Vasectomy in San Antonio

Learn more about our No-Needle, No-Scalpel Vasectomy

Our board certified, highly acclaimed physicians are the only ones who perform your vasectomy. Patients love the ease of scheduling, comfortable and private atmosphere, fast procedure, and “unbelievably” painless results.

What is a vasectomy?

A vasectomy is a minor surgical procedure where a doctor disconnects the tubes (called the vas deferens) that carry a man’s sperm from his testicles to his ejaculatory ducts. This prevents his sperm from mixing with his semen during orgasm. The good news? You will not notice any changes in your orgasm as a result of a vasectomy procedure. Further, your ejaculate flow rate and volume remains the same. Your semen just no longer contains the sperm cells that allow for pregnancy. Although reversals are sometimes possible, a vasectomy is considered a permanent contraceptive procedure and is one of the safest and most effective contraceptive options. In fact, one out of every six men over the age of 35 in the U.S. has had a vasectomy.

What kind of doctor performs a vasectomy?

At The Urology Place, experienced urologists are the only ones who perform your procedure. Most of our patients feel more at ease having our urologists perform their vasectomy because of our extensive experience with the procedure as well as our deep understanding of how to preserve and recover men’s sexual performance given any of a number of conditions. We regularly see patients from San Antonio, Austin, and all over South Texas. It’s not unusual for patients to travel to our San Antonio facility to ensure they get the best care and outcome. Our typical procedure takes 15 to 20 minutes and patients can comfortably walk out of our office after their vasectomy.

Does insurance cover the cost of a vasectomy?

Most insurance plans cover the cost of a vasectomy. They typically require you to have one pre-procedure office visit and then a second appointment on a different day for the actual procedure. Some insurance plans even require a waiting period of a set number of days between your initial consultation and your surgery.

How much does a vasectomy cost?

If you are paying out of pocket for your vasectomy, we can provide you with both the consultation and the procedure on the same day for a highly competitive prompt-pay price of $750. Insurance otherwise covers a vasectomy but you usually are required to have your consultation separate from the procedure. There is a $75 deposit required to secure an appointment for the procedure. We keep the deposit if your do not cancel a week ahead of the appointment. This is because we have dedicated our time slot to you and your procedure.

How is your cash price for vasectomy so low?

Our San Antonio facility and staff are set up to accommodate your vasectomy surgery. As such, we avoid having to charge you hospital fees or fees to bring in additional specialists for your anesthesia. Further, our urologists are highly experienced in performing your procedure, so it takes us less time and recovery can be faster than less experienced options. Also, it allows us to schedule and perform same-day vasectomies for patients who desire that option.

Does the $750 prompt pay price for vasectomy include everything?

Yes, our $750 vasectomy price includes your initial consultation as well as the procedure. Going to a lab for testing afterwards is a separate charge unless you come to our office to drop off the semen sample. There is a $75 deposit required to secure your appointment. Cancelling with less than a week’s notice is fine but we will keep your deposit because the staff time dedicated to you and your procedure will be lost.

Fill out my online form.

Compare Vasectomy to Other Forms of Birth Control

Vasectomy, Essure, & Tubal Ligation
 
Vasectomy Essure Tubal Ligation
Anesthesia Local Anesthetic IV Sedation or General Anesthesia General Anesthesia
Surgery Location Office Office or Hospital Hospital
Procedure Description Tiny opening in scrotum. Least invasive surgical birth control option. Thin tube to thread the device through the cervix into the uterus and into the fallopian tubes. More invasive than vasectomy, less invasive that tubal litigation. Incisions in abdomen and insertion of a telescope and instruments to seal the tubes shut. Invasive surgical procedures with long recovery.
Cost $ $$ $$$
Onset of Results Works quickly. Requires a semen analysis to confirm lack of sperm. Requires birth control for 3 months and a special x-ray to verify that the tubes are blocked. Works quickly after recovery from surgery.

