September 27, 2022 • 44 mins
You can uncross your legs you big babies. Getting a vasectomy isn’t bad at all – recovery time is a breeze, pain is minimal, and you can consider it a gift to your partner. Learn the real deal on vasectomies (and get 20% off with our code: STUFF).
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff You Should Know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh,
and there's Chuck and Jerry's here with us too, and
that makes this Stuff you Should Know. With the snip
snip addition, snip snip a dish very nice. We're talking
(00:26):
about getting the snip a k A. A vasectomy a
k a. A vast otomy if you really want to
be smart about the whole thing. Um and Chuck, our
buddy Dave Russ helps us with this. And I have
to say, Dave is a really big proponent of vasectomies,
and I get why, but he really is all about vasectomies.
I suspect he would get a couple if he could. Yeah,
(00:50):
it's funny now that I know about them. It is
a remarkably basic thing that's being done. And sometimes that's
sort of the beautiful simplicity of certain medical procedures is
it's like, just cut that thing there and you're all good.
There's a problem that's not cut. So it is remarkably easy.
(01:13):
The recovery time is really fast. It's relatively cheap, even
if you don't have insurance covering it, which most most
people don't in the United States, and yet in the
US and a lot of other countries. Um. The the
it's really disproportionate the number of men in reproductive age
who have a vasectomy um compared to the number of
(01:35):
women who have undergone tubal ligation getting your tubes tied,
and both are basically equally effective, but getting your tubes
tied is way more involved. It requires general anesthesia, the
recovery time is much longer, and it seems to basically
come down to men just being scared of some guy
(01:55):
monkeying around their junk with a scalpel um and worrying
about what the after effects will be. But it turns
out totally unnecessarily and unfairly. Yeah, I mean, we'll get
to some of the myths, um and I would say
it's it's equal parts being scared of those myths and
quite simply the patriarchy, I mean kind of full stop
(02:19):
men saying like, uh, you need to take care of
that on your end. Uh, and and then we can
start having unprotected sex and the And that's why a
lot of people frame it as it's a real gift
that a man can give to his wife or his
spouse or his sexual partner, you know, the person who's
(02:40):
monogamously having sex with, Because we should point out vasectomy
is going to handle pregnancy basically every time. Um, it's
not going to help with S T I S. So
if you're running around exposing yourself, the monkey pox of
vasectomy is not going to help with any of that.
It's going to just help with the pregnancy partner. Yeah,
(03:00):
and I hope that counts as a blanket statement. So
when we say things like and now you can have,
you know, all the sex you want without using a condom,
without fear of getting pregnant, we don't. We don't mean
like a step right up. What we mean is is
you know with your monogamous partner you can now live,
(03:22):
and you know with your monogamous partner you can get
tested and you can know that that part is safe
as well. But we are definitely not saying just that
means you can go around and and spread your seed,
your your biological material. It was even worse somehow. Oh
(03:43):
it's terrible, Dave us as well. We'll get to the
material part. But it's such a gross way to describe
any thing that comes out of your body. But you
mentioned the patriarchy. Here's a patriarchal um stat for you.
Thirty of American women age thirty five to forty four
have their tubes tied thirty nine percent. Do you want
(04:04):
to know how many men aged thirty five to forty
four in America have had a vasectomy. I've got to
be at least twenty five right percent? Percent? That's it.
So that means that, um, what more than about three
times right on the nose, three times more women have
their tubes side than men undergo vasectomy. And hopefully, like
(04:28):
as people are hearing about this stuff, um, it becomes
less scary and maybe more men will be prone to
do it, because if you're looking to stop having kids
or never have a kid, this this is a really
good way to go. It's safe, it's effective, and again
it's relatively cheap, and the recovery time is like nothing. Yeah,
(04:49):
some of those myths that we mentioned that are not true.
Or is that the operation is painful, which is not true.
That it affects sex, that it affects your erection, it
affects your orgasm and ejaculation, it affects your sex drive
and testosterone. It means you're not a real man, Like,
none of those things are true. And if any of
(05:11):
those dudes were speaking to you, if any of those
are reasons why you don't want to get a vasectomy,
then you have no reason to just like that is
a fact. Yeah, and we'll go into those in more detail.
But yes, all of those are totally incorrect. Probably everything
you think or worry about vasectomes is incorrect. That's that's
(05:32):
a pretty good bet, actually, Yeah. Or if your reason is, well,
I don't know, I may want to have kids one day,
that is a very good reason because as you'll see,
there is a reversal surgery, but it they definitely haven't
perfected it. It is expensive, it's more invasive. Um, this
is something you really need to consider very very strongly
(05:56):
as a long term life decision. Yeah. Like if you
were like, oh, it's one more kid, and you're like,
I regret having this third kid, maybe it is time
to talk about getting a vasectomy. Or if you're like,
I think this world is grossly overpopulated, we're treating it terribly.
I don't want to introduce yet another human into it
and screwed up even more. Um, that might be a
(06:18):
good reason. I have a sectomy too, and apparently that's
an increasing um the reason for gen z and millennials
getting vasectomies these days. Yeah, Or if you have already
bore a couple of children and you look at your
partner and say, hey, dude, I don't want any more kids,
how about you get a vasectomy, and they give you
(06:39):
a reason that equates to I want to keep my
life options open. That's a different conversation. Yeah, then you're
with the wrong person, right, you know, But no, on
down the road, I might meet someone else. Right now,
I guess I should say, Chuck, we've we've been talking
almost exclusively about like men and women, you know, like
biological sex um as far as vasectomies go. And I
(07:02):
actually looked. I was like, is this part of transitioning
in the trans community? And I saw that probably isn't.
I mean, you can imagine like going from transitioning from
male to female. Um, you might want to get a vasectomy.
But I saw specifically that the hormone therapy renders that
like no and void, there's no point in getting one
(07:24):
from what I saw, right, So that's why we're using
the terms that we're using in the words we're using
so um. One of the things about a vasectomy One
of the reasons why it is so great is because
it is basically a hundred percent effective at preventing pregnancy.
And like I said, tubal ligation is is just as effective, um,
(07:47):
but as far as other stuff that men can do
to prevent to act as birth control, I mean, like
vasectomy is far in a way superior to all of them.
Like you've got coitus interrupt us a k a. The
pullout method. Yeah, that's only seventy eight percent effective. I
am too. You can just ask the pullout king if
(08:09):
that works or not. Hey, get in here, pullout king,
and then uh, condoms are eight five percent effective. That
seems high to me too, but I guess actually no,
and on second thought, it's probably pretty accurate. But even still,
that's a fifteen percent chance every time you have sex
that you're going to accidentally impregnate your partner. That's what's
(08:33):
so great about vasectomy. You have no worries whatsoever because
there's a whole bunch of steps that we'll talk about
that say Okay, you're good to go go forth and
have sex with your partner, that one partner that you're
monogamous with and is monogamous with you as much as
you like without a condom for the rest of your life.
Anytime you want, just go ahead and do it. Do
it in a changing room at Target, do it in
(08:55):
your card at the police station when you get arrested
for doing then changing room and Target, none of these
places you should do that. But you could because you
don't have a condom on you and it doesn't matter
in that sense. Uh. You mentioned it being relatively cheap.
Did you say the actual number, which is about a
thousand bucks? Yes? I did not. Okay, okay, yes you
(09:19):
did not. That kind of episode, Chuck. A thousand dollars
is certainly nothing to sneeze at. But um tubal ligation
is about six times that much. Um. Condoms aren't cheap.
So if you're if you're choosing to have a lot
of sex and were a lot of condoms and you're
going to run up a bill there. Uh. And it
doesn't take super long. It's a twenty minute outpatient surgery,
(09:42):
very very low risk of complications. Uh. It does not
require general anesthesia like tubal ligation does. It's just local anesthesia,
which that right there is like there's your like how
much do you love me kind of thing? Are you
going to let me risk dying under general anesthesia comp
here to your local anesthesia. That's the that's what makes
(10:02):
that kind of conversation hard when you're like, should you
get your tubes tied or should I get a vasectomy?
You know absolutely, uh in recovery time, it's just a
couple of days later. Um for vasectomy is you're kind
of doing pretty well, and it takes a few weeks
or up to a few weeks for recovery for tubal ligation. Yeah,
because tubal ligation is so much more invasive. You know,
(10:23):
it's it's a much greater surgical procedure. Um. And then
one other thing that is really important is like, like
I said, it's considered a gift from the guy to
his wife because you're saying like, hey, you don't have
to worry about this stuff anymore. You don't have to
take the pill anymore, you don't have to get an
I U D, you don't have to get injections. Um,
(10:45):
you don't have to get your tubes tied. Like I'll
handle this for both of us, and I'll take one
for the team. And that that really is like a
genuine gift that you can give your partner. That I mean,
like they I imagine they will value you for it
at the very least to put it in a really
sta away Sure, no pun intended, No, sadly, no, I'm
(11:08):
not that sharp today. Well, let's take a break. I'm
gonna sharpen you up, and we're gonna come back and
talk about the procedure right after this. All right, so
(11:37):
we're back. We're talking vasectomes. Keep saying it like it's
got an F in their vasectomese vasectomies, And the point
of a vasectomy is to keep your sperm away from
your semen. Uh. And this is where Dave uses a
word that just cracks me up. It's that material. Uh.
