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Interviewer: When it comes to vasectomy, there are a lot of myths that you might hear about from friends or maybe you've even read them on the internet and they're simply not true. And a lot of times, these myths could contribute to the fact that maybe not as many men get a vasectomy in the United States compared to other parts of the world.

Dr. Alex Pastuszak is a urologist and a reproductive expert at University of Utah Health. And I'd love to get you as the expert to address some of these common myths that I found out on the internet about vasectomy and find out if they're true or not. I think one of all them that you hear is it's called getting snipped sometimes, which makes me think that this is a pretty major surgical procedure. Is that true?

Dr. Pastuszak: Great first question, great leading question. And ladies and gentlemen, I'm here to tell you that this is one of the least invasive procedures that a guy can have or a human being can have for that matter, because literally we're talking about two half-inch incisions, one or two half incisions in your scrotum and a quick pulling up of your vas -- clipping, cutting, putting it all back in there and suturing it up. All of this takes 15 minutes, very quick, not invasive.

Interviewer: All right. So getting snipped, that's really unfortunate isn't it that people refer to it as that?

Dr. Pastuszak: I mean it is factually correct, but it's not invasive.

Interviewer: Yeah, okay. What about this myth? It's really, really painful. Oh, it's going to hurt.

Dr. Pastuszak: Not true. If we did it back the way they would have done it back in the 1200s or 1400s before there was any form of anesthesia, then yes, maybe. But we use really good local anesthesia. We give you some oral meds that also numb things up a little bit for you. So the pain scale here is really minimal.

Interviewer: All right. And what about recovery pain? Sometimes I hear that it can be kind of painful to recover?

Dr. Pastuszak: Yeah. You know, I'll be frank with you. I tell guys to expect that, you know, they will feel like they got kicked in the boys for a day or so, on and off, so it's not constant and then that goes away.

Interviewer: All right. And that's really kind of a small price to pay when you think about it that from then on out, for the rest of your life, you don't have to think of birth control for you and your spouse?

Dr. Pastuszak: Think about the freedom that comes with a minor bit of pain for a day or two.

Interviewer: Absolutely. All right. What about this myth? It will affect my testosterone production, and all of a sudden I'm going to start watching "Gilmore Girls" and I'm going to have a high-pitched voice. My muscles are going to go away.

Dr. Pastuszak: Two words -- not true. Now, let me say just a word about that, because I think it's important. Okay? So guys, testosterone doesn't come up through your vas up into your body. It goes into your bloodstream. Your testicles make testosterone. Doing a vasectomy is not going to stop your testicles from making testosterone. Your testosterone levels may go down as you get older, but this has nothing to do with whether or not you had a vasectomy.

Interviewer: All right, that's good. What about this one? It's going to change sexual function or it's going to reduce a man's pleasure.

Dr. Pastuszak: Not at all. Your penis stays the way it was before vasectomy. And testosterone is really important in all those processes and, just like we said, we're not messing with that.

Interviewer: The key thing I'm picking up here is it's what are we actually doing, and we're just cutting that one little small tube that allows the sperm to go out into the world.

Dr. Pastuszak: That's right.

Interviewer: What about this one? This is a little bit more serious. It can cause prostate cancer, or it has been linked to cardiovascular disease if you get this procedure done.

Interviewer: There is no convincing evidence right now. There have been a couple of papers, but there is no evidence that would really suggest that vasectomy actually causes prostate cancer or is related to cardiovascular disease. These studies were all based on big cohorts that were not necessarily vetted very well. So there were imperfections in these studies, and in the urologic community right now, there's nobody who has changed practice as a result of any of them. So proof is certainly not 100% or even close to it.

Interviewer: It sounds like perhaps other things could have caused these things, not vasectomy in the data.

Dr. Pastuszak: Right. You know, guys will get prostate cancer as they get older.

Interviewer: That's just going to happen.

Dr. Pastuszak: It's just going to happen, exactly. Same thing with cardiovascular disease. Just because you link it to a vasectomy doesn't mean it's true.

