Total vasectomies performed by Dr. Monteith as of January 1st, 2023: 6,334
Patients were emailed surveys 1 month and 12 months after their vasectomy procedures. Survey response rates were:
- 1 month after vasectomy survey response rate 53%
- 12 month after vasectomy survey response rate 48%
Pain And His Choice Vasectomy
Patients were asked to rate pain during, the day after, and the month after His Choice Vasectomy with Dr. Monteith.
Pain was rated on a 10 point scale: 0 None, 1 to 3 mild, 4 to 6 moderate, 7 to 9 severe, 10 worse pain possible
Pain during His Choice Vasectomy
Average pain rating during procedure 2.5
Approximately 1 out of every 5 patients reported no pain during His Choice Vasectomy with Dr. Monteith.
The average pain rating during the procedure was 2.5.
Most men report experiencing mild pain during vasectomy and no patient reported experiencing the worse pain possible.
Dr. Monteith uses a no-needle, no-scalpel, minimally invasive vasectomy technique to minimize pain during and after vasectomy.
Dr. Monteith takes these steps to decrease pain during vasectomy:
- Provides comprehensive educational videos for patient education
- Performs vasectomy procedures without an assistant to decrease patient anxiety
- Allows a supportive partner in the procedure room if the patient desires
- Utilizes a combination anesthetic (both short and long acting) during procedure
- Makes a single opening in the scrotal skin without using a scalpel
- Administers 72 hour extended release local anesthetic to provide additional pain control after the procedure
Dr. Monteith does not routinely prescribe or use anti-anxiety or narcotic pain medications before, during, or after vasectomy.
If patients believe they will require these medications, they must make a consultation appointment before having their procedure.
Pain the day after His Choice Vasectomy
Average pain rating day after procedure: 3.2
Approximately 3 out of 4 patients reported mild pain the day after vasectomy. No patient reported experiencing the worse pain possible.
The average pain rating the day after vasectomy was 3.2
Many patients do not need to take any medication for pain after vasectomy. If patients experience discomfort after vasectomy, Dr. Monteith recommends over-the-counter anti-inflammatory medication and the majority of patients will obtain adequate relief with these medications.
Did patients require prescription pain medication after His Choice Vasectomy?
Dr. Monteith does not routinely provide anxiety reducing medications or narcotic pain medications before, during, or after vasectomy.
Most patients will not have significant discomfort after their procedure. If patients experience discomfort after their procedure then most will experience adequate relief with over-the-counter anti-inflammatory medications (ibuprofen, Motrin, Advil, Aleve).
Approximately twice a year Dr. Monteith will have to provide a prescription narcotic for a patient after vasectomy.
Survey respondents who indicated requiring prescription pain medication typically had their own supply of these medications from previous surgical procedures or pre-existing medical conditions.
Pain one month after His Choice Vasectomy
Average pain rating one month after vasectomy: 1.3
Approximately 3 out of 4 men reported having no pain one month after their vasectomy and approximately 1 out of 4 men reported mild episodic discomfort one month after vasectomy. The average pain rating 1 month after vasectomy was 1.3.
The majority of patients who report mild to moderate discomfort one month after vasectomy will experience complete resolution of their symptoms by the time of the 3 month after vasectomy semen sample test.
Did patients require a doctor’s visit for possible vasectomy related complications?
Dr. Monteith offers patients single visit vasectomy appointments and, as a result, patients travel from outside of North Carolina to have vasectomy with Dr. Monteith.
Dr. Monteith does not require a follow-up visit and the vast majority of patients reported no complications after vasectomy. Men who travel to Dr. Monteith for vasectomy procedures can be reassured the chance of having a serious complication requiring medical evaluation is low.
Since a routine follow-up visit is not a part of Dr. Monteith’s approach to providing vasectomy, Dr. Monteith has a broad definition of ‘vasectomy complication’, which includes any unplanned doctors visits for scrotal complaints within 30 days of the vasectomy.
Approximately 2% of men returned to either Dr. Monteith or their local doctor to be evaluated for possible vasectomy complications. The vast majority of these visits were for transitory pain/discomfort that resolved with over the counter medications by the time of the 3 month semen sample test.
Scrotal pain one year after His Choice Vasectomy
The majority of patients reported no scrotal pain 12 months after His Choice Vasectomy with Dr. Monteith. Approximately 10% of patients reported they did have scrotal ‘pain’ after vasectomy. Evaluation of scrotal pain 12 months after vasectomy is complicated because of the following:
- Pre-existing conditions. Some vasectomy patients report experiencing scrotal pain before having vasectomy procedures.
- New conditions. Some patients were diagnosed with other medical conditions coincidentally after their vasectomy, i.e. hernias and kidney stones.
- Observational bias. Some men develop heightened awareness after vasectomy and may be more vigilant about sensations after vasectomy that they may have otherwise ignored.
