentally felt like being at the dentist getting a cleaning, except obviously it being easier to talk with nothing in my mouth. I could smell the cauterizing and could see how some might be disturbed by that. I got to keep the cauterizing iron they used which was a cool souvenir (it was a plastic container around the battery, so it couldn't be autoclaved/sterilized).
I drove myself home with mild discomfort; I seem to recall that I had taken ibuprofen 30 minutes before the procedure started, but that memory feels suspect, and more likely I took some shortly after, or a few hours later. I definitely used the frozen bags of peas that night, but by the next day I didn't bother and was fine with just taking it easy. There was no bruising and my girlfriend at the time visited about 24 hours after the procedure, and was amazed at how she could hardly see anything had been done. Relatedly I ended up failing at the 7 days you're supposed to refrain from orgasm, but kept to it excepting that night and next day. There was no pain, and it ended up not interfering with the operation, but obviously not advisable.
30 day sperm count was 0, same for a year later. I also had another sperm count done a few years later; that office the person giving the results wasn't immediately aware I had the vasectomy so was initially approaching it as "are you sure you gave a fresh/correct sample" and trying to soften the news of infertility.
It's now 20+ years later, and I and my wife and both happy to not have to give any considerations to birth control. No pain/oddities. A++, would recommend for everyone.
posted by nobeagle at 7:07 AM on April 21, 2021
Several people have said it, and I just want to pick it out here in very explicit terms: follow the recovery instructions as if they are a map to treasure, not a measure of how weak you are as a person.
Use the ice packs as directed (including not using them MORE than directed, but also not less), take the medicine on the schedule, do the resting, don't do lifting, wear what they tell you to wear, wash how they tell you to wash, keep your toddlers/pets out of the room for a couple days if they are likely to jump/stomp on you, sound the alarm at any concern about infection or issues, and let your dang janglies heal like they tell you to.
Most of the instructions you're sent home with are not for "in case of unspeakable agony", they are "this is how to heal so there are no long-term effects even if you feel 'fine'". Most of those long-term effects include nerve damage and nerve pain, and I promise it's worth being an eager follower of the instructions for two entire weeks rather than fuck with that risk. It seems like everyone wants to talk about how they did not really follow the instructions, pffft instructions, but I had to live with someone who also pfft'd the instructions and was lucky the nerve pain resolved after a year or so.
Please have someone else drive you, as well. The chances of your blood pressure or blood sugar freaking out after a stressful office surgery on your genitals using epinephrine-based local anesthesia is why the doctor generally does not let you leave the office alone, because they don't want to get sued by your victims and family.
posted by Lyn Never at 10:30 AM on April 21, 2021 [2 favorites]
Use the ice packs as directed (including not using them MORE than directed, but also not less), take the medicine on the schedule, do the resting, don't do lifting, wear what they tell you to wear, wash how they tell you to wash, keep your toddlers/pets out of the room for a couple days if they are likely to jump/stomp on you, sound the alarm at any concern about infection or issues, and let your dang janglies heal like they tell you to.
Most of the instructions you're sent home with are not for "in case of unspeakable agony", they are "this is how to heal so there are no long-term effects even if you feel 'fine'". Most of those long-term effects include nerve damage and nerve pain, and I promise it's worth being an eager follower of the instructions for two entire weeks rather than fuck with that risk. It seems like everyone wants to talk about how they did not really follow the instructions, pffft instructions, but I had to live with someone who also pfft'd the instructions and was lucky the nerve pain resolved after a year or so.
Please have someone else drive you, as well. The chances of your blood pressure or blood sugar freaking out after a stressful office surgery on your genitals using epinephrine-based local anesthesia is why the doctor generally does not let you leave the office alone, because they don't want to get sued by your victims and family.
posted by Lyn Never at 10:30 AM on April 21, 2021 [2 favorites]
I had the full anesthesia, a little sore for a few days. No big deal.
posted by signal at 12:35 PM on April 21, 2021
posted by signal at 12:35 PM on April 21, 2021
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posted by Lyn Never at 11:17 AM on April 20, 2021 [6 favorites]