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FIRST
CONSIDERATIONS
NO-SCALPEL VASECTOMY
RISKS
PREPARING FOR YOUR
VASECTOMY
AFTER THE VASECTOMY
FAQ
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FIRST
CONSIDERATIONS
Vasectomy should be considered
permanent and irreversible. Don't be fooled by claims of reversible
vasectomies...there is no such thing. If you attempt to reverse your
vasectomy within the first three years of having it done, you have
about a 70% chance of success (this falls considerably after ten
years). The reason for this is simple. It may be
possible to rejoin the tubes (the vas deferens) but the sperm that go
through may be infertile. Most men, after vasectomy, develop immunity,
or
antibodies, to sperm. This is not a concern from the point of view of
general health. But it means that the body may inactivate the sperm as
they
are produced, making successful reversal difficult.
Men under the age of 30, who opt for vasectomy, are statistically 12
times more likely to
undergo reversal surgery...a 3-hour operation under general anaesthetic
with a painful recovery costing many thousands of dollars and with no
guarantee of success! Those with children under 4-6 months of age may
want to consider waiting before proceeding to vasectomy. The risk of
sudden infant death syndrome (SIDS) is greatest under this age.
Obviously natural conception is the best method. However it is possible
to freeze semen prior to vasectomy (for a fee) for those with infants
or men who have no children.
The bottom line is this: if you are in doubt about whether you want to
have any more children, don't have a vasectomy. Your partner may wish
to consider other forms of contraception.
A vasectomy has no bearing on sexual function. Your ability to obtain
and maintain an erection is unchanged. When you ejaculate after
vasectomy there will be an equivalent amount of semen that comes out.
If there are problems in your sexual relations, however, work them out
before you have a vasectomy. It could only magnify problems
psychologically.
You will be asked about any medical conditions, bleeding problems and
allergies to medication or anaesthetics. It is your responsibility to
make certain that the doctor is aware of the presence of any of these.
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NO-SCALPEL
VASECTOMY
No-Scalpel Vasectomy can be done
in the doctor's office. No knife is needed. Using a special no-needle
'freezing' technique called jet injection, the doctor numbs the area.
This method of local anaesthesia, or freezing, works with air pressure
and does not require a needle. The sensation is like a little
pop, not unlike a small rubber band against the skin. A tiny hole is
made with a special instrument and stretched open just enough to lift
out the tube (vas deferens) on each side. The vas is cut and one end is
cauterized. One of the ends is then tucked back into its sleeve, or
sheath, which is then closed. The testicles continue to
produce sperm for the rest of your life. After a vasectomy, however,
the sperm are broken down and reabsorbed by the body.
The No-Scalpel No-Needle Vasectomy is faster, safer and more
comfortable than
conventional techniques. The surgery itself takes about 5-10 minutes.
Add another 5 minutes for the sterile preparation and you are in and
out of the 'operating' room in about 15 minutes (of course the doctor
will keep you for 15 minutes afterwards before letting you leave). The
risks of bleeding and infection, the most common complications of
vasectomy, are much less than with conventional vasectomy. The
anaesthetic (freezing) technique causes less discomfort because a
needle is not necessary and the numbing effect with jet injection is
more profound. Recovery time is usually faster and less painful because
the procedure itself is less traumatic.
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RISKS
Most men report feeling a bruised
sensation for a few days to a week following surgery. Actual bruising
is normal. Sperm granuloma is an expected outcome of vasectomy surgery.
A tiny pea-sized lump forms at the cut end of the vas deferens (the
tube carrying sperm from the testicle) naturally sealing the canal.
This little lump shrinks over time and is usually undetectable by one
year after your surgery. Do not touch
or examine this as it will cause complications. The risk of
epididymitis (tender swelling of the epididymis - the part of the vas
that joins to the testicle) is about 6/1000. The risk of hematoma
(bleeding) and infection are low (about four in a thousand). Serious
complications requiring hospitalization are about 1/1000. There is a
rare long-term complication of vasectomy, post-vasectomy pain syndrome,
a kind of chronic ache in the testicle. Treatment may require reversal
of the vasectomy. It is rare, occurring in 1 in 10,000 vasectomies. The
risk of cancer (prostate or otherwise) has been investigated for many
years. Most experts agree that vasectomy does not
cause cancer or cancer of the prostate or any other disease. There are
no guarantees, of course, that we aren't going to find something at
some point in the future, so each man must decide for himself what he
is comfortable with.