The Urology Place No-Scalpel, No-Needle Vasectomy

Both Dr. Kella and Dr. Hlavinka use an advanced, no-scalpel, no-needle vasectomy technique for your procedure. Our urologists are expert surgeons who have extensive experience with this technique. We want to insure your comfort during the procedure and give your body as fast as a recovery as possible. Some patients may want the most painless, nerve-free approach possible. Please ask us about IV sedation or our nitrous approach. Using a bit of nitrous gas can eliminate any anxiety and reduce your sensation of any pain. Also, it is very safe. The nitrous is available for approximately $100. You can drive home afterwards.

What happens during the vasectomy procedure?

To begin, we numb the area with lidocaine. With our no-needle technique, we use what’s called a MadaJet to actually spray on a local anesthetic. Sometimes, we may elect to use injected lidocaine. We use a very tiny needle to minimize discomfort.

The Opening

Next, a special instrument is used to make a tiny opening in your scrotum the size of this dash —. At The Urology Place, we specialize in performing your entire procedure through this single tiny opening. We gently move around your blood vessels and nerves to locate and then isolate your vas deferens, or “vas” for short. Some doctors cut across your blood vessels and nerves to speed up the procedure; we disagree with this technique.  By gently moving around your vessels and nerves, and numbing you internally as we do, we reduce bleeding, pain, sexual side effects and infection risk.

Sealing Off your Vasa 

Once we have located your first vas, we carefully cut it. We then use pinpoint heat cautery to seal off your vas deferens tube. Multiple studies show cautery is superior to clips for vas occlusion and has a lower failure rate. Dr Kella uses an open ended procedure, meaning we only seal off the upper portion of the vas, leaving the lower half of the divided vas deferens open. After we seal the tissue we place a tiny suture to further seal off the upper vas. Finally we do an “interposition” or put the ends of the vasa into separate compartments. All these steps minimize the chance of the vas accidentally reconnecting.

We then allow the ends of the vas deferens to gently release back into the scrotum. Given your vasa move freely about within your scrotum, we can locate your second vas deferens via the same tiny hole and repeat the procedure without any additional openings.

What are the benefits and differences of an open-ended vasectomy?

All vasectomy procedures involve dividing both the left and right vas deferens. During an open-ended procedure, only the upper half of the vas is sealed with pinpoint cautery and the lower half is left alone. During a closed-ended vasectomy, both the upper and lower portions of the vas are sealed. Open-ended vasectomy reduces pain after the procedure, as well as the longer term risk of painful epididymal disruption. It is equally as effective as closed-ended vasectomy but is easier to reverse should you ever desire a vasectomy reversal. Dr Kella typically performs the open ended technique.

Keeping it Pain Free

One of the biggest keys to keeping your surgery and recovery pain free is our tiny puncture hole and gentle method. In addition, those wanting the least painful route should ask about nitrous gas or IV sedation.

Given we haven’t disrupted or cut any of your blood vessels or nerve endings during the procedure, recovery is actually quite easy. Once we release your second vas back into your scrotum, the tiny puncture hole contracts to a few millimeters. It’s so small it doesn’t require any of the big closure methods required of traditional vasectomies. Depending on your specific case, we may or may not place a tiny self-dissolving stitch in the skin. At this point, your procedure is complete. It’s important to lie down for the first 24 to 48 hours after your procedure as much as possible for optimal healing.

How to Prepare for Your Vasectomy

It’s important to prepare mentally for a vasectomy and ensure that both you and your significant other are comfortable and ready to pursue permanent contraception. Once you make this decision, do research to ensure you choose the right doctor for you. It’s not unusual for patients to travel for their vasectomy procedure to ensure they receive it under the most skilled hands. New vasectomy techniques, such as the no-scalpel vasectomy performed at The Urology Place, have greatly reduced side-effects and complications over more traditional methods.

Decide whether or not to use health insurance

The next step is to decide whether or not you want to use insurance to cover the cost of your procedure. Most insurance plans do cover the cost of a vasectomy, but insurance plans vary in their requirements. Most all plans require two office visits (an initial consultation followed by a separate surgery date) in order for them to cover the cost. Some plans also require pre-authorization for your surgery. Our medical staff can research exactly what your specific insurance company requires and facilitate the entire process for you. Most patients who desire a same-day consultation and surgery choose to pay out of pocket instead of using insurance.