(11:58):
He says that semen is all of the material that
comes out of the penis during ejaculation. For some reason,
I don't know. It just sounds like you're pulling a
silk scarf out of a sleep or something. That's that's great,
but when you add biological in front of it, it
gets even worse because you're like, for some reason, you
just imagine it everywhere for as I do at least,
(12:22):
but sperm and semen are two different things, right, Yes,
sperm is just one tiny component component of semen and um.
You could make a really good case that semen exists
if you're into intelligent design and that kind of thing,
as a vehicle for sperm. But what humans have cleverly
figured out is you can keep the semen, you can
(12:43):
get rid of the sperm, and you can do this
you can spread the biological material all over the place
without any worry of getting pregnant because all you're doing
is removing the sperm from entering the semen, and the
semen comes out like normal. It's just sperm free after
of a vasectomy, that's right. Uh. It's called a vasectomy,
(13:05):
by the way, because of the vase the A S
deference a k a. The sperm duct um that is
basically the target of this operation. It is a tube
in the scrotum in the pelvis. It's called the vast deference.
There are two of them because you have two testes
and so a vase difference. If you well, we'll talk
(13:28):
about what you actually do, but it's called a vast
ectomy because of that, right, And you can remember that
by saying a vasectomy makes a vast deference in your
sex life. Very nice those off the cuff. I do
not have that written down at least so um with
so with the with the vasectomy, the vast deference is
just cutting. That's it. The vest difference from each testicle.
(13:52):
That's that's all there is to it. I mean there's
a little more to it, but it's really that basic.
You want to talk about the procedure. Yeah, like I said,
you've got these two vast deference each one, uh is
about twelve to eight eighteen inches. But size isn't important
here from what I've been told. Uh. And they run
from the base of your test e s up around
(14:13):
to the back of the bladder where your seminal vesicles are.
And like you said, their their job is to take
your sperm mix it in with the rest of your
semanic material. Which I don't think we said what it was.
It's fluids from the seminal vessel, fluids from the prostate, uh,
(14:34):
and from what's called the bulb I had it earlier,
the bulba erethoral grands. No, I'm afraid not go ahead
hit me. I think it's bulbo your rethroll. Yes, it
absolutely is so bad to me, is one of the
worst words I've ever seen. It looks like what it describes.
(14:56):
In my imagination, that word looks like it can't you
can't you just see it. But you put all this
stuff together, and you've got the biological material that comes
out of the penis during ejaculation, Like Dave says, right,
So the vast difference its role is to move sperm
from the testies too. I think the prostate um to
(15:16):
deliver this to your um, to your semen. And again,
when you have a vasectomy, all you're doing is cutting
the vast difference, so you're removing sperm from the equation um.
And now I think it's probably time to talk about
the surgery step by step, right, And I think when
we do this, most people who don't know about this
(15:36):
are going to be amazed because it is wham bam,
thank you, ma'am kind of surgery. Considering what you're doing
and the effect that it has, the outcome it has,
it's incredibly simple and fast. Yeah, maybe we should cue
up Yakety Sacks. That's the perfect Did you ever see
Dolly Parton at um? Oh? I can't remember what the
(15:58):
glaston Bury I think festival I did she said, I
can play yakety sacks backwards and she turns around and
plays it. Oh my god. Still after all this time,
she is National Treasure, International, Treasure Global. So what they're
gonna do is they're gonna numb the area that they're
(16:19):
going to be working on with local anesthetic on either
side of the scrowtum. That may be the most harrowing
part for for people listening to this. H They're gonna
make two small incisions at the top of the scuretum
so they have access to uh each vast deference, and
they're going to I love that, he says. Gently. They're
going to do gently withdraw part of it through the incision.
(16:42):
They're gonna snip it, and they're gonna seal it up.
Sometimes the stitches, sometimes they cauterize it. Uh. Sometimes it's
a combination of things. But they're basically just gonna seal
up that tube and they're gonna close those tiny incisions
up with stitches or maybe glue even that is it.
Whatever they have lying around exactly a little sawdust and spit.
(17:04):
But that's it, man, that is it. And again, yes,
the guy is cutting into your scrowedum, into your junk um,
I should say, I mean guy in a gender neutral way.
You know, who knows who your erologist is. But they
like they they are cutting into it. They know what
they're doing. It's really just cutting through a little bit
of skin that again has been anesthetized locally. And I
(17:26):
mean that's it. Like this, it's almost like cutting a
rope and then taking a lighter and burning each end
so that it doesn't fray any longer. That's pretty much
analogous to a vasectomy, except the rope is in your
your scrowed them and they don't use it like a
big lighter. They probably use something else to cauterize it. Yeah,
(17:47):
and then your riding your horse the next day. Actually,
you probably don't want to be doing that next day.
You want to wait a week to ride your horse.
But the point taken, you know. Uh. They're also what's
called no scalpel vasectomes, which are not completely no scalpel,
but there are no incisions made in a technical sense.
They use a this sounds even norse. Actually they use
(18:09):
a punch tool to punch a small hole in the
skin of the scrotum, and then they withdraw the section
of the vast difference that way. Um, you still have
to use a scalpel to cut the cut the tube,
but apparently you heal up a little bit faster with
this method. Yeah, because there's no actual incision. It's just
a puncture wound basically. So yeah, I mean it's smaller
(18:31):
surface area to to recover, I guess. Yeah. And if
you're thinking, Josh Chuck or doctor, doctor, well what about
all that sperm? I got so much sperm? Where is
it gonna go? And it is gonna build up? And
that you know that's a problem. Uh, that is not
what happens. Your body absorbs the sperm. You don't get
(18:52):
some big, like massive sperm build up. Let me tell
you about your sperm and where it matures over seventy days.
And then also it's in the epididymus. And your epididymus
is eighteen feet long, and it's coiled up in your testies.
Each testicle has an epididymus that's eighteen ft long if
you stretched it out, and this is where the sperm
(19:14):
kind of gathers and grows and and gets ready for action.
And apparently after your vasectomy and the sperm has nowhere
to go. It stays in the epididymus, which naturally absorbs
it back into the bloodstream because if you, you know,
don't see any action for a while, your sperm can
get kind of old and your body wants new, fresh
good sperm to be used, so the old stuff gets
(19:37):
absorbed anyway happening, Yes exactly. This isn't like some new
thing that your body has to do. It's just that's
all it does now is absorbs sperm. It doesn't ejaculate
it anymore. Right, Um, you mentioned the term bestotomy earlier.
Technically that's probably what it should be called. Uh ectomy
is is usually when you are removing something, and you're
(19:58):
really not removing anything in this So if you want
to get super technical, you could call it a bestotomy
and your doctor might just say yeah, yeah, yeah, I
got you, or they might be like, oh, I'm going
to give you a nice valium too, because you impressed
them so much. There's one other thing about the sperm.
There's a kind of vasectomy called an open end vasectomy,
(20:19):
where they just caught or eze them the tube leading
to your prostate and the tube that's coming right out
of your testicle is left open. So that the sperm
actually just does flow out into your scrotum and it
gets absorbed in there as well. And is it like
one of those uh spaghetti sprinklers that kids run through
when you turn it on. No, it's like one of
(20:42):
those um those like air blow guys that like tire
stores used to bring in the customers. I think it's
more like that or either one, because they're both the life. Um, this,
like we mentioned, takes about twenty minutes, doesn't even have
to take that long. Sometimes they can get you in
another and as little as ten minutes you might get
a little bit of pain meds. But um, and you
(21:05):
know this is from from Dave sort of telling his
firsthand that after the first day or so, it's really
not that big of a deal. But you're gonna be
resting for twenty four hours you meet chilling out in bed. Basically, Um,
you want to wear this is pretty funny. Um, you
want to wear tidy whitey's very tight underwear or a
(21:25):
jock strap for forty eight hours? Right, Probably the tidy
whities is preferable. I don't know, jock strap is pretty good. Look,
you just don't want to think swinging around because you
have two incisions on your scrotum that have been stitched up,
and you don't want to, you know, loosen the stitches,
I think is the point. Yeah, what else you gonna do?
Cold pack? No, no, no doubt, like actual frozen bag
(21:48):
of frozen peas could work, um, because it could become inflamed.
Your body has been insulted and it's going to react
with inflammation. That helps with it. Um. Again, you're gonna
have pain, and you probably won't need them after the
first day. You might need like advil or tail and
all or whatever. Your regular analgesic is. Um. But like
we're saying earlier, you can't ride a horse for a week, right, Yeah,
(22:13):
in a couple of days, you can do desk work
and stuff like that and you're off your feet, but um,
no sports and and uh no sexual activity for a week.