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PREPARING FOR YOUR VASECTOMY
(Re-read this section the day
before your surgery!) If you can, avoid the use of
A.S.A. (or Aspirin®) in
the
week
before,
and
alcohol
the day of, your vasectomy. Don't worry if
you normally use this medication for a medical condition...in that case
please take it as prescribed. Shave the
penis, the scrotum and the adjacent areas the day before with the razor
provided in the kit. With this
razor you shave dry...no shaving cream, no soap, no water. It
removes all the hair without hurting you. If in doubt about how much to
take off, take off more. Some men have used depilatory (Neet®) cream: experience has shown that this causes
painful sensitivity in many cases. On the day of the procedure take a
shower and scrub the scrotum well with soap and clean beneath the
foreskin (if you are uncircumcised)...if the scrotum is very tight,
take a hot bath. Don't use powder or talcum on the scrotum. Wear the
scrotal support (over your underwear) into the clinic, do not bring it
in a bag. Don't
bring your 'Vasectomy Kit'. Make sure you wear old clothing because the
iodine used to prepare you may stain; wear a T-shirt because you want
to avoid being over-heated. Have a little something to eat, don’t
arrive with an empty stomach. Take the prescribed diazepam
(Valium®) one hour prior to the appointment
(the doctor may also suggest that you take 50 mg of Gravol®
if you get queasy with medical things). Arrive 15
minutes early (if you are late, your appointment will be cancelled and
you will be charged). Arrange for a lift home 30 minutes after your
appointment time (you will be asked to remain at the clinic for about
15 minutes after the procedure.) You cannot drive yourself home. In
all, expect to be there for approximately 45 minutes. If you have a
special work absence form to be completed by the doctor, this is the
time to bring it.
Please do not
bring any children with you to your appointment. Our waiting room is
small and we ask this in consideration of our other patients and for
your own safety.
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AFTER
THE
VASECTOMY
The tiny opening will, in
most cases, be
sealed with a special surgical skin adhesive (2-octyl
cyanoacrylate). The advantages to having this 'glue' is that it
seals the wound, stops the bleeding, can help reduce the risk of
infection and allows you to shower immediately. The doctor
applies it once after the vasectomy and it falls off on its own after a
few days to a week. There is no need for you to do anything more
with it other than to keep some gauze pads over the area for extra
cushioning for the first 2 days.
(IMPORTANT: Do not apply ointment once skin glue has been applied -
ointment
removes this glue prematurely!). You may also notice a little blood in
the semen the first few times you
ejaculate. You may
shower (no swimming or bathing for one week), but do not pull or
scratch the wound while it is healing.
Rest at home after your surgery. Do not lift anything (especially
children of ANY age) and avoid
strenuous work or exercise (including golf, shopping, swimming,
hockey...you get the idea)
for the
first 7 days. If in doubt about what you can and can't do, don't do it!
The better care you take of yourself in the days following your
vasectomy, the less risk of major complications. You don't have to lie
in bed...sitting behind a computer is just fine and you may return to
work, if you sit behind a desk, as early as the day after the surgery.
Walk as little as possible in the first week. Place an ice pack
on the scrotum (over the support) several
times on the evening of your surgery (10 minutes on, 20 minutes off).
You do not need to ice the
scrotum after this unless you want to. You will begin to feel an aching
or bruised feeling within hours to several days, particularly when
shaking the penis after
urination. Urination itself is not a problem and normal forcing with a
bowel movement is okay too. It is not necessary to take anything for
minor discomfort, but do use the prescribed medication if you do
feel that you require something for pain (even many days after the
surgery). A little bit of everything is
to be expected: a
little pain and a little swelling.
If there is more than a little bit, or if you are concerned, call the
doctor. Bruising or black marks on the scrotum in the days following
your vasectomy are common and are not dangerous. Wear your
scrotal support for four days at least, over your
underwear (the position of the penis is unimportant). It will keep the
scrotum well supported, reducing the risk of internal bleeding. You may
wear it for longer if you wish. It takes, in all, about a month to heal
completely after this sort of surgery. But, if you are okay after a
week,
you may ease back into your usual physical activities, keeping in mind
that
things are still healing up. Wear the support whenever you work out or
exercise in the 1st month after the vasectomy. If it hurts, back off
and go slow. The doctor is happy to see you at any time if there are
problems (he wants to know if there are problems), so don't hesitate to
call in the months or years after your vasectomy.