Interviewer: And finally, how about this one that my sperm is going to build up? Now I'm saying this is just what I found on the internet. I mean, I don't know how somebody believes this, but apparently somebody does. My sperm's going to build up, and my testicles will explode as a result.

Dr. Pastuszak: So that, that's one of my favorites. And it's a legitimate question, right, because you are blocking the exit of sperm from the testicles.

Interviewer: And as high schoolers we know what that did.

Dr. Pastuszak: Right. Exactly, the blue and five letter word after that. The answer to this is that know your boys are not going to explode after you have a vasectomy. The body just reabsorbs the sperm that are made in your testicle. I mean, it knows that they have nowhere to go, and then it's just going to soak them right back up. So don't worry about it.

Interviewer: All right. Any other myths out there?

Dr. Pastuszak: You know, I think you've covered it pretty well. I did also just want to touch on the orgasm one, because we talked a little bit about sexual function and we talked about sensation but not orgasm. No effect on orgasm either. Guys, just be reassured that this is a very local thing that we're doing. We're going to keep you from having babies in the future, and it's not going affect anything that you associate with your sexuality, manhood or your livelihood.

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Announcer: Health information from experts supported by research. From University of Utah Health, this is thescoperadio.com.

Interviewer: A vasectomy is one of the most effective forms of birth control available. But there can naturally be some apprehension about a procedure that's been nicknamed "getting snipped." Joining us is urologist and male fertility specialist, Dr. Alex Pastuszak from University of Utah Health. And in order to help make this a little less scarier procedure, Doctor, I'd like you to give us an overview from preparation to procedure what to expect during and what recovery looks like. But first of all, let's talk about the procedure itself first. So where does it happen? Where does it all start?

Dr. Pastuszak: Yeah, great question, Scott. So a vasectomy is one of the easiest procedures that anybody can undergo. We either do it in the clinic or in an operating room as a day surgery. So it's very simple.

Interviewer: All right, a very simple operation, which is fantastic. What exactly happens? Now, again, there's that getting snipped thing, which brings up visuals that I don't want to talk about. But it's nothing like that actually. It's very non-invasive.

Dr. Pastuszak: No, exactly. I mean, we make one or two very small holes in your scrotal skin, and we just pluck your vas up. We'll clip it. We'll cut it, make sure the two ends don't come back together, and then we'll put it right back. All of that takes anywhere from 15 to 40 minutes.

Interviewer: So actually, probably preparing for and recovering from it takes a lot longer than the surgery. I mean . . .

Dr. Pastuszak: That's right.

Interviewer: You'll probably spend more time in the waiting room than you will actually getting the procedure done.

Dr. Pastuszak: Absolutely. I actually tell guys to budget about an hour, an hour and a half. And as I just told you, a minority of that is actually spent doing the procedure.

Interviewer: A lot of guys think it's kind of painful. So it does use local anesthetic, which is another advantage, right? You're not completely going under. It's just in the area, like if you went to the dentist, for example, and had a tooth extracted.

Dr. Pastuszak: That's right, and that's part of what makes it really safe. And a lot of guys come in very anxious about it. But we give them some medication to relax ahead of time. And like you already said, they get some local anesthetic. At the end of it, most of them ask me, "Why was I so anxious? I shouldn't have."

Interviewer: Yeah, I got you. And so I guess I'm a little anxious about the fact I'd be awake during this procedure, right? So should I be concerned about that, or how do you kind of alleviate, you know, that stress?

Dr. Pastuszak: Not at all. Well, usually, guys are actually pretty relaxed by that point.

Interviewer: From the medication. Okay.

Dr. Pastuszak: From the medication. But if they're not, please bring your iPad, bring your iPod, bring your iPhone or your Android, listen to some music. And, you know, you should expect to have very professional, courteous staff. They'll help laugh you up during the procedure, too, if you're anxious. We're good at that.

