u/Realistic-Rip5735

I want to have a vasectomy, so I started looking around to gather information. So far I have had consultations with 4 doctors. I narrowed down the selection to two of them. In general, it seems like doctors in the country where I am (Germany) don't seem to be super up to speed with modern vasectomy techniques, at least based on the research I have done. Please correct me if you see anything wrong in my analysis.

Both clinics have doctors with stellar reviews. The clinics are modern, the price is similar. All the doctors claimed they haven't had any case of serious chronic pain after surgery.

Based on the following points, which one would you choose and why? I tried to be as exhaustive as possible in the description. Thanks to everyone who will give me pointers and suggestions

CLINIC A

Run by just one doctor. Vasectomy method: micro needle for local anesthesia, vasectomy using a scalpel (5 mm incision), cut the vas deferens, remove one part to be sent to the lab, self dissolving ligatures on both sides, cauterization of both sides, fascial interpolation. He will check the wound two days after surgery

Green flags:

- Secretary extremely kind, talkative and helpful

- Doctor is around 50 years old and carries out more than 200 vasectomies a year

- He uses the fascial interpolation method

- He also took a urine sample, presumably to check for STI or other issues (only doctor that went above the standard ultrasound check)

Red flags:

- The doctor told me he will provide me with a three day sick note, despite the fact that the other three doctors all said that this is not possible since a vasectomy is an elective surgery

- He was ever so slightly annoyed by all the questions I asked, even though he was not pushy or anything

- He was dismissive when I asked him if he would also perform no scalpel vasectomy, saying that for a cut of 5 mm there is no difference with the standard method. To my knowledge the traditional scalpel method is much worse in terms of post op pain and complications.

- He said ice after surgery is not important (to my knowledge it is)

CLINIC B

Run by two doctors. Vasectomy method (a bit less clear for me): micro needle for local anesthesia, one single incision in the center (3-5 mm) for the no scalpel method. The vas deferens is severed but a small thread is kept so that it does not detach completely (not sure why), then fulguration of both ends. No ligatures. Advertised failure rate around 0.5% . Will check the wound the day after

Green flags:

- Super super kind, not pushy, he explained everything with no rush whatsoever

- He said during the surgery there will also be no rush, they keep a lot of time between patients so that they can take their time

- Only clinic performing no scalpel vasectomy out of 4 I visited

Red flags:

- Personnel at the counter a bit unfriendly at the beginning

- Coming back the day after for the checkup would be 3 hours by car (I will take a taxi), this might affect the recovery process?

- The doctor was fairly young (35-ish). The other doctor is 50+, I am not sure which one will perform the surgery. He said they perform more than 200 vasectomies a year at the clinic

- He said that chronic pain after the vasectomy can happen and it is a problem for sure, but he also thinks that in some cases it is more of a psychological problem

Throwaway account because it is a sensitive topic.

I am planning on having a vasectomy in Germany where I live. I am 31 and healthy, if that matters.

I did some research, and what I would like to avoid is chronic pain after surgery (even at the cost of an increased likelihood of vasectomy failure, as quality of life is more important to be than being infertile), so here are my notes, which I wish for you to confirm or otherwise tell me what is wrong about them.

Best kind of surgery to minimize the risk of PVPS: open-ended (so the testicular end of the vas deferens is left open), no needle (jet injector used instead) and no scalpel vasectomy.

Best way to reduce chances of failure: mucosal cautery with fascial interpolation.

To avoid after surgery: physical or sexual activity for two weeks, cycling for three weeks.

Recovery tips: use very tight underwear for the first weeks, apply ice and keep your legs raised for a few days after surgery.

Is this correct? Any additional tips or recommendations?

And another question, I will try to have the opinion of a few surgeons before committing, but what if for example they do not offer open-ended or no-needle vasectomies, how much would this impact the chances of developing PVPS, and what should I absolutely not back down on, considering that in general my body is a slow healer for any kind of injury pretty much?

Thank you in advance to those of you willing to help!