Snip and Tuck

"You can sometimes sense when [the man] isn't a willing participant in this decision," he said. "There may be family or marital issues that are bringing them to your office; he may be in a position where he's forced into it, and vice versa -- where he wants the procedure and she doesn't.

"There are some situations where I've turned some patients away. They act a little indignant, but I tell them the guys who don't do well after this procedure are not really the guys who have a physical problem, it's the guys who weren't ready for this decision.

"You can pick up when the guy is ticked off at being there in the first place."

Vasectomy joke No. 2: A man comes to the doctor and says, "Doc, I want a vasectomy." The doctor says, "Well, that's a big decision; have you discussed this with your family?" And he replies, "Yes, and they're in favor, 11 to 3."

After describing the procedure and informing me of possible side effects, Laurent explains that I will be required to return six weeks after the operation with a semen specimen, which will be examined to see if I'm clear of sperm. Other docs say anywhere from 10 to 20 ejaculations is adequate, but Laurent is more cautious.

"Some guys never come back and assume with time everything is clear," Laurent said. "I've had a guy come back four months out and still had a few non-moving sperm. You usually see it in a guy who isn't very sexually active. Maybe his wife is in the last trimester of a pregnancy and he's not having intercourse or ejaculating frequently; you really do have to go with time as well as frequency of ejaculation."

Before leaving Laurent I have to ask: Everyone calls it "snip" and "snipped" and "snipping." Is there any actual snipping involved?

"Well," he said, "there are surgical scissors involved -- you're removing a half-inch segment so the two ends [of the vas deferens] don't come back together. So, yes, there is some snipping."

Welcome to My Operation

Most vasectomies are done with the patient numbed by a local anesthetic. But Laurent finds it easier to sedate.

"I like to focus on what I'm doing," he said. "I like to have someone else monitor the patient. I have more comfort level using sedation."

Hey, if it's good for him it's good for me.

When I arrived at Reston Surgery Center for my operation I spoke with Tammy Sparks, who is very slim and plays ice hockey when she isn't chemically knocking people out. She is the medical director and chief anesthesiologist for the center. Of the eight urologists who practice there, she said, most do their vasectomies on Fridays.