So here's the sort of trick is you're gonna still
have sperm in your system after a vasectomy. Uh. So
there's a chance if you had unprotected sex with your
(22:35):
partner right away, uh, that you could get them pregnant. Uh.
You need to clear the system. So it takes up
the fifteen to twenty ejaculations to clear the system out.
So if you want to go back to having sex
that you know, like literally one week after you have
had this operation without getting pregnant with your partner, you're
(22:57):
you know, do the math, You're you're welcome back to
seven grade. Basically, yes, So like for a good three months,
they're basically like, you need to really be careful and
they're going to get you in there um afterward as
part of this post operative care about you know, anywhere
from like a month and a half to three months
later to say, okay, give us a sperm sample and
(23:19):
we're gonna see if you have any any guys swimming
around in there, and uh, if you pass, they will
say you've got no sperm, go forth and have fun um.
And if you don't pass, they'll say, okay, well we
need to to you know, keep safe a little longer
and then come back and give us another sample. And
they'll keep doing that until there's just no sperm found,
(23:40):
like zero no sperm, so zero percent sperm, I guess
is what I'm trying to say. Yeah, am I reading
this correctly? Though? Because you can have sex seven days later,
it takes fifteen to twenty ejaculations yet they check you
out six to twelve weeks later. Yeah, they're saying, like
(24:02):
you behave as if you did before your vasectomy for
six to twelve weeks. Like if your wife or your
partners on the pill, she should probably stay on the
pill for six to twelve weeks until you get the
all clear if you use condoms, keep using condoms, and
during that time when you have sex, there is that
risk that you will still get pregnant until you get
(24:22):
that all clear from a sperm test that finds no sperm. Right,
But is that because they assume it will take six
to twelve weeks to have those twenty ejaculations. I got you,
I got you. I don't know, because that does seem
like a really long time, doesn't it. Well, I mean
that's why I said, welcome back to seventh grade. If
you want to knock that out in a week, I'm
(24:44):
glad you went back and explain that. I thought you
were what you were saying, like you're worried about getting
someone pregnant. I can say this in a grown up way.
Does that mean you can masturbate twenty times in a
week and clear out your system and you're you'll be good?
To go or is it really like you really need
to think about this six weeks later to twelve weeks later.
(25:05):
I don't know. I would guess if you boasted to
your urologist that twenty ejaculations is not going to take
you six weeks, they might say, okay, well, schedule lists
for three weeks from now or four weeks or whatever.
You know. I would think, so, yeah, yeah, I would guess,
so all right, because they have like a wall of
fame in the office. Right, it's just covered here in
(25:27):
two days. Um, so yeah, I fifteen to twenty ejaculations
and ejaculations and ejaculation, right, it doesn't it doesn't have
to just be through intercourse or coitus, I think, is
what the kids call it. That is true. How many
times have we said ejaculation in this episode? More than ten?
(25:47):
I would say, So you want to take another break
and then come back and talk about some of the
risks involved, because there are risks, it's true, but they're
just fairly small. Yeah, let's get let's do that and
get back to it. M Okay. So when you cut
(26:19):
into a scrotum, when you cut a part of an
internal network of tissues, um and steal it back up
and called it as it. There are risks UM, even
though you're not under the risk of general anesthesia. UM,
you could conceivably get an infection at the incision site.
UM that you can get blood clots um inside of
(26:40):
the scrotum, Blood can show up in your semen, your
scrotum can become bruised. All of these things, at least
the first few that I mentioned are stuff that you
probably will get as a result of a vasectomy, but
they're going to clear up fairly quickly. And again that
bag of frozen Peace can really help with the inflammation
the tile and all or advil come and help with
(27:01):
everything else. There are some some actual possible longer term
complications that you should be aware of though. Two. Yeah,
there's a very small percentage I think one to two
people who have chronic pain after the surgery. UM. And
these are the people in this category or the part
(27:21):
of the percentage of people who one day might want
to get this reverse because of that chronic pain. UH.
An abnormal cyst called a UH spermato seal, Yeah, I
think so. Yeah, that could develop UH in the coiled
tube located at the upper part of the testicle UH
that collects and transports that sperm. But these are, like
(27:43):
we said, these are down. If you're down in the
low single percentage points, it's you know, considered very low
risk UM. And you know, the the upshot of her
the UM. The upside of it, I should say, is
that again, UM, you actually will probably experience, at least
as far as some studies have found, UH, an increase
(28:05):
in sexual satisfaction. Because cutting your vast difference has nothing
to do with hormones. That has nothing to do with UM,
your ability to get an erection, your ability to ejaculate.
There's another one UM instead. Again, it's just removing sperm
from the equation. That that's it. That's right. UH. Testosterone,
don't worry about that. That is produced in the test
(28:27):
is like the sperm. But there's a different kind of cell.
It's called the late late egg cell or the lighting cell.
I like the second one better, let's go with that,
the lighting cell UM. But it goes it has a
one way trip. It goes directly from the tests into
the bloodstream. It does not go through the vast deference.
(28:48):
There is no impact whatsoever on your testosterone. UH. In
sex drive and in fact, it may actually increase your
sexual desire. Um. They've done studies. It had one in
Germany that said that, uh that if you've had a vasectomy,
you have a greater or at least they reported greater
satisfaction than the control with orgasm, with sexual desire, with
(29:12):
satisfaction of intercourse with erectile function. Spontaneity, that's a big one. Yeah.
I mean a lot of it may just be psychological,
like all right, um, I'm free, I don't have to
worry about this anymore, so that that'll probably increase all
kinds of happiness. Yeah, exactly. I get the impression that
that is um from this German study from I think
two thousand and seventeen. Um. They they surveyed both men
(29:37):
with vasectomies and their partners, uh, and found that the
partners were like, yeah, actually it's a little more arousing.
The actual act of sex didn't change for me at all,
but there's something, there's something going on here, And I
think I would chalk that up to spontaneity and not
having to stop to like put on a condom or
you know, feeling freer because you didn't have to take
a pill that day. That kind of thing. It wasn't like, doc,
(30:00):
I gotta tell you. We started doing some crazy stuff.
Have you ever done it in a target changing? Oh no, no, no,
don't tell your doctor that. So um, well, we said
it's you know, a thousand dollars, which is, like you said,
nothing to sneeze at all. But compared to tubal ligation,
which is six thousand dollars at least, um, it's much cheaper.
(30:24):
The thing is, in the United States, insurance companies don't
have to cover vasectomies. They do have to cover tubal
ligation procedures. And it's probable that that accounts in addition
to the patriarchy that you mentioned full stop. Um, in
addition to that full stop some people just being cheap
and saying like no, I mean like we can get
a tubal ligation for like fifty bucks and you know,
(30:46):
rather than vasectomy for a thousand dollars. And if there's
any man out there who does not want to get
a vasectomy, he's going to hammer that point home every
chance he gets until he went he gets his way. Yeah. Maybe, uh,
we mentioned people getting wanting these reverse About six percent
of people who get a vasectomy end up wanting that reversal.
(31:08):
Like we said, some of those come from the chronic
pain category, and other people you know, want to have
kids and decide, oh I've made a great mistake. Um,
that'll cost you between five and fifteen grand and it'll
take four to six hours. And even when you do, uh,
if it's considered you know, quote unquote successful, your pregnancy
(31:28):
success rate UM is between thirty and moving forward. So
some people say, just go I v F. Then if
you want to do that and get that sperm directly
from the testicles, uh, because as a much better success rate,
you can do that if you want. That'll still cost
you a bundalow IVF. It's not cheap, yeah, but it's
(31:48):
a lot less invasive and permanent than reversing your vasectomy. Right,
that's right. Um, Remember how we said that vasectomes are
like effective or something like that, they have like a
one percent fail your rate. I think we said that
that failure rate comes very often from something called reconalization.
Did you see that part? I don't think it's all
(32:09):
that part. So reconalization is where the vast deference grows
back together. It creates new tissue that basically go around
the stitches or the clamps or the cauterization and grows
new tubes that seek out and connect with the other
end of the vast difference and reconnect. It's which is
(32:33):
it just goes to show you that nature finds a way.
But again, O, man is it? Life almost had it? Um.
But again this is really really rare. And apparently the
positioning of the to the separate ends of the vast
difference has a huge effect on that too, Like you
don't want to leave them anywhere near each other, you know, Oh,
(32:55):
I see you over there. And one of the things
about that reversible vasectomy UM, like apparently that's a holy
grail in neurology. Uh, And they're looking at ways to
to basically temporarily UM create a vasectomy. There's stuff called
reversible inhibition of sperm under guidance. It's a type of
gel that you can put into the vast deference and
(33:17):
then it has to be flushed out later on UM
to remove it, and then all of a sudden, it's
like your vasectomy was reversed. Yeah. That this falls under
the same category of like simplicity, Like I imagine they
were trying to think of an easy way to reverse this,
and somebody was like, hey, you have any gum, You
have any chewing gum? Right, we could, we could clog
(33:40):
up that tube. And that's basically all they're doing. They're
clogging the tube with a gelled implant, and uh, yeah,
it makes a lot of sense. Better make sure that
that clog is pretty tight. Yes, apparently that has a
failure rate from one Indian study in two thousand nine
of four percent, where again of vasectomy as one percent. Yeah,
(34:01):
I think safety is the concern. They're right, absolutely right.
