Over the last 25 years and 2,500 no scalpel vasectomies that I’ve performed, I’ve have learned a lot about men. A famous cancer surgeon once told me that he thought that a well-done vasectomy under local anesthesia is “probably the hardest surgical procedure in the entire field.” Harder than taking out a bladder? Yep! Because you’re dealing with a man’s family jewels while he’s awake!
For the life of me, I cannot think of a good reason for why God or Darwin put a man’s genitals out in the breeze like they are. A woman’s ovaries are neatly tucked in the pelvis, all warm, cozy and protected, which makes sense. But the male junk hangs way out there between the legs, like nobody’s business, and is prone to all sorts of things: a stray elbow in a basketball game, an errant pitch in baseball, a large dog’s paw, or a 3-year old’s head butt. Nothing buckles a man faster than a direct hit down there.
Vivaldi of Vasectomy
A vasectomist must be not only skilled and swift like a concert pianist, but also attentive to the man squirming at the head of the table. Telling a man to “just relax” when he’s spent his entire life guarding his jewels from just this sort of attack is futile. What’s he supposed to do?
The key is to never let him get tense to begin with.
My go-to tricks for keeping men relaxed for the 6-8 minutes it takes to do the snip are oral sedatives and jazz. The secret sauce is ‘diversion,’ which is precisely why my Brosectomy patients do so well—in group vasectomies, men are distracted by their friends and comforted in knowing that they are not facing the challenge alone. But even these bells and whistles can fail to calm in the face of extreme anxiety, which occurs almost reflexively in a few men.
A Laughing Matter
As I was pondering how to further improve the acceptability of vasectomies, I thought about dentists. The mouth is another extremely delicate body part, replete with nerves all over. Honestly, I still get anxious when I find myself plastered to the dentist chair, hands gripping my clothes, wondering whether that thin, curved, sharp probe being stuck in my chops will find a cavity or hit a nerve.
And then it occurred to me: dentists have been using “laughing gas” (nitrous oxide) during their procedures for almost two centuries! Discovered by Joseph Priestly in 1772, right before we became a nation, nitrous oxide was first used by a dentist, Horace Wells, in 1844. In fact, Wells used laughing gas to have his own tooth painlessly extracted! Nitrous oxide is now as common as spitting sinks in dental offices. And what it does really well is to break down anxiety. It’s a fabulous anxiolytic. And it’s so safe it’s used on children for all sorts of procedures.
So, with our nitrous-powered vasectomy, I can pretty much guarantee that your tension and anxiety will go out the window during your procedure. Indeed, vasectomies are now little more than a laughing matter.