Avoid sexual activity for one week after your vasectomy. If you get an
erection or have a 'wet dream', you needn't worry. However, intercourse
in the first week may increase the risk of failure. Remember that
vasectomy does not work immediately, and you can still get your partner
pregnant. Continue to use an alternative method of birth control until
the doctor tells you it is safe to have unprotected intercourse
(provided that you and your partner do not have A.I.D.S. or other
sexually transmitted disease). The first ejaculation should not be
painful, don't be scared. After 12 weeks send your semen sample to the
designated laboratory only for analysis. The number of ejaculations
during the 12 week period should be 15-20, if possible. Follow the
instructions given to you to
produce, package and post the sample. The result will normally be
available within a day of the
doctor receiving it (usually a week after you post it). You are
asked to provide a second sample only if the first result is unclear.
About 90% of men will have a zero sperm count after 12 weeks.
Occasionally it takes longer to clear the semen (6-12
months). The presence of live sperm three months after your vasectomy,
however, may indicate something called 'recanalization'. This is when
the sperm have managed to create their own tunnel to rejoin the tubes.
The risk of failure in this way averages 1 in 3 thousand. No method of
birth control is 100%. Vasectomy has the lowest failure rate of any
form of sterilization (lower than a woman having tubal ligation -
'tubes tied'). But - there is a very small chance of late failure years
after your vasectomy. You may consider having a semen analysis
regularly to avoid an unwanted pregnancy. Like a woman's breasts, your
testicles need support. Jockey-type or similar underwear are
recommended before and after a vasectomy for regular use.
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FAQ
Q. Is it reversible?
A. It's not ethical to do vasectomies on a hundred men and then go
ahead and reverse them after and see how many are successful. There are
those that claim open-ended vasectomy (the 'technique within a
technique' done here) increases the reversibility…but such claims
suffer from the same problem of not having any hard evidence. The
bottom line is you can put the tubes back together in the majority of
cases, but you cannot guarantee that a pregnancy will result. And that
is regardless of the method of vasectomy and the time between the
vasectomy and its reversal.
Q. Where does the sperm go after
the vasectomy?
A. A man does not eliminate all of the sperm he produces throughout
life. The body is able to break down and re-absorb what is not
otherwise ejected. The small volume of spermatic fluid containing the
sperm is thus reabsorbed after vasectomy in a process that was present
before the vasectomy. The prostate continues to make semen, however,
which is ejaculated in the normal fashion after vasectomy…there's just
no sperm in it anymore. You don't notice any difference after vasectomy
in this way.
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Q. Does vasectomy cause cancer?
A. A statistical study released in 1996 apparently showed a slightly
increased statistical risk of prostate cancer in men who had undergone
vasectomy (the same study also showed a reduction in most causes of
death in men who had undergone vasectomy!). Subsequent studies and
further analysis indicated that there is, in fact, no difference in
risk of cancer in men with or without vasectomy. One study of autopsies
in men over age 90 indicated a 100% risk of cancer of the prostate in
all men over 90 with or without vasectomy (most have not had a
vasectomy). The bottom line appears to be that vasectomy doesn't
improve health, but it doesn't make things worse either.
Q. Does vasectomy change my sex
drive or performance?
A. Many studies have been done looking at tens of thousands of men over
decades after vasectomy. There is no evidence to suggest that vasectomy
increases the risk of erectile dysfunction (difficulty getting an
erection) or changes one's sex drive or male sex hormone level. It is
important to note that erection problems are common (about 40% of men
aged 40 and about 2/3rds of men aged 70) and that these problems are
often associated with other medical conditions that increase in
frequency with age…with or without a vasectomy. Male sex hormone levels
decline naturally with age…with or without a vasectomy. All things
being equal, age should not preclude the enjoyment of healthy sexual
activity.
Q. Does vasectomy cause dementia?
A. Some women feel that their partners exhibit demented behaviour with
or without a vasectomy. More seriously, no. There was a
single study involving a rare form of dementia in which the researchers
suggested that antibodies to sperm may be the cause. However,
this form of dementia occurs in men with or without vasectomy and there
is no evidence in the medical literature to suggest that vasectomy
increases the risk.
Q. Can I drink alcohol after my
vasectomy?
A. Alcohol and Valium do not mix and so alcohol should not be consumed
for some time after having taken Valium. Consult your pharmacist to
determine when it will be safe for you to have a drink.
Q. Can I take Advil?
A. You can take whatever you want. But if you want my advice,
take what I prescribed for post-op pain.
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Q. Can I lift my children after the
vasectomy?
A. You should try and not lift anything for one week after the
procedure, including babies and children.
Q. When can I start playing golf
again?