So I saw it explained as with a with a
pill with women UM, the control group in when you're
figuring out safety is pregnant women and UM pregnancy is
riskier than the side effects are complications from taking the pill.
So the pill wins out. It's safer, it's justified, and
(34:23):
that's how it gets um UM the green light for
use UM. With a male pill, the control group is
just healthy men. There's no pregnancy, so the male pill
has to stop sperm production withoutside effects, like any side effects.
Because if you go beyond a healthy male um as
the which is the control group, then all of a
(34:44):
sudden it's less safe and it probably won't get approved,
so they're actually, yeah, there actually is. I'll though I
don't know how hard they're working on a mail pill.
Probably not so hard, although you never know. Is that funny?
I'd rather not say. Come on, um, all right, we'll
finish up with a little bit of talk on eugenics.
(35:07):
We did an episode many, many years ago about sterilizing addicts,
specifically uh, which is you go back and listen to
that episode. It's pretty interesting, probably somewhat outdated at this point,
but who knows. Yeah, just the use of addicts I
think is outdated, so but it's still it's a pretty
interesting episode. But this is a notion that started out
(35:31):
all the way back in the mid eighteen hundreds. Veterinarians
started experimenting with dogs, giving dogs vasectomys instead of castrating them,
and in the eighties started performing performing them on men.
And of course it didn't take very long for eugenicists
(35:53):
to get involved and say, hey, this is a great
thing because we can just essentially nouter crim pinals, we
can neuter people who are mentally ill, we can neuter
people who are poor, and that will solve a lot
of the world's problems. Yeah, and so the eugenics movement
really took this up. Um. There was a guy named
Dr Harry Sharp in the United States. He was a
(36:14):
leading performer of vasectomys among eugenicists, among anybody. I would
guess he actually performed the first vasectomy for non medical reasons. Um.
It was on a nineteen year old inmate at a
reform school in Indiana who had complained of excessive masturbation,
and so Sharp game a vasectomy and said that he
(36:35):
quote became more of a sunny disposition, brighter of intellect,
and ceased to masturbate end quote. And um, he kind
of went from there within a decade on just a
tear where anybody who he deemed or the eugenics movement
deemed undesirable to the gene pool should be should receive
a vasectomy. Yeah. Alongside him was an American named Albert
(37:01):
Osner published a book, or I guess at least a
pamphlet called Surgical Treatment of Habitual Criminals, Uh that advocated for, uh,
you know exactly what it says, making criminals sterile. Um.
And it was just sort of a time in the world,
and especially in the United States where they thought that
(37:22):
like I said, if you were in an almshouse, if
you were in an asylum, um, if you were certainly
if you were in prison, then it was a good
option to force a vasectomy on somebody. And this happened
to an alarming degree. I think through the end of
World War Two they estimated about three hundred and twenty
thousand UH forced sterilizations without consent. I did not see
(37:47):
a racial breakdown, but you can bet that it affected
people of color more than others. It just would make
sense because that's how it's kind of gone in this country. Yeah,
and it wasn't. I mean, America was deaf really an
early proponent leader of eugenics. But if all this sounds,
you know, ghastly familiar, that whole thread was picked up
(38:07):
by the Nazis in the early nineteen thirties and they
sterilized countless people, both um through vasectomys and um through
tubal ligation. And apparently I didn't realize this. Switzerland had
early eugenics law, apparently the first eugenics law, and they
targeted the roma, and the roma could were still subject
(38:29):
to involuntary vasectomys up until nineteen seventy two in Switzerland,
isn't that insane? Yeah, that's uh, that's shameful. And by
the way, when I said it made sense that they
forced sterilization probably on people of color more you know
how I meant it? Right? Everyone Sure, it didn't mean
(38:50):
that made sense in any kind of ethical way. It
made sense because that's how people of color have been
treated in this country. I like the person who thought
that this had to have been their first episode and
now explained it to that one person. Just want to
clear that up. Alright, good, everybody knows chuck. So ending
it on eugenics is kind of a sour note. So
let's talk about one more old timey thing, um medical procedure.
(39:13):
It is misguided, but it's not nearly as bad as
vasectomys for eugenics. Um. There's an Austrian andrew chronologist named
Eugene Steinuk, and he said, I've got this great idea.
If I cut just one vast difference, the other one
will still be able to contribute sperm to the seamen,
but the severed vest difference will give up on sperm
(39:33):
and go into overdrive for producing hormones like testosterone, which
will give men just this huge boost of virility, and
he started going crazy performing it on everybody who would
step up. Yeah. Basically like, if you want to increase
your sex drive, you can have this elective procedure. Uh.
And people like Sigmund Freud and writer William Yates use
(39:57):
this uh procedure and under went this procedure to boost
their sex drive. Yeah. And apparently, um, they were like, well,
actually testosterone works totally differently and that what you just
did all these people doesn't work at all. So I
guess Steinock went retired in disgrace. Um. And if you
thought that was a pretty fun factoid, prepare for this one, Chuck.
(40:19):
I think you should take us out with us. Okay. Uh,
day found a statistic because and who knows that this
is correlation or not, but there is a statistic because
you you're supposed to lay around for a couple of days.
When you're laying around for a couple of days, maybe
you're reading a book, educating yourself, or maybe you're just
watching a lot of television. But didn't they find that.
(40:40):
I think the finding was that the procedure went up
a lot during March Madness in c double a basketball
tournament time, so men could have an excused to lay
around and watch it. Is that right? A thirty percent
increase in vasectomy procedures in the US during the first
round of the n c a A A basketball tournament. They
(41:01):
call it vast madness. I gotta know if that's true.
If that's why, gotta know? Well, the only way to
find out, Chuck, is to undergo of a sectomy procedure
and ask your eurologists during the middle of it, because
you won't be under general ESTI anesthesia, it'll be local
mhm uh do you got anything else? I've got nothing else? Okay, well,
(41:23):
Chuck said he's got nothing else, which means, of course
it's time for a listener mail. That's right. Uh. This
is from our buddy Mark Koontz. Mark and Gayl Counts
are longtime listeners and and real life pals of mind.
They came to our show in Cleveland, and Gayl is
a longtime movie crusher. But Mark wrote us an email
about suicide Awareness Month, which it is right now. Uh.
(41:47):
And this is a Mark is you know he's out
there doing like the tough work. Great dude. Uh. September
is back to school season, guys in Suicide Prevention Month,
which means you. Suicide prevention is on my mind more
than usual. As know. I'm a licensed art therapist at
Clark County Educational Service Center in Springfield, Ohio, helps schools
meet the mental health needs of thousands of students. Most
(42:09):
people think of suicide prevention with youth means focusing on
trauma and handling and handing out hotline information, and of
course sometimes you do those things. But my favorite suicide
prevention program and the reason I'm writing is called Sources
of Strength. That is a youth led suicide prevention program
that has been used in schools across the U. S
(42:29):
and Canada and Australia. Sources of Strength are things like
positive friends, mentors, and mental health. These are some of
the protective factors that we can rely on when we're
stressed or to help us get through a crisis. UH
And for the past year I've been trying to get
sources of strength and every single one of my county
schools and with funding and support from the Ohio Suicide
(42:51):
Prevention Foundation and Prevention First with an exclamation point, schools
in Ohio can implement sources of Strength at no cost.
So if your list some thing he just want to
Grant for like tin Grand or something like that, which
is genius grant. He's won it before, I think, but
he says. If you're listening to this and you're in Ohio,
you can learn by visiting Sources of Strength Ohio dot org.
(43:13):
Even if you're not in Ohai, you should still visit
the Sources of Strength dot org website and learn about
the sources eight protective factors. Also, adults need protective factors too.
I'd like to thank both of you for always advocating
for mental health as well as spreading useful and be
official information to all of us, and for being positive
(43:34):
people in the world. Your voices mean so much to
so many. Greatest thanks from your old pal Mark Counts.
So hey Mark and Gale and your cute pets. I
appreciate the work you're doing. Yeah, same here at Mark. UM.