Schedule your procedure

It’s easy to schedule your vasectomy at The Urology Place. Just call, email, or text us. For same-day appointment requests, please call so that we can check availability immediately. Schedule your procedure on a day where you can stay home and rest both the day of surgery as well as 1-2 days afterward.

Remember to eat, clipper, buy peas & bring underwear

Eat normally on the day of your procedure. Use an electric hair clipper to clip (NOT SHAVE) your scrotum before you come for your appointment. Shaving with a razor can cause uncomfortable cuts and infection risk.  Avoid taking aspirin, ibuprofen (Advil) or naproxen (Aleve) for a week prior to your vasectomy. You should wear supportive underwear immediately after your vasectomy procedure as well as for about 5 days afterward. Make sure that you bring one pair on surgery day and have a few extra sets at home so that you don’t have to take a last-minute trip to the store. Many patients also like to bring a set of headphones so that they can listen to music during their procedure. It’s also a good idea to buy one or two bags of frozen peas and have them on hand when you get home. Peas really are one of the best options for after-surgery care. They are small and round and provide a softer cooling alternative than many of the manufactured cooling packs. Further, they do a very good job conforming their shape, so are pretty comfortable to sit on post-surgery.

What happens at our office?

Once you arrive at our office, we start by having you complete some paperwork. We then bring you back for a pre-surgery consultation. We encourage you to bring your spouse or significant other into the room for this discussion so that both of you can ask any questions you may have. Feel free to come with a written list – our doctors and staff take their time to ensure you are completely comfortable before we begin.

We then go over the procedure with you in detail so that you know exactly what to expect. Your doctor will also explain what to look for and how to care for yourself in the days following your surgery. Additionally, we will review your medical history to ensure there isn’t anything in your specific history that indicates vasectomy may not be a good option for you.

During this time, for patients using insurance, our staff does a double-check to ensure we have secured any required authorizations from your insurance company.

Just before your procedure

Most patients feel completely at ease by the time we are ready to start the procedure. At this time, we ensure you are dressed for surgery, comfortable, and relaxed.

After Your Vasectomy

Immediately after your vasectomy, you can usually expect any discomfort to be mild. The local anesthesia will begin to wear off about an hour after the procedure. Most patients don’t need pain relievers or antibiotics after their vasectomy, but you may take acetaminophen (Tylenol) or ibuprofen (Advil) if needed.

Our caring staff will take care of you and make sure you are feeling comfortable after the procedure. Before you are discharged, we will come back in to check on you, review your take-home care protocol, and answer any questions you or your spouse/significant other may have. We will send you home with written instructions on your at-home care and your follow-up semen analysis, as well as our contact information just in case you need us.

 

Can I drive myself home after my vasectomy?

In the event you were prescribed valium before your procedure, we ask that you arrange to have someone else drive you home. Otherwise, you are free to drive yourself! You will spend a while comfortably resting in our facility after your surgery, so please let your loved ones know that you will not be discharged until our doctors and medical staff feel you are ready to travel. It’s important to allow for 1-3 hours at our office just in case. Once you are discharged, go directly home to rest on the couch or in bed for a few hours.

You will need to wear a snug scrotal support garment after the procedure. Do this for about 5 days after your vasectomy as well. Remember to wear or bring these with you to your vasectomy procedure.

 

What should I expect once I get home?

Once you get home after your vasectomy, lie down and put some ice or frozen peas on your scrotum for 20 minutes. Leave on your supportive garments as you do this. Use ice periodically for the rest of the day. Ice does two things. First, it reduces swelling. Second, it blocks your pain receptors, helping you achieve a pain-free recovery. This is why it’s important to rest and take it easy even though you’re not in pain.

You can shower the day after your vasectomy, but avoid soaking in a tub for at least 48 hours. You should count on spending a quiet weekend at home. You do not have to stay home all day, but don’t plan on lots of activity. Avoid sports, sex or heavy exercise for a week.