A. Refrain from all activities for one week after your vasectomy and
try to stay off your feet as much as possible.
Q. Is it better to wait longer to
get back to certain
sports like Hockey?
A. You can wait as long as you like. However, in my experience,
unless you are talking about horseback riding (where you are
practically sitting on your testicles), easing back into most sporting
activities is okay after 7 days. If your vasectomy was on April
1st, you can start easing back on April 8th. Not the 7th.
Not the 6th…
Q. Can I take a
Sauna/bath/Jacuzzi/Whirlpool?
A. You don't want to bathe the scrotum in hot water no matter
what…hence the recommendation to ice the scrotum the day of surgery.
Also, even if you have the wound closed with skin glue, it is pushing
it a bit to be immersing yourself in water. Showers are fine.
Q. Do I have to put ice on
afterwards?
A. It is a good idea to ice the scrotum the day/evening of the
vasectomy. The reusable gel ice pack provided in your kit is placed
over the support, not directly on the skin, for 5-10 minutes on and 20
minutes off. Repeat this 3-4 times the day and evening of your
vasectomy.
Q. What happens if I get an
erection during the procedure?
A. Funny you should ask. Out of some 33,000+ vasectomies, I have seen
this occur only once. It is not an issue.
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Q. Is there anyone else in the room
during the procedure?
A. You will always be asked if someone else is to be present. On
occasion the doctor has other physicians visiting to observe the
procedure. All physicians greatly appreciate the opportunity to learn
from others…but you may decline if you feel strongly otherwise. On the
same note, however, no family members or partners will be allowed to
attend. There is a difference between watching to learn as a physician
and watching a loved one go through a surgical procedure.
Q. Can I waterski/ride
horseback/snowmobile/bike/ride a motorcycle/do martial arts?
A. The idea here is that you want to avoid trauma to the scrotum for 30
days after the vasectomy. If there is a risk of receiving a blow to the
scrotum, wear a hard cup or don't do it for 30 days. There is no harm
in exercising…just not if you're going to increase the risk of internal
bleeding which will take you out of action for another month or two.
Q. How many procedures do you do in
a day/week/month/year?
A. About 2,600 a year. You can do the math.
Q. Am I going to gain weight after
my vasectomy?
A. Only if you eat too much and don’t exercise enough.
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Q. Why wait 12 weeks for testing
after the vasectomy?
A. Because the sperm live for some time in your body. We want to be
sure that enough time has passed so that all the sperm 'downstream'
have died before doing the test. If your test shows zero sperm, it
won't be an issue. However, if a second test is necessary, and we find
a few dead sperm
(which is not unusual) we can be sure that they are just 'leftovers'.
Doing the test earlier risks finding these 'leftovers' still alive and
then we have to wonder if they are new (meaning a failure of vasectomy)
or old.
Q. How soon can I travel afterward?
A. The considerations here are two-fold. Firstly, should a problem
arise, it is a good idea to be able to come back to see the doctor to
check things out. Secondly, you want to avoid lifting luggage. It's
probably best to consider avoiding travel for 7-10 days after the
surgery.
Q. How long does it take the Valium
to wear off?
A. For the most part, the Valium wears off after about 4 hours. You are
advised to avoid driving for the remainder of the day of your vasectomy.
Q. When can I shower afterwards?
A. You can shower immediately, but
wait until you get home.
Otherwise wait 48 hours.
Q. Do I have to re-apply the glue?
A. No. The physician puts on a sufficient amount to last until
the wound begins to close naturally.
Q. Does the iodine come off?
A. Yes, in the shower.
Q. Do the clips set off airport
metal detectors?
A. No.
Q. Will vasectomy improve my
singing?
A. Vasectomy doesn’t improve your voice or make you speak or sing in a
high voice.
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Q. Is it better not to shower even
if I have the glue?
A. With the glue, showering is really not a problem and you don't have
to wait. Just be gentle and don't scrub the area.
Q. Do I have to count the number of
ejaculations before the test or is it 12 weeks no matter what?
A. 12 weeks regardless of the number of ejaculations. Sperm do not live
for 12 weeks and so if there are live sperm at the 12 week mark, I am
concerned and would want to repeat the test. Dead (or non-motile) sperm
at 12 weeks is less of a worry.
Q. Can I do the post-vasectomy test
in 8 weeks instead of 12? How about 10 weeks instead of 12?
A. You can do the test before 12 weeks. But it will be useless
regardless of the result. Most failures occur in the first 12
weeks. You can have a clear test at 11 weeks and then see sperm
at 12. No matter how you figure it, 12 weeks is 12 weeks.