- Entry errors. Patients are contacted by Dr. Monteith’s office staff when they report scrotal pain and some patients admit accidentally entering the wrong information at the time of survey submission.
- True vasectomy related pain. Some men will experience occasionally twinges of scrotal discomfort after vasectomy with exertion or lifting. Usually these episodes resolve over time. Many patients report discomfort but also admit the discomfort is not significant enough to require medical evaluation.
- Vasectomy related complications. A small number of men will develop hematomas (within 24 hours), infection, transient inflammation to sperm (1 to 6 weeks), epididimyal congestion (1 to 6 months), or painful nodules at the vasectomy site. Very few of these conditions require additional surgical intervention and most completely resolved within 3 months. Some men could experience painful nodules at the vasectomy site(s) that persist for greater than 6 months (<1%) and these nodules may require a second procedure, similar to the initial vasectomy procedure, to remove these nodules if symptomatic 12 months or more after the vasectomy.
About 1 out of 10 patients report scrotal ‘pain’ 12 months after vasectomy. The majority of these men seem to be acknowledging they notice a difference after having a vasectomy but they are not necessarily experiencing pain. Many report mild pulling or tugging sensations or mild tenderness at the vasectomy site or in the epididymis but very few report it as true pain requiring treatment by a medical professional.
If patients reported scrotal pain one year after His Choice Vasectomy was pain sufficient enough to require medical evaluation?
The most feared complication of vasectomy is the development of chronic scrotal pain. Chronic scrotal pain can occur after any surgery to the male genitourinary tract and can occur after vasectomy. Chronic scrotal pain is often defined as pain referred to the scrotum after a surgical procedure, pain lasting for more than six months, pain significant enough to impact quality of life and daily functions, and requires medical evaluation. The chance of developing chronic scrotal pain is thought to be about 1 patient for every 2000 vasectomy procedures.
Approximately 10% of Dr. Monteith’s patients reported scrotal pain on their 12 month survey; however, 96% of these patients reported the pain/discomfort was not significant enough to require medical evaluation.
Of the 4% of reporting requiring medical evaluation, many of these patients were being seen and evaluated for resolving hematomas, transitory post vasectomy inflammation, or painful nodules at the vasectomy site.
In almost all cases these conditions resolved without treatment and with over the counter anti-inflammatories. Only three patients have required a second procedure to remove a symptomatic vasectomy site nodules and one patient required an injection of an anti-inflammatory medication into a painful vasectomy site nodule. In both cases the treatment resolved the discomfort.
Approximately 2 patients (0.06%) have developed Chronic Scrotal Pain after vasectomy with Dr. Monteith. These two patients acknowledge they have developed enough discomfort after vasectomy to seek additional treatment but neither patient described the pain as severe enough to make them significantly alter their daily activities.
Sexual function After His Choice Vasectomy
When did our patients resume sexual activity after vasectomy?
Percentage total may not equal 100% due to rounding estimates
Dr. Monteith recommends patients abstain from sexual activity or ejaculation for 2 days after His Choice Vasectomy.
Sex drive one year after His Choice Vasectomy
The effect of vasectomy on sexual satisfaction is a major concern for men considering vasectomy. The majority of Dr. Monteith’s patients report no change in sexual satisfaction 12 months after their vasectomy.
Approximately 18% of men reported their sex drive libido increased. This is 1 out of 5 men and could represent a pleasant effect from vasectomy.
Most medical studies on sexual satisfaction after vasectomy do demonstrate improvement and this improvement is experienced by both men and women. This improvement is attributed primarily to decreased anxiety over the fear of pregnancy.
More information: Does Vasectomy Affect Your Sex Life?
Approximately 1 out of 10 men will report a decrease in sex drive. It is important to note there could be other reasons why vasectomy patients report decreased sex drive at 12 months.
Many men seek vasectomy after having their last child and or after a separation/divorce from a significant other. Nothing puts a damper on your sex life like having multiple young children or personal relationship issues. These factors plus others can have a negative effect of on sex drive.
Ability to have erection one year after His Choice Vasectomy
The majority of patients report no change in the ability to have an erection 12 months after vasectomy with Dr. Monteith.
Approximately 1 out of 10 men will report their ability to have an erection is slightly less. As with sex drive other social factors that cause men to have vasectomy can also have negative effects on erection. Erectile dysfunction is also a common condition in men as they age and develop other medical conditions (i.e. hypertension, diabetes, depression, etc).
Most medical studies demonstrate vasectomy has no direct effect on erectile function.
Strength of orgasm one year after His Choice Vasectomy
Most patients who have vasectomy with Dr. Monteith report no change in strength of orgasm 12 months after their vasectomy procedure. Some men report their strength of orgasm is increased and some report the strength of orgasm is decreased.
Most medical studies demonstrate vasectomy has no direct effect on strength of orgasm.
