Vasectomy is a short office procedure, but it is still permanent surgery. Dr. Chapman believes patients should understand the anatomy, the technique, the expected recovery, the limitations, and the testing process before deciding to proceed.
What does a vasectomy actually do?
A vasectomy prevents sperm from traveling through the vas deferens and entering the semen. It does not remove the testicles, affect testosterone production, change erections, reduce sex drive, alter orgasm, or meaningfully change the amount of semen produced.
The testicles continue producing testosterone and sperm. Testosterone continues entering the bloodstream normally. Sperm that can no longer travel through the vas deferens are broken down and absorbed by the body.
Most semen comes from the prostate and seminal vesicles, not from the testicles. That is why ejaculation generally looks and feels essentially the same after vasectomy.
What does “No-Needle. No-Scalpel. No-Clip.” mean?
No Needle
Dr. Chapman uses a needle-free device to deliver local anesthetic through the skin. Patients may feel a brief snap or pressure, but there is no conventional injection needle used for the numbing.
No Scalpel
The vas deferens is reached through a very small puncture in the scrotal skin rather than a traditional scalpel incision. Because the opening is so small, Dr. Chapman does not place stitches in the skin.
No Clip
Dr. Chapman does not leave permanent metal clips in the scrotum. He uses dissolving suture to secure the tissue interposition. The suture is absorbed after healing.
Exactly how does Dr. Chapman divide the vas deferens?
A short section of each vas deferens is removed. The body-side end is cauterized. Dr. Chapman then places a layer of surrounding tissue between the divided ends and secures that tissue with dissolving suture. This is called tissue or fascial interposition.
The testicle-side end is not cauterized, clipped, tied, or otherwise sealed. It is left open. This is called an open-ended vasectomy.
Why does Dr. Chapman use an open-ended technique?
The testicles continue to produce sperm after vasectomy. Dr. Chapman believes leaving the testicle-side end open makes anatomical sense because it may reduce pressure buildup within the epididymis.
Open-ended vasectomy is an accepted technique. It cannot guarantee that chronic discomfort will never occur, and Dr. Chapman does not claim that it has been conclusively proven superior to every closed-ended technique. It is the approach he personally prefers and the method he would want used on himself.
Why does Dr. Chapman avoid metal clips?
Metal clips and dissolving sutures can both be used to secure tissue interposition. Success does not appear to depend simply on whether a clip or suture is chosen.
Dr. Chapman personally prefers not to leave permanent metal in the scrotum. When he chose a physician for his own vasectomy, he selected someone who used dissolving sutures rather than permanent clips. He treats patients the way he wanted to be treated.
Patients should know what technique will be used and should be allowed to decide whether permanent metal clips matter to them.
Where is the procedure performed?
Every vasectomy is performed in the Texas Vasectomy Center office in Pearland. Dr. Chapman does not send his vasectomy patients to a hospital or ambulatory surgery center.
He never uses an anesthesiologist or general anesthesia for vasectomy. There are no hospital, surgery-center, or anesthesiology charges added to the office procedure.
What happens during the consultation?
Dr. Chapman personally conducts every consultation. There are no physician assistants or nurse practitioners in the practice.
The consultation includes:
- Review of medical and surgical history
- Discussion of permanence, alternatives, risks, and possible complications
- Explanation of the no-needle, no-scalpel, no-clip technique
- An opportunity to ask Dr. Chapman questions directly
- An examination to determine whether the anatomy is suitable for an office no-scalpel procedure
Many patients choose to have the consultation and vasectomy on the same day.
Why is the examination important?
Most men are good candidates for an office no-scalpel vasectomy, but some anatomy does not allow the vas deferens to be safely isolated through a small puncture.
If direct visualization through a larger incision is required, the procedure should be done in an operating room with anesthesia. Dr. Chapman does not perform operating-room cases, so he refers those patients to a urologist who does.
If Dr. Chapman determines that the patient is not a candidate for his office procedure, the patient is not charged for that consultation.
Is the procedure painful?
The goal is that patients should not feel sharp pain. They may feel pressure, pulling, or movement. If discomfort occurs, additional local anesthetic can be given.
The only optional comfort measure is the Pro-Nox nitrous oxide system, available for $100. The gas wears off within minutes after it is stopped. Patients may drive themselves home after they have recovered and feel normal.
Dr. Chapman does not use routine oral sedatives, IV sedation, general anesthesia, or an anesthesiologist for vasectomy.
How long does the procedure take?
The vasectomy itself generally takes about 10 minutes, although anatomy varies. Patients should allow additional time for check-in, preparation, consultation if performed the same day, and postoperative instructions.
His priority is to keep the patient comfortable, identify the anatomy correctly, and perform every step carefully. Finishing safely and correctly matters more than claiming the fastest time.
Can I drive myself home?
Yes. Patients receiving local anesthetic may drive themselves home. Patients who choose Pro-Nox may also drive once its effects have worn off and they feel completely normal.
What is recovery like?
Most patients have mild soreness, tenderness, bruising, or swelling for a few days. Patients receive clear written instructions at the procedure.