Doesn’t matter if you’re going on a cruise or going to Las Vegas or
whatever. We cannot give you the green light unless the test is
done after 12 weeks and it is clear.
Q. I’m worried because my mail-in
sperm count showed sperm in the result and now I have to do another
test. Does that mean the vasectomy failed?
A. At our clinic, vasectomy is better than 99.9% successful in the
first 12 weeks (that is, 1:3,000 fail in this time period). But
10% of men will carry dead sperm in their ejaculate for months or years
after their vasectomy…so the second test is to make sure that whatever
sperm are there are dead. Our success rate after 12 weeks is
better than 99.99%! Vasectomy is the most effective birth control
method. Period.
Q. How large is the ‘clip’?
A. It is several millimeters long and placed in such a way that you
will not be aware of it. However…if you search for it and poke around,
you will cause inflammation and pain. It is normal to have a tiny lump
at the point of the vasectomy, with or without a clip. Leave it alone!
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Q. Do I have to wear the support 24
hours a day? To sleep?
A. You should wear the support while you are awake for the first 4 days
and then anytime that you work out or exercise for the first month. You
might be more comfortable wearing the support or snugly fitting
underwear to bed for the first 4 days also, but that is your choice.
Q. When can I pick up my kids? (I
put this in again because it gets asked so many times!!)
A. 3 guesses and the first 2 don’t count. No lifting for the first week.
Q. Do I have to ejaculate 20 times
before doing the test?
A. What you tell your partner is your business…but time is more
important than the number of ejaculations. Do your test at least 12
weeks after the vasectomy regardless of the number of ejaculations,
although I recommend as many as possible.
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Q. How can a vasectomy fail if
you’re cutting and burning the tubes?
A. The body has a remarkable ability to heal itself and, in rare cases,
the tubes will ‘rejoin’ (about 3 in 1000 on average, 1 in 3000 cases
for Dr. Weiss). Nothing in life is 100%. However, vasectomy has the
lowest failure rate of any form of contraception. Period. Can it fail
even after a clear test at 12 weeks? Yes, but this is extremely rare.
You can test your semen every year, if you choose, but this is very
seldom done.
Q. What was the “older” technique
and what is the advantage of “no-scalpel-no-needle”?
A. We used to use a scalpel, or knife, to cut through the skin and all
the layers of tissue to get down to the vas deferens, the tube that
carries the sperm. That means that we cut through blood vessels on the
way down. With no-scalpel technique, we make a tiny opening and stretch
it just enough to pull out the vas deferens and block it. By stretching
a tiny opening, we push the blood vessels to the side instead of
cutting through them. You would think that this results in less
bleeding and that is precisely what it does…by about 90%. And remember
that bleeding is the major painful complication of vasectomy. No-needle
anaesthesia (freezing) uses air pressure to push the anaesthetic
solution through the skin quickly and easily. Instead of a needle, you
feel a ‘pop’ like a small rubber band against the skin. Aside from the
fact that “you don’t have to get a needle down there”, this method
results in a more rapid (seconds) and profound (deeper) freeze. Many
men feel nothing during the vasectomy, others may feel some pressure or
pulling, as a result of the better ‘freezing’.
Q. Why did my vasectomy not ‘hurt’
until 3 days after?
A. The body responds to any injury or insult with what is called an
inflammatory reaction. Your immune system gets geared up and the
healing process begins. Everyone is different and some may not feel
these effects for several days. It is also a function of how you are
built and how difficult the vasectomy was…how much the doctor had to
pull etc.. The anti-inflammatories that were prescribed to you are just
the right thing for this kind of discomfort. Of course, everyone has a
different ‘pain threshold’ and one man might feel discomfort while the
next feels nothing at all.
Q. Will it hurt to pee (urinate)?
A. No.
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Q. What holds the testicles if you
cut the tube?
A. The vas deferens, the tube that carries the sperm, is only one of
many structures that hold the testicles in place. There are blood
vessels and other tissues that provide support and these are not
disturbed. Your testicles will still be supported after the vasectomy,
they won’t roll around loosely in your scrotum.
Q. Can any lab do the
post-vasectomy test?
A. No and yes. The lab we recommend processes
literally thousands of tests each year for us according to our exacting
specifications. Other labs may also infrequently perform such tests. In
general, it is best to have the test done where they are most familiar
with doing it.
Q. Will the sample remain fresh in
the mail? Won't it go bad?