That's magnificent stuff. Thanks for writing in to let everybody know. UM,
if you want to write in like marketed and just
basically say I'm a hero without saying I'm a hero,
(43:57):
we would love to hear from you and tell everybody
about out that you can wrap it up spanking on
the bottom and send it off to stuff podcast at
iHeart radio dot com. Stuff you Should Know is a
production of I heart Radio. For more podcasts my heart Radio,
visit the iHeart radio app, Apple Podcasts, or wherever you
listen to your favorite shows. H
Welcome to Stuff You Should Know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh,
and there's Chuck and Jerry's here with us too, and
that makes this Stuff you Should Know. With the snip
snip addition, snip snip a dish very nice. We're talking
(00:26):
about getting the snip a k A. A vasectomy a
k a. A vast otomy if you really want to
be smart about the whole thing. Um and Chuck, our
buddy Dave Russ helps us with this. And I have
to say, Dave is a really big proponent of vasectomies,
and I get why, but he really is all about vasectomies.
I suspect he would get a couple if he could. Yeah,
(00:50):
it's funny now that I know about them. It is
a remarkably basic thing that's being done. And sometimes that's
sort of the beautiful simplicity of certain medical procedures is
it's like, just cut that thing there and you're all good.
There's a problem that's not cut. So it is remarkably easy.
(01:13):
The recovery time is really fast. It's relatively cheap, even
if you don't have insurance covering it, which most most
people don't in the United States, and yet in the
US and a lot of other countries. Um. The the
it's really disproportionate the number of men in reproductive age
who have a vasectomy um compared to the number of
(01:35):
women who have undergone tubal ligation getting your tubes tied,
and both are basically equally effective, but getting your tubes
tied is way more involved. It requires general anesthesia, the
recovery time is much longer, and it seems to basically
come down to men just being scared of some guy
(01:55):
monkeying around their junk with a scalpel um and worrying
about what the after effects will be. But it turns
out totally unnecessarily and unfairly. Yeah, I mean, we'll get
to some of the myths, um and I would say
it's it's equal parts being scared of those myths and
quite simply the patriarchy, I mean kind of full stop
(02:19):
men saying like, uh, you need to take care of
that on your end. Uh, and and then we can
start having unprotected sex and the And that's why a
lot of people frame it as it's a real gift
that a man can give to his wife or his
spouse or his sexual partner, you know, the person who's
(02:40):
monogamously having sex with, Because we should point out vasectomy
is going to handle pregnancy basically every time. Um, it's
not going to help with S T I S. So
if you're running around exposing yourself, the monkey pox of
vasectomy is not going to help with any of that.
It's going to just help with the pregnancy partner. Yeah,
(03:00):
and I hope that counts as a blanket statement. So
when we say things like and now you can have,
you know, all the sex you want without using a condom,
without fear of getting pregnant, we don't. We don't mean
like a step right up. What we mean is is
you know with your monogamous partner you can now live,
(03:22):
and you know with your monogamous partner you can get
tested and you can know that that part is safe
as well. But we are definitely not saying just that
means you can go around and and spread your seed,
your your biological material. It was even worse somehow. Oh
(03:43):
it's terrible, Dave us as well. We'll get to the
material part. But it's such a gross way to describe
any thing that comes out of your body. But you
mentioned the patriarchy. Here's a patriarchal um stat for you.
Thirty of American women age thirty five to forty four
have their tubes tied thirty nine percent. Do you want
(04:04):
to know how many men aged thirty five to forty
four in America have had a vasectomy. I've got to
be at least twenty five right percent? Percent? That's it.
So that means that, um, what more than about three
times right on the nose, three times more women have
their tubes side than men undergo vasectomy. And hopefully, like
(04:28):
as people are hearing about this stuff, um, it becomes
less scary and maybe more men will be prone to
do it, because if you're looking to stop having kids
or never have a kid, this this is a really
good way to go. It's safe, it's effective, and again
it's relatively cheap, and the recovery time is like nothing. Yeah,
(04:49):
some of those myths that we mentioned that are not true.
Or is that the operation is painful, which is not true.
That it affects sex, that it affects your erection, it
affects your orgasm and ejaculation, it affects your sex drive
and testosterone. It means you're not a real man, Like,
none of those things are true. And if any of
(05:11):
those dudes were speaking to you, if any of those
are reasons why you don't want to get a vasectomy,
then you have no reason to just like that is
a fact. Yeah, and we'll go into those in more detail.
But yes, all of those are totally incorrect. Probably everything
you think or worry about vasectomes is incorrect. That's that's
(05:32):
a pretty good bet, actually, Yeah. Or if your reason is, well,
I don't know, I may want to have kids one day,
that is a very good reason because as you'll see,
there is a reversal surgery, but it they definitely haven't
perfected it. It is expensive, it's more invasive. Um, this
is something you really need to consider very very strongly
(05:56):
as a long term life decision. Yeah. Like if you
were like, oh, it's one more kid, and you're like,
I regret having this third kid, maybe it is time
to talk about getting a vasectomy. Or if you're like,
I think this world is grossly overpopulated, we're treating it terribly.
I don't want to introduce yet another human into it
and screwed up even more. Um, that might be a
(06:18):
good reason. I have a sectomy too, and apparently that's
an increasing um the reason for gen z and millennials
getting vasectomies these days. Yeah, Or if you have already
bore a couple of children and you look at your
partner and say, hey, dude, I don't want any more kids,
how about you get a vasectomy, and they give you
(06:39):
a reason that equates to I want to keep my
life options open. That's a different conversation. Yeah, then you're
with the wrong person, right, you know, But no, on
down the road, I might meet someone else. Right now,
I guess I should say, Chuck, we've we've been talking
almost exclusively about like men and women, you know, like
biological sex um as far as vasectomies go. And I
(07:02):
actually looked. I was like, is this part of transitioning
in the trans community? And I saw that probably isn't.
I mean, you can imagine like going from transitioning from
male to female. Um, you might want to get a vasectomy.
But I saw specifically that the hormone therapy renders that
like no and void, there's no point in getting one
(07:24):
from what I saw, right, So that's why we're using
the terms that we're using in the words we're using
so um. One of the things about a vasectomy One
of the reasons why it is so great is because
it is basically a hundred percent effective at preventing pregnancy.
And like I said, tubal ligation is is just as effective, um,
(07:47):
but as far as other stuff that men can do
to prevent to act as birth control, I mean, like
vasectomy is far in a way superior to all of them.
Like you've got coitus interrupt us a k a. The
pullout method. Yeah, that's only seventy eight percent effective. I
am too. You can just ask the pullout king if
(08:09):
that works or not. Hey, get in here, pullout king,
and then uh, condoms are eight five percent effective. That
seems high to me too, but I guess actually no,
and on second thought, it's probably pretty accurate. But even still,
that's a fifteen percent chance every time you have sex
that you're going to accidentally impregnate your partner. That's what's
(08:33):
so great about vasectomy. You have no worries whatsoever because
there's a whole bunch of steps that we'll talk about
that say Okay, you're good to go go forth and
have sex with your partner, that one partner that you're
monogamous with and is monogamous with you as much as
you like without a condom for the rest of your life.
Anytime you want, just go ahead and do it. Do
it in a changing room at Target, do it in
(08:55):
your card at the police station when you get arrested
for doing then changing room and Target, none of these
places you should do that. But you could because you
don't have a condom on you and it doesn't matter
in that sense. Uh. You mentioned it being relatively cheap.
Did you say the actual number, which is about a
thousand bucks? Yes? I did not. Okay, okay, yes you
(09:19):
did not. That kind of episode, Chuck. A thousand dollars
is certainly nothing to sneeze at. But um tubal ligation
is about six times that much. Um. Condoms aren't cheap.
So if you're if you're choosing to have a lot
of sex and were a lot of condoms and you're
going to run up a bill there. Uh. And it
doesn't take super long. It's a twenty minute outpatient surgery,
(09:42):
very very low risk of complications. Uh. It does not
require general anesthesia like tubal ligation does. It's just local anesthesia,
which that right there is like there's your like how
much do you love me kind of thing? Are you
going to let me risk dying under general anesthesia comp
here to your local anesthesia. That's the that's what makes
(10:02):
that kind of conversation hard when you're like, should you
get your tubes tied or should I get a vasectomy?
You know absolutely, uh in recovery time, it's just a
couple of days later. Um for vasectomy is you're kind
of doing pretty well, and it takes a few weeks
or up to a few weeks for recovery for tubal ligation. Yeah,
because tubal ligation is so much more invasive. You know,
(10:23):
it's it's a much greater surgical procedure. Um. And then
one other thing that is really important is like, like
I said, it's considered a gift from the guy to
his wife because you're saying like, hey, you don't have
to worry about this stuff anymore. You don't have to
take the pill anymore, you don't have to get an
I U D, you don't have to get injections. Um,
(10:45):
you don't have to get your tubes tied. Like I'll
handle this for both of us, and I'll take one
for the team. And that that really is like a
genuine gift that you can give your partner. That I mean,
like they I imagine they will value you for it
at the very least to put it in a really
sta away Sure, no pun intended, No, sadly, no, I'm
(11:08):
not that sharp today. Well, let's take a break. I'm
gonna sharpen you up, and we're gonna come back and
talk about the procedure right after this. All right, so
(11:37):
we're back. We're talking vasectomes. Keep saying it like it's
got an F in their vasectomese vasectomies, And the point
of a vasectomy is to keep your sperm away from
your semen. Uh. And this is where Dave uses a
word that just cracks me up. It's that material. Uh.