Ejaculatory fluid volume one year after His Choice Vasectomy
Approximately 3 out of 4 patents who have vasectomy with Dr. Monteith report no change in their ejaculatory fluid volume 12 months after vasectomy. Approximately 1 out of 5 men will report a decrease in volume.
Technically vasectomy can decrease the volume of your ejaculation because by decreasing the volume of sperm added to the ejaculatory fluid. This decrease is estimated to be about 5% of the total volume of ejaculatory fluid and is this decrease is imperceptible to most patients. Some men may notice a slight color change after vasectomy (less white and more clear).
More information: His Choice Vasectomy | How does a vasectomy procedure work?
The vasectomy blocks sperm transport from the epididymis to upstream storage sites. Most ejaculatory fluid volume is produced upstream from the vasectomy by the prostate and the seminal vesicles.
His Choice Vasectomy: Failure and Regret
How many of our patients completed the 3 month after vasectomy semen sample test?
Reasons for not completing the 3 month after vasectomy confirmatory test:
- Did not have time 29%
- Relying on fact vasectomy is highly successful 29%
- Had test done elsewhere 17%
- Forgot 17%
- >Don’t care 5%
- Would not mind if vasectomy failed 5%
Percentage total may not equal 100% due to rounding estimates
His Choice Vasectomy is highly effective with a low rate of failure. The chance of an early (failure less than 3 months) vasectomy failure is approximately 0.3%.
Dr. Monteith recommends patients abstain from ejaculation for 2 days after their vasectomy procedure. Patients are then encouraged to have a minimum of 20 ejaculations (the more the merrier) and also wait 3 months (both time and number of ejaculations are important) before returning a semen sample for confirmation the vasectomy was successful. Dr. Monteith prefers patients bring a fresh sample (same day collection) for evaluation but allows men who live longer distances to send their samples by mail.
More information: Dr. Monteith’s After Vasectomy Instructions
The 3 month sample is designed to allow patients enough time for complete sperm clearance but also enough time to detect an early failure (reconnection). Once the 3 month after vasectomy semen sample confirms the absence of sperm the chance of a late vasectomy failure (failure after 3 months) decreases to 0.05%.
Many patients will not have the after semen sample confirmatory test because they are too busy and rely on the fact that vasectomy is highly effective at preventing pregnancy.
Did our patients cause pregnancy within 12 months of His Choice Vasectomy?
Two pregnancies were reported after vasectomy but within the first 3 months of the procedure due to residual sperm that were not completely evacuated. Subsequent semen sample tests in all these patients confirmed persistent absence of sperm.
More information: His Choice Vasectomy: Chance of failure and pregnancy
Several additional reports of pregnancy after vasectomy have been reported but these were attributable to infidelity.
No patients have reported causing pregnancy after their 3 month after vasectomy semen sample test confirmed absence of sperm.
Did our patients regret vasectomy one year after their procedure?
The vast majority of patients who have vasectomy with Dr. Monteith do not regret their vasectomy after 12 months.
Some patients may have not reported regret because of embarrassment. With the passage of additional time the percentage of patients experiencing vasectomy regret could increase.
Most men who seek vasectomy reversal do so an average of 8 years after their vasectomy procedure.
Did our patients consider reversal one year after their vasectomy?
The vast majority of patients who have vasectomy with Dr. Monteith did not consider vasectomy reversal after 12 months.
Dr. Monteith occasionally receives inquires about vasectomy reversal from patients within the first month of having a vasectomy. Interestingly these patients are all in stable relationships and they have children. Regret may be a common adaptive response after making an important life decision. It also appears men who report depression or anxiety are at increased risk of vacillating about regret after their vasectomy.
Approximately 1% of patients reported considering reversal of their vasectomy 12 months after vasectomy.
More information: Common Risks of Vasectomy
Dr. Monteith offers but does not require a consultation before having a vasectomy procedure. The vast majority of men >99% choose to have a single visit vasectomy procedure.
Patients only need to answer one question before having a vasectomy procedure with Dr. Monteith: Do they want to have any additional children?
How many of our patients have fathered children?
A significant number of men who have vasectomy with Dr. Monteith reported having no children and no desire to father children.
Dr. Monteith does not require men have children to have a vasectomy. He only requires men be above the age of 21 and be able to provide informed consent.
His Choice Vasectomy: How did we do?
Would you recommend His Choice Vasectomy to friends or family?
The majority of our patients would recommend His Choice Vasectomy to their friends. A personal recommendation to a trusted friend of family member is the best testament about the acceptableness, safety, and effectiveness of vasectomy.
How our patients rated the care received from our office?
The majority of our patients rated their care as exceptional or very good. This is important in any health care setting but especially important when men are considering a life changing procedure, during a single appointment, with a doctor and staff they have never met before.
Would our patients recommend us to a friend?
A personal recommendation to a trusted friend of family member is the best testament about the quality of our practice.
More information: Google reviews about vasectomy with Dr. Monteith