A. The mail-in option for post-vasectomy testing has been used in
England for over 10 years with great success. They receive samples from
as far away as Indonesia! In some cases the sample has been in the
postal system for 2 weeks without a problem. If you follow our
instructions, the sample will be fine.
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Q. When can I start swimming?
A. What do you think? If the wound was closed with glue, you may shower
but not bathe. I’d say swimming is closer to a bath than a shower.
Q. Does the hair grow back after
you shave?
A. You bet it does.
Q. What can I do about the itching
when the hair starts to grow back?
A. You’ve got to be kidding! If your worst problem is itching, I’d say
you have little to worry about. Just don’t apply any creams or
ointments to the skin until the little wound is completely healed and
closed (usually one week).
Q. How soon will I know if there
are complications?
A. Most complications will occur in the first week. This is the really
critical period. But you don’t want to traumatize the area (like
horseback riding) for the first month. Most other activities that don’t
involve an impact to the scrotum are unlikely to cause problems after
the first week. Rarely problems can arise after the first week.
Q. Does it hurt when you cut the
tube during the vasectomy?
A. In a word…no.
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Q. What can I expect in the first
few days after my vasectomy?
A. You really have to go back and read the “After the Vasectomy”
section on this website or in your pamphlet. Click HERE to go there.
Q. What happens if you cut the
wrong tube?
A. That would be terrible! If the testicular artery were cut, it might
result in loss of the testicle. Fortunately, this is not a common
problem and has never occurred in Dr. Weiss’ career. The vas deferens
has a characteristic feel to the surgeon who performs lots of
vasectomies and it would be very difficult to mix it up with something
else.
Q. How do I know if it’s okay to
start exercising?
A. You’ll have to take my word for it, ease back into your exercise
after one week. Of course, you’ll know if you can’t start
exercising if you continue to have pain or discomfort. Otherwise, if
you are feeling okay, consider that a sign that you can go ahead.
Q. Do I have to abstain from sexual
activity prior to the vasectomy?
A. No. Have all the fun you want before...just don't ejaculate for one
week after.
Q. Can I have oral sex in the first
week after the vasectomy?
A. Some say it is better to give than to receive. In the first
seven days you may give, but you cannot receive. No ejaculation
for 7 days.
Q. When you say not to ejaculate
for a week, does that include masturbation?
A. That’s one of those Bill Clinton questions again. Ejaculation
is ejaculation, no matter which bus gets you to the station.
Q. Can I sleep with my partner in the “spoon” position?
A. Yes, if your partner says that it’s okay with them.
Q. How long is a week?
A. Oh, let me think a little. Oh, yes, it’s seven days!
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Q. Are my testicles going to shrink?
A. I hope not! Vasectomy does not cause the testicles to change
in size.
Q. Can I climb stairs?
A. Do it if you have to. I think it’s pretty clear that you want to be
off your feet as much as possible for a week. Climbing a few stairs
from time to time and within reason should not be an issue.
Q. Can I donate blood before or
after a vasectomy?
A. Before should not be a problem. After…you have to ask Canadian Blood
Services what their policy is.
Q. Can my wife cut the tubes?
A. Not unless you're having the baby. Secondly, did you ask her if she
wanted to? Third, unlike a birth, everything is sterile...so, sorry,
but no.
Q. Nothing hurts…did you do the
operation? There’s no bruising, no swelling, no pain…maybe nothing was
done.
A. I only put this in because I have actually received a number of
these calls. I could not believe that some patients are angry at not
experiencing pain! I don’t guarantee a totally pain-free experience,
but if it does happen, please be thankful and don't be angry!
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Okay,
you
got
this
far.
Let
me leave you with a few infamous quotations:
You know “that look” women get when they want sex? Me
neither. --Steve Martin
Having sex is like playing bridge. If you don’t have a good
partner, you’d better have a good hand. --Woody Allen
Bisexuality immediately doubles your chances for a date on Saturday
night. --Rodney Dangerfield
Sex at age 90 is like trying to shoot pool with a rope. --George Burns
Women might be able to fake orgasms. But men can fake whole
relationships. --Sharon Stone
My girlfriend always laughs during sex – no matter what she’s
reading. --Steve Jobs
(Founder, Apple Computers)
Clinton lied. A man might forget where he parks or where he
lives, but he never forgets oral sex, no matter how bad it is. --Barbara Bush (Former US First Lady)
See, the problem is that God gave men a brain and a penis, and only
enough blood to run one at a time.
--Robin Williams
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