(11:58):
He says that semen is all of the material that
comes out of the penis during ejaculation. For some reason,
I don't know. It just sounds like you're pulling a
silk scarf out of a sleep or something. That's that's great,
but when you add biological in front of it, it
gets even worse because you're like, for some reason, you
just imagine it everywhere for as I do at least,
(12:22):
but sperm and semen are two different things, right, Yes,
sperm is just one tiny component component of semen and um.
You could make a really good case that semen exists
if you're into intelligent design and that kind of thing,
as a vehicle for sperm. But what humans have cleverly
figured out is you can keep the semen, you can
(12:43):
get rid of the sperm, and you can do this
you can spread the biological material all over the place
without any worry of getting pregnant because all you're doing
is removing the sperm from entering the semen, and the
semen comes out like normal. It's just sperm free after
of a vasectomy, that's right. Uh. It's called a vasectomy,
(13:05):
by the way, because of the vase the A S
deference a k a. The sperm duct um that is
basically the target of this operation. It is a tube
in the scrotum in the pelvis. It's called the vast deference.
There are two of them because you have two testes
and so a vase difference. If you well, we'll talk
(13:28):
about what you actually do, but it's called a vast
ectomy because of that, right, And you can remember that
by saying a vasectomy makes a vast deference in your
sex life. Very nice those off the cuff. I do
not have that written down at least so um with
so with the with the vasectomy, the vast deference is
just cutting. That's it. The vest difference from each testicle.
(13:52):
That's that's all there is to it. I mean there's
a little more to it, but it's really that basic.
You want to talk about the procedure. Yeah, like I said,
you've got these two vast deference each one, uh is
about twelve to eight eighteen inches. But size isn't important
here from what I've been told. Uh. And they run
from the base of your test e s up around
(14:13):
to the back of the bladder where your seminal vesicles are.
And like you said, their their job is to take
your sperm mix it in with the rest of your
semanic material. Which I don't think we said what it was.
It's fluids from the seminal vessel, fluids from the prostate, uh,
(14:34):
and from what's called the bulb I had it earlier,
the bulba erethoral grands. No, I'm afraid not go ahead
hit me. I think it's bulbo your rethroll. Yes, it
absolutely is so bad to me, is one of the
worst words I've ever seen. It looks like what it describes.
(14:56):
In my imagination, that word looks like it can't you
can't you just see it. But you put all this
stuff together, and you've got the biological material that comes
out of the penis during ejaculation, Like Dave says, right,
So the vast difference its role is to move sperm
from the testies too. I think the prostate um to
(15:16):
deliver this to your um, to your semen. And again,
when you have a vasectomy, all you're doing is cutting
the vast difference, so you're removing sperm from the equation um.
And now I think it's probably time to talk about
the surgery step by step, right, And I think when
we do this, most people who don't know about this
(15:36):
are going to be amazed because it is wham bam,
thank you, ma'am kind of surgery. Considering what you're doing
and the effect that it has, the outcome it has,
it's incredibly simple and fast. Yeah, maybe we should cue
up Yakety Sacks. That's the perfect Did you ever see
Dolly Parton at um? Oh? I can't remember what the
(15:58):
glaston Bury I think festival I did she said, I
can play yakety sacks backwards and she turns around and
plays it. Oh my god. Still after all this time,
she is National Treasure, International, Treasure Global. So what they're
gonna do is they're gonna numb the area that they're
(16:19):
going to be working on with local anesthetic on either
side of the scrowtum. That may be the most harrowing
part for for people listening to this. H They're gonna
make two small incisions at the top of the scuretum
so they have access to uh each vast deference, and
they're going to I love that, he says. Gently. They're
going to do gently withdraw part of it through the incision.
(16:42):
They're gonna snip it, and they're gonna seal it up.
Sometimes the stitches, sometimes they cauterize it. Uh. Sometimes it's
a combination of things. But they're basically just gonna seal
up that tube and they're gonna close those tiny incisions
up with stitches or maybe glue even that is it.
Whatever they have lying around exactly a little sawdust and spit.
(17:04):
But that's it, man, that is it. And again, yes,
the guy is cutting into your scrowedum, into your junk um,
I should say, I mean guy in a gender neutral way.
You know, who knows who your erologist is. But they
like they they are cutting into it. They know what
they're doing. It's really just cutting through a little bit
of skin that again has been anesthetized locally. And I
(17:26):
mean that's it. Like this, it's almost like cutting a
rope and then taking a lighter and burning each end
so that it doesn't fray any longer. That's pretty much
analogous to a vasectomy, except the rope is in your
your scrowed them and they don't use it like a
big lighter. They probably use something else to cauterize it. Yeah,
(17:47):
and then your riding your horse the next day. Actually,
you probably don't want to be doing that next day.
You want to wait a week to ride your horse.
But the point taken, you know. Uh. They're also what's
called no scalpel vasectomes, which are not completely no scalpel,
but there are no incisions made in a technical sense.
They use a this sounds even norse. Actually they use
(18:09):
a punch tool to punch a small hole in the
skin of the scrotum, and then they withdraw the section
of the vast difference that way. Um, you still have
to use a scalpel to cut the cut the tube,
but apparently you heal up a little bit faster with
this method. Yeah, because there's no actual incision. It's just
a puncture wound basically. So yeah, I mean it's smaller
(18:31):
surface area to to recover, I guess. Yeah. And if
you're thinking, Josh Chuck or doctor, doctor, well what about
all that sperm? I got so much sperm? Where is
it gonna go? And it is gonna build up? And
that you know that's a problem. Uh, that is not
what happens. Your body absorbs the sperm. You don't get
(18:52):
some big, like massive sperm build up. Let me tell
you about your sperm and where it matures over seventy days.
And then also it's in the epididymus. And your epididymus
is eighteen feet long, and it's coiled up in your testies.
Each testicle has an epididymus that's eighteen ft long if
you stretched it out, and this is where the sperm
(19:14):
kind of gathers and grows and and gets ready for action.
And apparently after your vasectomy and the sperm has nowhere
to go. It stays in the epididymus, which naturally absorbs
it back into the bloodstream because if you, you know,
don't see any action for a while, your sperm can
get kind of old and your body wants new, fresh
good sperm to be used, so the old stuff gets
(19:37):
absorbed anyway happening, Yes exactly. This isn't like some new
thing that your body has to do. It's just that's
all it does now is absorbs sperm. It doesn't ejaculate
it anymore. Right, Um, you mentioned the term bestotomy earlier.
Technically that's probably what it should be called. Uh ectomy
is is usually when you are removing something, and you're
(19:58):
really not removing anything in this So if you want
to get super technical, you could call it a bestotomy
and your doctor might just say yeah, yeah, yeah, I
got you, or they might be like, oh, I'm going
to give you a nice valium too, because you impressed
them so much. There's one other thing about the sperm.
There's a kind of vasectomy called an open end vasectomy,
(20:19):
where they just caught or eze them the tube leading
to your prostate and the tube that's coming right out
of your testicle is left open. So that the sperm
actually just does flow out into your scrotum and it
gets absorbed in there as well. And is it like
one of those uh spaghetti sprinklers that kids run through
when you turn it on. No, it's like one of
(20:42):
those um those like air blow guys that like tire
stores used to bring in the customers. I think it's
more like that or either one, because they're both the life. Um, this,
like we mentioned, takes about twenty minutes, doesn't even have
to take that long. Sometimes they can get you in
another and as little as ten minutes you might get
a little bit of pain meds. But um, and you
(21:05):
know this is from from Dave sort of telling his
firsthand that after the first day or so, it's really
not that big of a deal. But you're gonna be
resting for twenty four hours you meet chilling out in bed. Basically, Um,
you want to wear this is pretty funny. Um, you
want to wear tidy whitey's very tight underwear or a
(21:25):
jock strap for forty eight hours? Right, Probably the tidy
whities is preferable. I don't know, jock strap is pretty good. Look,
you just don't want to think swinging around because you
have two incisions on your scrotum that have been stitched up,
and you don't want to, you know, loosen the stitches,
I think is the point. Yeah, what else you gonna do?
Cold pack? No, no, no doubt, like actual frozen bag
(21:48):
of frozen peas could work, um, because it could become inflamed.
Your body has been insulted and it's going to react
with inflammation. That helps with it. Um. Again, you're gonna
have pain, and you probably won't need them after the
first day. You might need like advil or tail and
all or whatever. Your regular analgesic is. Um. But like
we're saying earlier, you can't ride a horse for a week, right, Yeah,
(22:13):
in a couple of days, you can do desk work
and stuff like that and you're off your feet, but um,
no sports and and uh no sexual activity for a week.