Interviewer: Okay. So the actual procedure, pretty painless. How do you prepare for the operation? So, you know, it only takes 15 minutes there. But what do I need to do before I come in?

Dr. Pastuszak: Well, so you should bring some tight-fitting underwear or a jockstrap because you're going to leave with your scrotum supported and you're going to want to have that for the following week just to sort of prevent your boys from jumping up and down and causing any undue discomfort. You should come in with a clean genital area. We don't necessarily require that you shave. But if you'd like to, you can do that the day of, and we'll do any sort of trimming that we need to in the clinic. And you definitely need to bring someone to drive you home because, like I said, these relaxing medications will basically be like drinking two or three martinis.

Interviewer: Okay. So I got you. What about any sort of medications or anything like that? Do I need to worry about that before surgery?

Dr. Pastuszak: Yeah. We don't want you to be on any anticoagulants. So if you take aspirin regularly, I would stay off of it for about a week. If you take any other prescription medications that would thin your blood, you should also make sure that the doctor who prescribed that is okay that you're off that. But I would be off that for a week. And also fish oil. A lot of guys don't realize that fish oil is an anticoagulant. So I would not take that for at least a few days to a week before the procedure.

Interviewer: What about after the procedure?

Dr. Pastuszak: So these are going to be the best couple of days of your life because . . .

Interviewer: That's what I hear. Pick something to binge-watch.

Dr. Pastuszak: Exactly. No, we don't want you being a complete couch potato, but you kind of have, hopefully, free reign in the house depending your partner. We do want you to rest. No real strenuous activity for three to five days. It's a great idea to buy a bag of frozen peas. In fact, some of my colleagues have branded ones that you put on your scrotum and keep them there not enough to freeze your boys, but just enough to kind of keep the discomfort at bay.

It really only takes a few days to heal from this. The discomfort is transitory. It'll be there for a few days to a week, but it's very minor, and you'll be back up and running before you know it. Point of note, you do want to get up and walk around while you're resting. You don't want to be a complete couch potato because you don't want blood clots in your legs. But sack out for a little bit.

Interviewer: All right. And how long until I'm back to work? So I get the procedure. I go home on, like, say, a Monday. When can I expect to go back to work?

Dr. Pastuszak: Yeah, that's a great question. So, basically, we don't want you lifting anything heavy for three to five days. So depending on what you do, just be aware of that, you know. If you're a guy at a factory who lifts 50-pound boxes every day, desk duty for a few days.

Interviewer: Got you.

Dr. Pastuszak: If you're, you know, a corporate executive, lawyer, doctor who just kind of pushes pencils or stands and does surgery, a day or two should be fine.

Interviewer: All right. And when will the patient know that the procedure was actually effective because it's not immediate?

Dr. Pastuszak: Right. So it takes your body three months to make sperm. So we only know that that tube is occluded with no sperm coming out three or more months after your vasectomy. Also, keep in mind that you need to ejaculate 10 to 20 times to clear the pipes between when you have your vasectomy and when you go in three or more months later to get your semen analysis.

Interviewer: All right, and the great thing about that is this is one of the . . . it might be the only birth control procedure you can test for effectiveness, that's not somebody getting pregnant.

Dr. Pastuszak: That's right. That's right. And, you know, just talking about birth control, you should use a second form of birth control while you're waiting for that three-month period to be over.

Interviewer: Got you. Are there any risks I should be aware of?

Dr. Pastuszak: Yeah. So any procedure comes with risks, but the risks for vasectomy are very minor. And the three main risks include infection, bleeding, and pain in the testicles that is present after the vasectomy itself, or develops weeks to months after the vasectomy itself. All of those risks are less than 1% to 2% of all patients who have a vasectomy.

Interviewer: Wow. So that is about as safe as it gets when you're talking about a surgical procedure, it sounds like.

Dr. Pastuszak: Absolutely. If you want to have a great sex life without worrying about getting your partner pregnant, vasectomy is the way to go.

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