How do I know when I don’t have to use another contraceptive measure (ie condoms, etc)?

It’s important to remember that your vasectomy procedure is not officially complete until there are zero signs of sperm in your ejaculate. Studies show that many men never re-test their sperm after their vasectomy; this is a big mistake. Your vas deferens tubes carry millions of sperm, so sometimes it can take some work to clean them out entirely! We ask patients to utilize an additional form of brith control for at least 20 ejaculations. At that point, we will test a sample of your ejaculate at the lab, or you can perform an easy at-home test called SpermCheck to ensure you don’t have any remaining sperm. The SpermCheck at-home test gives you results in 10 minutes and can be purchased through this link.

Risks of Vasectomy

Overall, a vasectomy operation is a very safe procedure with few risks. As with all surgeries, however, the vasectomy procedure does carry some risk. Our experienced urologists’ unique, no-scalpel technique greatly reduces the chance of sexual side effects and infection-related side effects as well as the following:

Infection, Bleeding or Pain

The risk of infection is similar to that of getting an IV placed and is very low. Bruising is more common, as is the development of a hematoma (when blood leaks outside of the blood vessel after injury and into your tissues). This can be decreased by wearing a simple cloth athletic support (jock strap) for 3–5 days and keeping a cold pack on your scrotum for 18 to 24 hours after surgery. Stay on the couch or in bed resting for 8 to 12 hours after your vasectomy. Most patients tolerate a vasectomy well. Some use Tylenol or Ibuprofen for discomfort.

Recanalization

Recanalization is where the sperm find another path from the testicle to the ejaculatory duct, or where the vas deferens grows back and reverses the vasectomy – restoring a man’s fertility. It could occur months or years after the vasectomy. The risk of recanalization is very small (<1%). Vasectomy is over 99.8% successful. We mention it because it has occurred in the history of vasectomy procedures.

Post Vasectomy Pain Syndrome

After your vasectomy procedure, there will small lumps and bumps called granuloma inside your scrotum where the surgery was performed. These are the ends of the vas deferens that have scarred down. These granuloma may be tender for 1–2 weeks post surgery, but will quickly self resolve. Fewer than 1% of men have any prolonged discomfort after their vasectomy. There is a condition called post vasectomy pain syndrome that has been reported in a very small percentage of men immediately or several years after vasectomy. Men with this syndrome experience chronic testicular pain that is thought to be the result of pressure build-up within the duct behind your testes. We have not seen this condition with any of our patients at The Urology Place. It is described in the literature and treatments exist.

Complications Leading to Removal of Testicle

Some surgeons have reported the need to remove one or both testicles in a patient after a vasectomy procedure. This is a very rare occurrence and one we have not ever had to perform at The Urology Place as a result of a vasectomy we have performed. The data states that complications leading to testicle removal are usually related to infection or loss of blood flow.

VASECTOMY:
IS IT RIGHT FOR YOU?

DR. NAVEEN KELLA TALKS ABOUT THE MYTHS AND THE MISUNDERSTANDINGS SURROUNDING THE SAFEST AND MOST EFFECTIVE CONTRACEPTIVE AVAILABLE TODAY. BY LENORE KAISER

 

Dr. Naveen Kella is a board-certified urologist who performed this region’s first robotic prostatectomy for prostate cancer and the first robotic cystectomy to treat bladder cancer. Kella is considered one of the top surgeons in the United States. He is the director of The Urology Place. For more information or to schedule an appointment, call the The Urology Place at 210-617-3670 or visit www.theurologyplace.com.

THINKING OF HAVING A VASECTOMY, but not sure? Speaking with Dr. Naveen Kella, a board-certified urologist in San Antonio, I found out it’s not only a minor surgical procedure to achieve male sterilization, but one that only takes less than 30 minutes.

“With failure rate of less than one in 1,000, a vasectomy is the most effective route to avoid an unwanted pregnancy, “Kella said, “compared to one in 250 to the female counterpart doing a bilateral tubal ligation.”