So here's the sort of trick is you're gonna still
have sperm in your system after a vasectomy. Uh. So
there's a chance if you had unprotected sex with your
(22:35):
partner right away, uh, that you could get them pregnant. Uh.
You need to clear the system. So it takes up
the fifteen to twenty ejaculations to clear the system out.
So if you want to go back to having sex
that you know, like literally one week after you have
had this operation without getting pregnant with your partner, you're
(22:57):
you know, do the math, You're you're welcome back to
seven grade. Basically, yes, So like for a good three months,
they're basically like, you need to really be careful and
they're going to get you in there um afterward as
part of this post operative care about you know, anywhere
from like a month and a half to three months
later to say, okay, give us a sperm sample and
(23:19):
we're gonna see if you have any any guys swimming
around in there, and uh, if you pass, they will
say you've got no sperm, go forth and have fun um.
And if you don't pass, they'll say, okay, well we
need to to you know, keep safe a little longer
and then come back and give us another sample. And
they'll keep doing that until there's just no sperm found,
(23:40):
like zero no sperm, so zero percent sperm, I guess
is what I'm trying to say. Yeah, am I reading
this correctly? Though? Because you can have sex seven days later,
it takes fifteen to twenty ejaculations yet they check you
out six to twelve weeks later. Yeah, they're saying, like
(24:02):
you behave as if you did before your vasectomy for
six to twelve weeks. Like if your wife or your
partners on the pill, she should probably stay on the
pill for six to twelve weeks until you get the
all clear if you use condoms, keep using condoms, and
during that time when you have sex, there is that
risk that you will still get pregnant until you get
(24:22):
that all clear from a sperm test that finds no sperm. Right,
But is that because they assume it will take six
to twelve weeks to have those twenty ejaculations. I got you,
I got you. I don't know, because that does seem
like a really long time, doesn't it. Well, I mean
that's why I said, welcome back to seventh grade. If
you want to knock that out in a week, I'm
(24:44):
glad you went back and explain that. I thought you
were what you were saying, like you're worried about getting
someone pregnant. I can say this in a grown up way.
Does that mean you can masturbate twenty times in a
week and clear out your system and you're you'll be good?
To go or is it really like you really need
to think about this six weeks later to twelve weeks later.
(25:05):
I don't know. I would guess if you boasted to
your urologist that twenty ejaculations is not going to take
you six weeks, they might say, okay, well, schedule lists
for three weeks from now or four weeks or whatever.
You know. I would think, so, yeah, yeah, I would guess,
so all right, because they have like a wall of
fame in the office. Right, it's just covered here in
(25:27):
two days. Um, so yeah, I fifteen to twenty ejaculations
and ejaculations and ejaculation, right, it doesn't it doesn't have
to just be through intercourse or coitus, I think, is
what the kids call it. That is true. How many
times have we said ejaculation in this episode? More than ten?
(25:47):
I would say, So you want to take another break
and then come back and talk about some of the
risks involved, because there are risks, it's true, but they're
just fairly small. Yeah, let's get let's do that and
get back to it. M Okay. So when you cut
(26:19):
into a scrotum, when you cut a part of an
internal network of tissues, um and steal it back up
and called it as it. There are risks UM, even
though you're not under the risk of general anesthesia. UM,
you could conceivably get an infection at the incision site.
UM that you can get blood clots um inside of
(26:40):
the scrotum, Blood can show up in your semen, your
scrotum can become bruised. All of these things, at least
the first few that I mentioned are stuff that you
probably will get as a result of a vasectomy, but
they're going to clear up fairly quickly. And again that
bag of frozen Peace can really help with the inflammation
the tile and all or advil come and help with
(27:01):
everything else. There are some some actual possible longer term
complications that you should be aware of though. Two. Yeah,
there's a very small percentage I think one to two
people who have chronic pain after the surgery. UM. And
these are the people in this category or the part
(27:21):
of the percentage of people who one day might want
to get this reverse because of that chronic pain. UH.
An abnormal cyst called a UH spermato seal, Yeah, I
think so. Yeah, that could develop UH in the coiled
tube located at the upper part of the testicle UH
that collects and transports that sperm. But these are, like
(27:43):
we said, these are down. If you're down in the
low single percentage points, it's you know, considered very low
risk UM. And you know, the the upshot of her
the UM. The upside of it, I should say, is
that again, UM, you actually will probably experience, at least
as far as some studies have found, UH, an increase
(28:05):
in sexual satisfaction. Because cutting your vast difference has nothing
to do with hormones. That has nothing to do with UM,
your ability to get an erection, your ability to ejaculate.
There's another one UM instead. Again, it's just removing sperm
from the equation. That that's it. That's right. UH. Testosterone,
don't worry about that. That is produced in the test
(28:27):
is like the sperm. But there's a different kind of cell.
It's called the late late egg cell or the lighting cell.
I like the second one better, let's go with that,
the lighting cell UM. But it goes it has a
one way trip. It goes directly from the tests into
the bloodstream. It does not go through the vast deference.
(28:48):
There is no impact whatsoever on your testosterone. UH. In
sex drive and in fact, it may actually increase your
sexual desire. Um. They've done studies. It had one in
Germany that said that, uh that if you've had a vasectomy,
you have a greater or at least they reported greater
satisfaction than the control with orgasm, with sexual desire, with
(29:12):
satisfaction of intercourse with erectile function. Spontaneity, that's a big one. Yeah.
I mean a lot of it may just be psychological,
like all right, um, I'm free, I don't have to
worry about this anymore, so that that'll probably increase all
kinds of happiness. Yeah, exactly. I get the impression that
that is um from this German study from I think
two thousand and seventeen. Um. They they surveyed both men
(29:37):
with vasectomies and their partners, uh, and found that the
partners were like, yeah, actually it's a little more arousing.
The actual act of sex didn't change for me at all,
but there's something, there's something going on here, And I
think I would chalk that up to spontaneity and not
having to stop to like put on a condom or
you know, feeling freer because you didn't have to take
a pill that day. That kind of thing. It wasn't like, doc,
(30:00):
I gotta tell you. We started doing some crazy stuff.
Have you ever done it in a target changing? Oh no, no, no,
don't tell your doctor that. So um, well, we said
it's you know, a thousand dollars, which is, like you said,
nothing to sneeze at all. But compared to tubal ligation,
which is six thousand dollars at least, um, it's much cheaper.
(30:24):
The thing is, in the United States, insurance companies don't
have to cover vasectomies. They do have to cover tubal
ligation procedures. And it's probable that that accounts in addition
to the patriarchy that you mentioned full stop. Um, in
addition to that full stop some people just being cheap
and saying like no, I mean like we can get
a tubal ligation for like fifty bucks and you know,
(30:46):
rather than vasectomy for a thousand dollars. And if there's
any man out there who does not want to get
a vasectomy, he's going to hammer that point home every
chance he gets until he went he gets his way. Yeah. Maybe, uh,
we mentioned people getting wanting these reverse About six percent
of people who get a vasectomy end up wanting that reversal.
(31:08):
Like we said, some of those come from the chronic
pain category, and other people you know, want to have
kids and decide, oh I've made a great mistake. Um,
that'll cost you between five and fifteen grand and it'll
take four to six hours. And even when you do, uh,
if it's considered you know, quote unquote successful, your pregnancy
(31:28):
success rate UM is between thirty and moving forward. So
some people say, just go I v F. Then if
you want to do that and get that sperm directly
from the testicles, uh, because as a much better success rate,
you can do that if you want. That'll still cost
you a bundalow IVF. It's not cheap, yeah, but it's
(31:48):
a lot less invasive and permanent than reversing your vasectomy. Right,
that's right. Um, Remember how we said that vasectomes are
like effective or something like that, they have like a
one percent fail your rate. I think we said that
that failure rate comes very often from something called reconalization.
Did you see that part? I don't think it's all
(32:09):
that part. So reconalization is where the vast deference grows
back together. It creates new tissue that basically go around
the stitches or the clamps or the cauterization and grows
new tubes that seek out and connect with the other
end of the vast difference and reconnect. It's which is
(32:33):
it just goes to show you that nature finds a way.
But again, O, man is it? Life almost had it? Um.
But again this is really really rare. And apparently the
positioning of the to the separate ends of the vast
difference has a huge effect on that too, Like you
don't want to leave them anywhere near each other, you know, Oh,
(32:55):
I see you over there. And one of the things
about that reversible vasectomy UM, like apparently that's a holy
grail in neurology. Uh, And they're looking at ways to
to basically temporarily UM create a vasectomy. There's stuff called
reversible inhibition of sperm under guidance. It's a type of
gel that you can put into the vast deference and
(33:17):
then it has to be flushed out later on UM
to remove it, and then all of a sudden, it's
like your vasectomy was reversed. Yeah. That this falls under
the same category of like simplicity, Like I imagine they
were trying to think of an easy way to reverse this,
and somebody was like, hey, you have any gum, You
have any chewing gum? Right, we could, we could clog
(33:40):
up that tube. And that's basically all they're doing. They're
clogging the tube with a gelled implant, and uh, yeah,
it makes a lot of sense. Better make sure that
that clog is pretty tight. Yes, apparently that has a
failure rate from one Indian study in two thousand nine
of four percent, where again of vasectomy as one percent. Yeah,
(34:01):
I think safety is the concern. They're right, absolutely right.
