Care with Roscoe Nelson, MD, board-certified urologist.
How I do it
I have performed more than five thousand vasectomies and I still do every one myself. The anesthetic goes in with a jet injector, a fine spray driven through the skin by pressure rather than a needle. Most men describe it as a rubber band snapping against the skin, and nobody gets an injection into the scrotum. Instead of cutting, a small instrument makes one opening a few millimeters wide and spreads the tissue apart. Each vas is lifted through, divided and sealed, and the opening closes on its own without a stitch.
You have laughing gas running the whole time. It keeps you relaxed while the local does the numbing. The procedure itself takes under fifteen minutes, and most men are back at a desk in a day or two. The most common thing I hear at the end is a slightly surprised "was that it?"
The price
$1,000, all in. That covers the procedure, the laughing gas, and up to two semen analyses afterward, with the second included in case the first is still positive. No separate anesthesia charge. It is a cash price; I do not bill insurance for vasectomy, so there is no claim, no denial and no bill months later. HSA funds work.
Getting ready
- Aspirin, ibuprofen, naproxen and similar drugs stop a week ahead. If a physician prescribed you a blood thinner, do not stop it on your own; that physician and I will decide together how to handle it.
- Buy a jock strap and bring it. Not a cup, not tight underwear.
- Arrange a ride home.
- Shave the scrotum before you come in.
- Put a bag of frozen peas or corn in the freezer. It molds to the right shape better than an ice pack.
Afterward
Two days of jock strap, ice and very little activity. Ice matters more than men expect and does the most to change how the first forty-eight hours feel. A week of light duty, still in the jock strap, with no lifting, no workouts and no long days standing. After that most men are back to normal. Sperm downstream of the vasectomy take two to three months to clear.
What it does: divides and seals each vas so sperm no longer reach the ejaculate. What it does not do: it does not touch the testicles, lower testosterone, change erections or stop ejaculation. Sensation is the same and the volume drop is minimal, because sperm are a small fraction of the fluid. Treat it as permanent. Reversal exists, is a much larger operation, and does not always work.
You are not done until the test says so
Almost every failure I see is a man who skipped the follow-up test, not a surgical failure. Keep using contraception until a semen analysis shows zero. Feeling recovered proves nothing about the count.
We make the test easy. Your lab order is written the day of the procedure for the laboratory your insurance uses, and both included analyses run through it. If the lab trip is what will make you procrastinate, we also sell a mail-in kit so you can test at home until the count is negative. Do not test early. The first analysis is at three months and roughly twenty ejaculations, or it tells us nothing and wastes your recheck.
I filmed the full talk I give in the office, and I want every patient to watch it before coming in. It is on PeeDoc, linked below. Peri opens Late 2026 in Draper, Utah, and nothing is bookable yet. The waitlist hears first.