So why does a procedure that is more cost-effective, safer and less invasive even have to be talked about? Shouldn’t men be flocking to have the procedure done after their girlfriends or wives have spent years doing their part by taking the pill or giving birth to their kids?

“Obviously, misconceptions about vasectomy can hinder its usage,” Kella went on to explain. “Women end up with the ultimate responsibility of pregnancy rather than men. African American and Latinos populations actually have more women than men taking the plunge for contraception compared to New Zealand, where vasectomy’s rate is 57 percent of men between 40 and 50.”

One of the misconceptions about the vasectomies is that some men worry they won’t perform the same. The fact is, the volume and appearance is the exactly the same. About 1 percent of a man’s withdraw comes from sperm. There is actually no link to sexual function. There is actually a small increase in testosterone after vasectomy.

Another misconception is that vasectomies can cause other health problems like prostate cancer. Kella assured me, “No. There was controversy at one point that patients who had prostate cancer were more likely to have had a vasectomy were just more likely to see the doctor. There is no link with vasectomy and any kind of cancer.”

Vasectomies are generally performed in a doctor’s office, and most doctors use Lidocaine for local anesthetic. The needle is so tiny that patients sometimes don’t realize they have already been anesthetized. In fact, if the needle were any smaller, it would not be able to penetrate skin.

Next, a special instrument is used to make a tiny puncture the size of this dash: “_.” The vas is identified, isolated and further numbed with more medicine. A small section of the vas is separated and removed. A few minutes later, a tiny suture is placed to seal off the vas and the procedure is repeated on the other site, sometimes though the same incision. No metal clips are used. A single suture closes the skin opening.

It’s a good idea to bring some supportive underwear to the visit,” Kella went to say. “Athletic spandex shorts from Under Armour or Reebok provide great support for the next couple days, and you should remember to take it easy. Placing a frozen peas bag for 10 minutes on the area works great. If the procedure is done Friday, most can be back to work by Monday. Pain pills are provided, but not always needed. Showers are OK, but we ask men to avoid bathtub soaks for two to three days.”

The only thing men need to keep in mind after the procedure is that they are not officially done until it is confirmed that all sperm is gone since tubes carry millions of sperm and sometimes it can take some work to clear them out entirely. Patients are asked to practice protective sex until they receive the OK after their checkup, which is typically six weeks.

Ending my discussion, I asked if there were options for the future. “Science continues to bring out new advances,” Kella answered. “We have progressed to using no scalpels and even no needles for the procedure. Polymers are being developed that could just be injected into the vas and then seal them off. This could be potentially be a reversible procedure, as the polymer could be heated until it liquefies and washes away. Ultrasound treatment has also been tried to seal off the vas.

“But for now, the most dependable way of achieving contraception can be done in less than 30 minutes with just a few drops of numbing medicine and your helpful urologist.”


Lenore Kaiser is the wellness director and owner of Kaiser Medical Management. To learn more, call 1-800-746-0418 or visit www.kaisermedicalmanagement.com.

Questions and Answers:

There are many risks involved with women and the long-term use of contraceptive pills, hysterectomy, or the higher failure rate of tubal litigation for women. Vasectomy is nearly 100 percent effective in permanent contraception. If your family is considering permanent birth control options, please read the Q&A section below, and call us for your consultation.

Men sometimes worry that they won’t ejaculate after a vasectomy procedure. They will be “shooting blanks.” In fact, the volume and appearance of semen will be exactly the same. Only about 1 percent of the ejaculate comes from sperm. Related to this is the idea of losing your sexuality or libido. There is absolutely no link between vasectomy and loss of sexual function. In fact, there is a small increase in testosterone after vasectomy! Also, there hasn’t been any research that indicates a link between the increased risks of certain cancers or of heart disease.