So I saw it explained as with a with a
pill with women UM, the control group in when you're
figuring out safety is pregnant women and UM pregnancy is
riskier than the side effects are complications from taking the pill.
So the pill wins out. It's safer, it's justified, and
(34:23):
that's how it gets um UM the green light for
use UM. With a male pill, the control group is
just healthy men. There's no pregnancy, so the male pill
has to stop sperm production withoutside effects, like any side effects.
Because if you go beyond a healthy male um as
the which is the control group, then all of a
(34:44):
sudden it's less safe and it probably won't get approved,
so they're actually, yeah, there actually is. I'll though I
don't know how hard they're working on a mail pill.
Probably not so hard, although you never know. Is that funny?
I'd rather not say. Come on, um, all right, we'll
finish up with a little bit of talk on eugenics.
(35:07):
We did an episode many, many years ago about sterilizing addicts,
specifically uh, which is you go back and listen to
that episode. It's pretty interesting, probably somewhat outdated at this point,
but who knows. Yeah, just the use of addicts I
think is outdated, so but it's still it's a pretty
interesting episode. But this is a notion that started out
(35:31):
all the way back in the mid eighteen hundreds. Veterinarians
started experimenting with dogs, giving dogs vasectomys instead of castrating them,
and in the eighties started performing performing them on men.
And of course it didn't take very long for eugenicists
(35:53):
to get involved and say, hey, this is a great
thing because we can just essentially nouter crim pinals, we
can neuter people who are mentally ill, we can neuter
people who are poor, and that will solve a lot
of the world's problems. Yeah, and so the eugenics movement
really took this up. Um. There was a guy named
Dr Harry Sharp in the United States. He was a
(36:14):
leading performer of vasectomys among eugenicists, among anybody. I would
guess he actually performed the first vasectomy for non medical reasons. Um.
It was on a nineteen year old inmate at a
reform school in Indiana who had complained of excessive masturbation,
and so Sharp game a vasectomy and said that he
(36:35):
quote became more of a sunny disposition, brighter of intellect,
and ceased to masturbate end quote. And um, he kind
of went from there within a decade on just a
tear where anybody who he deemed or the eugenics movement
deemed undesirable to the gene pool should be should receive
a vasectomy. Yeah. Alongside him was an American named Albert
(37:01):
Osner published a book, or I guess at least a
pamphlet called Surgical Treatment of Habitual Criminals, Uh that advocated for, uh,
you know exactly what it says, making criminals sterile. Um.
And it was just sort of a time in the world,
and especially in the United States where they thought that
(37:22):
like I said, if you were in an almshouse, if
you were in an asylum, um, if you were certainly
if you were in prison, then it was a good
option to force a vasectomy on somebody. And this happened
to an alarming degree. I think through the end of
World War Two they estimated about three hundred and twenty
thousand UH forced sterilizations without consent. I did not see
(37:47):
a racial breakdown, but you can bet that it affected
people of color more than others. It just would make
sense because that's how it's kind of gone in this country. Yeah,
and it wasn't. I mean, America was deaf really an
early proponent leader of eugenics. But if all this sounds,
you know, ghastly familiar, that whole thread was picked up
(38:07):
by the Nazis in the early nineteen thirties and they
sterilized countless people, both um through vasectomys and um through
tubal ligation. And apparently I didn't realize this. Switzerland had
early eugenics law, apparently the first eugenics law, and they
targeted the roma, and the roma could were still subject
(38:29):
to involuntary vasectomys up until nineteen seventy two in Switzerland,
isn't that insane? Yeah, that's uh, that's shameful. And by
the way, when I said it made sense that they
forced sterilization probably on people of color more you know
how I meant it? Right? Everyone Sure, it didn't mean
(38:50):
that made sense in any kind of ethical way. It
made sense because that's how people of color have been
treated in this country. I like the person who thought
that this had to have been their first episode and
now explained it to that one person. Just want to
clear that up. Alright, good, everybody knows chuck. So ending
it on eugenics is kind of a sour note. So
let's talk about one more old timey thing, um medical procedure.
(39:13):
It is misguided, but it's not nearly as bad as
vasectomys for eugenics. Um. There's an Austrian andrew chronologist named
Eugene Steinuk, and he said, I've got this great idea.
If I cut just one vast difference, the other one
will still be able to contribute sperm to the seamen,
but the severed vest difference will give up on sperm
(39:33):
and go into overdrive for producing hormones like testosterone, which
will give men just this huge boost of virility, and
he started going crazy performing it on everybody who would
step up. Yeah. Basically like, if you want to increase
your sex drive, you can have this elective procedure. Uh.
And people like Sigmund Freud and writer William Yates use
(39:57):
this uh procedure and under went this procedure to boost
their sex drive. Yeah. And apparently, um, they were like, well,
actually testosterone works totally differently and that what you just
did all these people doesn't work at all. So I
guess Steinock went retired in disgrace. Um. And if you
thought that was a pretty fun factoid, prepare for this one, Chuck.
(40:19):
I think you should take us out with us. Okay. Uh,
day found a statistic because and who knows that this
is correlation or not, but there is a statistic because
you you're supposed to lay around for a couple of days.
When you're laying around for a couple of days, maybe
you're reading a book, educating yourself, or maybe you're just
watching a lot of television. But didn't they find that.
(40:40):
I think the finding was that the procedure went up
a lot during March Madness in c double a basketball
tournament time, so men could have an excused to lay
around and watch it. Is that right? A thirty percent
increase in vasectomy procedures in the US during the first
round of the n c a A A basketball tournament. They
(41:01):
call it vast madness. I gotta know if that's true.
If that's why, gotta know? Well, the only way to
find out, Chuck, is to undergo of a sectomy procedure
and ask your eurologists during the middle of it, because
you won't be under general ESTI anesthesia, it'll be local
mhm uh do you got anything else? I've got nothing else? Okay, well,
(41:23):
Chuck said he's got nothing else, which means, of course
it's time for a listener mail. That's right. Uh. This
is from our buddy Mark Koontz. Mark and Gayl Counts
are longtime listeners and and real life pals of mind.
They came to our show in Cleveland, and Gayl is
a longtime movie crusher. But Mark wrote us an email
about suicide Awareness Month, which it is right now. Uh.
(41:47):
And this is a Mark is you know he's out
there doing like the tough work. Great dude. Uh. September
is back to school season, guys in Suicide Prevention Month,
which means you. Suicide prevention is on my mind more
than usual. As know. I'm a licensed art therapist at
Clark County Educational Service Center in Springfield, Ohio, helps schools
meet the mental health needs of thousands of students. Most
(42:09):
people think of suicide prevention with youth means focusing on
trauma and handling and handing out hotline information, and of
course sometimes you do those things. But my favorite suicide
prevention program and the reason I'm writing is called Sources
of Strength. That is a youth led suicide prevention program
that has been used in schools across the U. S
(42:29):
and Canada and Australia. Sources of Strength are things like
positive friends, mentors, and mental health. These are some of
the protective factors that we can rely on when we're
stressed or to help us get through a crisis. UH
And for the past year I've been trying to get
sources of strength and every single one of my county
schools and with funding and support from the Ohio Suicide
(42:51):
Prevention Foundation and Prevention First with an exclamation point, schools
in Ohio can implement sources of Strength at no cost.
So if your list some thing he just want to
Grant for like tin Grand or something like that, which
is genius grant. He's won it before, I think, but
he says. If you're listening to this and you're in Ohio,
you can learn by visiting Sources of Strength Ohio dot org.
(43:13):
Even if you're not in Ohai, you should still visit
the Sources of Strength dot org website and learn about
the sources eight protective factors. Also, adults need protective factors too.
I'd like to thank both of you for always advocating
for mental health as well as spreading useful and be
official information to all of us, and for being positive
(43:34):
people in the world. Your voices mean so much to
so many. Greatest thanks from your old pal Mark Counts.
So hey Mark and Gale and your cute pets. I
appreciate the work you're doing. Yeah, same here at Mark. UM.
That's magnificent stuff. Thanks for writing in to let everybody know. UM,
if you want to write in like marketed and just
basically say I'm a hero without saying I'm a hero,
(43:57):
we would love to hear from you and tell everybody
about out that you can wrap it up spanking on
the bottom and send it off to stuff podcast at
iHeart radio dot com. Stuff you Should Know is a
production of I heart Radio. For more podcasts my heart Radio,
visit the iHeart radio app, Apple Podcasts, or wherever you
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