We recommend applying an ice pack to the scrotum intermittently for the first 48 hours. After 48 hours, patients may resume light-duty activities such as walking, desk work, driving, and other non-exertional tasks. Avoid exercise, jogging, bicycle riding, strenuous activity, and intercourse for the first week. After one week, most patients may return to normal activities. Activities that involve significant impact to the scrotum or unusually high physical strain—such as mountain biking, Brazilian jiu-jitsu, or powerlifting—may require a longer recovery period before resuming.
When can I stop using birth control?
A vasectomy does not work immediately. Patients must continue contraception until cleared by Dr. Chapman’s office.
Patients have two options for determining when they are clear after vasectomy.
Option 1: Bring semen samples to Dr. Chapman’s office. Dr. Chapman personally examines each sample and uses a strict standard: no sperm seen. The first sample is due six weeks after the vasectomy. To be cleared using in-office testing, the patient must have two negative samples in a row, collected at least two weeks apart.
Option 2: Use the Fellow home semen sample kit. Patients may purchase the kit from our office for $140 or directly from Fellow for $149. Because our office receives the kits at a discount, we pass those savings on to patients. Patients who choose this option should submit their first sample no earlier than eight weeks after the procedure. Because of the way Fellow analyzes the sample, only one negative result is required for clearance. If the result is positive, Fellow provides additional kits at no charge until a negative result is obtained.
More information is available at www.meetfellow.com.
How much does semen testing cost?
In-office semen testing is free. The practice provides specimen cups, and repeat office samples remain free until the patient has two negative samples in a row.
Dr. Chapman personally examines office samples. Results are generally available the same day, usually within minutes to hours.
The Fellow home semen-testing kit is optional and costs $140. It is offered as a convenience for patients who prefer mail-in testing. It is not required.
After two negative office samples in a row, additional future testing requested by the patient is charged.
What happens if sperm are still present?
The patient is not cleared and must continue contraception. Additional samples are submitted as directed.
Occasionally, sperm persist for a prolonged period and the vasectomy needs to be repeated. Dr. Chapman estimates that this has occurred approximately 10–15 times during his career.
If the vasectomy needs to be repeated, Dr. Chapman does not charge the patient a second procedure fee.
What is Dr. Chapman’s experience with late failure?
Dr. Chapman is not aware of any late failures or pregnancies occurring after he personally cleared a patient based on post-vasectomy semen testing. However, no vasectomy can be guaranteed never to fail. Published estimates place the risk of late failure after documented clearance at approximately 1 in 2,000 vasectomies. Although this has not occurred in Dr. Chapman’s patients to his knowledge, that experience cannot guarantee that a late failure will never occur in the future.
What complications are possible?
Vasectomy is generally safe, but it is still surgery. Possible complications include:
- Bruising, swelling, or bleeding
- Hematoma
- Infection
- Inflammation of the epididymis
- Sperm granuloma
- Persistent or chronic scrotal discomfort
- Failure or reconnection of the vas deferens
- Need for repeat vasectomy
Can vasectomy cause long-term pain?
A small percentage of patients experience persistent scrotal discomfort after vasectomy. Symptoms can range from mild nuisance discomfort to pain that interferes with daily activity.
Dr. Chapman uses an open-ended technique because he believes leaving the testicle-side end open may reduce pressure buildup. However, no technique can guarantee that chronic pain will never occur.
Does vasectomy affect long-term health?
Current evidence has not established vasectomy as a cause of testicular cancer or cardiovascular disease. Patients with concerns about specific long-term risks should discuss them directly with Dr. Chapman during the consultation.
Can a vasectomy be reversed?
Sometimes, but a vasectomy should be considered permanent. Reversal is a more complex microsurgical procedure, is often not covered by insurance, and does not guarantee pregnancy.
Anyone who thinks he may want biological children later should delay vasectomy or discuss sperm banking before proceeding.
Can younger, single, or childless men have a vasectomy?
Yes. Dr. Chapman does not require men to be married, have children, or be a certain age in order to have a vasectomy. He understands that having children is a personal decision and is not the right choice for everyone.
Who may not be a candidate for an office no-scalpel vasectomy?
Most adult men can be considered for vasectomy regardless of marital status or whether they already have children, provided they can give informed consent and understand that the procedure is intended to be permanent.
An office no-scalpel vasectomy may not be appropriate when:
- The patient cannot provide informed consent or is being pressured by someone else
- The patient is uncertain about permanent infertility or expects reversal to reliably restore fertility
- The anatomy cannot be safely managed through a small office puncture and requires direct visualization in an operating room
- The patient is taking a blood thinner that cannot be safely managed for the procedure
- The patient has already had a vasectomy, a reversal, and now wants another vasectomy, because internal scarring may require an operating-room approach
- There is an active infection or another unresolved medical issue that should be addressed first
Dr. Chapman makes the final determination during the consultation. If the anatomy is unsuitable for his office technique, he explains why, refers the patient to a urologist who performs operating-room cases, and does not charge for that consultation.
Will I have a routine postoperative appointment?
We do not require routine in-office postoperative visits. We ask every patient to call our office one week after the procedure so we can make sure he is doing well and review the semen-analysis requirements. If a patient has any concern that cannot be handled over the phone, we ask him to return to the office for a personal evaluation by Dr. Chapman.
Medically necessary postoperative visits related to the vasectomy are free.