About 1 in 1,000 men experience ‘chronic pain syndrome’ after the procedure. One cause of pain is the continued production of sperm post-procedure. Usually the sperm just breaks down in the body, but sometimes the sperm builds up and causes pressure as they travel out of the testicle in a long, coiled tube called the epididymus. As they leave the epididymus, the sperm enter a straighter tube, which is the vas. Pressure can build up and cause pain, especially if the tube is tied off. Our technique is to do an ‘open ended’ vasectomy where the tube coming from the testicle is left open, allowing sperm to be harmlessly reabsorbed by the body. The other side of the vas is sealed off. This prevnts sperm from continuing its journey and possibly leading to an undesired pregnancy.

Most patients fear the knife and the needle. We do not use a scalpel for vasectomy. We use a tool that spreads open tissue to this size: “–”  This type of vasectomy approach has been shown to have less complications. See here.  We offer a no-needle technique using the MadaJet. This applies a spray of lidocaine. Most patients say the MadaJet feels like a rubber band for a second. Once the vasectomy is underway, patients report some sensation of pulling, but usually no pain. Most patients are pleasantly surprised that the procedure was not painful at all. The literature suggests the no needle approach may have less pain.

There are basic steps you can take to make any pain go away. Anti-inflammatories (Advil, Ibuprofen) can help. In addition, wearing supportive underwear and using a cold pack can help. Half of the patients do not take ANY pain medication at all. A third of patients take a tylenol just in case. The rest of the patients may take a couple of pills.

We tell men to “clean out the ducts” of preexisting sperm in the vas. About 20 ejaculations or 6 weeks of time will usually do the job. Men should confirm they are good to go by bringing us a fresh sample for a semen analysis, or men can order SpermCheck. The semen analysis is the best way, but patients who cannot make it to the office can do the at home test, which is 98% accurate. The test, which is FDA-approved for monitoring sperm after the procedure, detects SP-10, a protein present at constant levels in each sperm nucleus. The test is available from SpermCheck. Not worrying about an unexpected pregnancy is a relief, but men should be aware that vasectomies do not prevent the contraction of HIV/AIDS or other sexually transmitted diseases or infections. Vasectomies primary purpose is for the prevention of pregnancy only.

Vasectomy procedure is the most effective contraceptive available. Vasectomy failure can occur if sperm recreate a channel through the vas. Vasectomy is over 99.8% successful. Vasectomy failure is most frequent in two situations. Patients do not ejaculate at least 20 times before unprotected sex. Patients not confirm lack of sperm with a semen analysis.

A man should be certain that he does not want to reproduce ever again before deciding to get a vasectomy procedure. To be honest, we prefer not to have the reversal discussion as we tell men to have the mindset that a vasectomy is a permanent solution. Reversal success depends mostly on time and surgeon experience. It is a successful procedure in the right hands about 80 percent of the time if done soon.

Insurance may cover the vasectomy cost in San Antonio. If you would like to be cash pay, we have a prompt pay discount covering the office visit and the procedure for approximately $750. This covers the no scalpel procedure. This increase the chance for a fast recovery. Remember, you should get a semen sample later.

We will request a $75 nonrefundable deposit. The practice has to reserve time and equipment for your procedure and that is why a deposit is enforced. Once you have the procedure, the deposit can be refunded or applied to your procedure.

The Holy Grail. The dream. No one can promise a completely painless procedure. However, we strive to offer you everything possible. We offer nitrous gas before any of our procedures. Nitrous eliminates anxiety and reduces pain. It is very safe. You can drive afterwards. This is the same type of anesthetic at your dentist’s office. There is an out of pocket fee of approximately $105. If you want it to be painless as possible, consider nitrous as the way to go. Let our staff know.

Some people may even want IV sedation. IV sedation requires special scheduling, so please let us know.

Why The Urology Place?

We strive to make your vasectomy at our San Antonio center as easy and painless as possible. Your choice of music. A relaxing atmosphere. No scalpel. No needle. Our pinpoint cautery and open-ended techniques maximize effectiveness and minimize pain. If your family is complete, we are ready to help. Patients from San Antonio, Austin, Laredo and all over South Texas see us for their vasectomy. Feel free to contact us using the form to the upper right of this page, email us at messages@theupi.com, or call us at 210-617-3670.

adminVasectomy