"It's a very simple decision," my wife informs me. "Either you get your tubes tied, or I get mine tied. And if I get mine tied, you'll wish you'd done yours instead."

This is last February, and Marlene has just returned from her doctor. After two decades on The Pill, and for obvious health reasons, she must find an alternate method of birth control. So, what am I going to do about it?

Good question. Latex gives me contact dermatitis, so vasectomy has always been in my future. Every man reaches the time when he outlives his biological function. I'm cool with that concept, too.

I just thought my time would come … later.

"I'll look into it," I assure her, vaguely. And I do. But she has to ask a couple more times before I make the call.

Options
Specialists use a variety of surgical techniques to perform vasectomies, but the outcome is always the same. The doctor blocks or cuts the tubes (vas deferentia) that carry sperm from your testes into the semen, and after four to six weeks you are no longer able to impregnate your partner. The procedure is considered to be permanent and irreversible.

I opt for the no-scalpel method. This is performed at the doctor's office, doesn't require a knife or stitches, and recovery is less painful.

The doctor uses a special instrument to cut a tiny hole in the scrotum and then stretch it open just enough to lift out the 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, and the sheath is closed with one or two tiny titanium clips. The clips remain inside your scrotum for the rest of your life. They do not pose a health hazard.

Consultation
For my surgeon I select Dr. Ronald Weiss, one of the first two physicians in Canada to be trained in the no-scalpel technique and co-developer of the no-needle Jet Injector method of local anesthesia.

My consultation with Dr. Weiss consumes exactly 15 minutes of my time, excluding travel to and from his clinic. It is divided into two sessions.

Session One: The introductory video, a ten minute morality tale on the joys of no-scalpel vasectomy. In it, Geraldo and his wife Maria learn that Maria is "late" but definitely not pregnant. Another close call! Their relief is palpable.

Maria, however, is tired of popping out children like candies from a Pez dispenser, so she asks Geraldo to do his bit for the cause. Like me, Geraldo reluctantly agrees to look into it.

Next scene, our hapless protagonist sits cheerlessly at an information seminar with a selection of muscular, good-looking nitwits who pepper their host (a urologist whose name escapes me) with such insightful questions as, "Is this going to turn me into a girl?" "Ho ho ho," chortles the urologist, "of course it won't. You'll still be your old virile self. You just won't be able to make babies." And so it goes, with the inevitable outcome that Geraldo happily enlists for the surgery.

Session Two: A five minute get-to-know-you with Dr. Weiss, who looks an awful lot like character actor Stanley Tucci. Somehow, this reassures me.

Dr. Weiss quickly runs through the risks of surgery. These are:

• Inflammation or infection;
• A blood clot or bruise that usually clears up by itself;
• Skin binding to the vas deferentia, or a connection forming between vas and skin. This may require surgical correction;
• Fluid build-up in the scrotum;
• Swelling caused by leakage of sperm from the vas deferens;
• Transient discomfort or pain in the testicles;
• The growing back together of the cut ends of the vas (very rare);
• Sexual disfunction. Occurs in four out of every thousand vasectomies, but is believed to be psychosomatic;
• There may be a weak link between vasectomy and the later development of prostate cancer. Today, the relationship is said to be "uncertain."

Having explained the possible complications, Dr. Weiss asks if I am still agreeable to the procedure. I say that I am. Absolutely. Sort of.

Dr. Weiss then instructs me to drop my drawers, whereupon he seizes both vas deferentia through my scrotum, to be sure they're easily located for surgery. I slip into a self-induced acid flashback.

My consultation now over, Dr. Weiss ushers me out the door to his receptionist, who schedules my surgery, hands me a prescription for a single tablet of Valium and some anti-inflammatory pills, and proffers a "vasectomy kit" in a clinical-looking paper bag.

Shaken, and a little concerned that I'll have a full month to obsess over my sense of impending doom, I stuff my prescription and vasectomy kit into my coat pocket and stumble back to my car.

I spend the next month obsessing over my sense of impending doom.

Prep
The night before my surgery, I open my vasectomy kit and pull out:

One (1) athletic supporter;
One (1) Wilkinson Sword disposable surgical razor;
One (1) box of sterile, individually wrapped gauze pads;
One (1) information booklet;
Two (2) sealed, sterile specimen jars.

Information booklet first. I am to shave myself with the razor, no soap. The no-soap thing has me a bit concerned, but I'm not one to argue with a guy who does 40 of these procedures every month. Besides, the razor has a tooth bar below the twin blades, to protect me from nicks. What could possibly go wrong?

As it turns out, not a thing. The shave is much easier than I'd imagined. I perch on the edge of my bath tub, my legs inside the tub, and shave first the base of my penis and then the scrotum. It's actually quite a simple process and really does go more smoothly without soap or cream.

I make a mental note to revise Shaving Private Ryan, and spend the remainder of my evening with a case of four-alarm stubble itch.

On the day of my surgery, I shower and slip into the athletic supporter. For some reason I think of Banana Hammock, and wonder if it's too late for a bikini wax.

One hour before my surgery, I down the Valium and one anti-inflammatory. A customer calls with a telephone order, just as I'm starting to get a good buzz. It takes me three tries to enter his credit card number. After I hang up, my wife informs me that I'm too far gone to be of any further use to my business. She drives me to the clinic.

Surgery
The actual surgery is not so much an experience as it is a conversation. I'm not a witness to my own vasectomy, so I talk to calm my nerves.

Dr. Weiss is obviously skilled at the art of misdirection — a magician's trick that diverts his victim's attention while his hands are busy stuffing rabbits into hats (or, in this case, slicing and cauterizing ejaculatory tubes). His patter is practiced and engaging, his voice unruffled, his manner precise and efficient:

"I'm going to anesthetize your testicles with this jet injector. It'll feel a bit like I'm snapping your nut with a rubber band."
"Okay." I steel myself for the delivery.

Snap! The shock almost sends me through the back wall of the clinic.

"Geez! You didn't say how big that rubber band would be."
"Hang on. I have to do it three more times."
"Oh."

By the third injection, I'm completely numb from the waist down. Still, I have to ask:

"Are you sure I'm properly anesthetized?"
He pokes me with a metal instrument. "Do you feel that?"
"No."
"Then let's get started."
"Uh …"

But he's already working. There's … something going on down there. I can't identify the sensation. I stare up at the ceiling. Directly above my head is a poster of an ethereal looking forest. I can actually hear a babbling brook in the distance — spa music, playing over the sound system. It's supposed to be soothing.

"Nice poster," I say.
"Yes," Dr. Weiss mumbles, "those are BC redwoods, the kind you can drive a car through."
"Interesting photography, how the tops of the trees converge at the center of the image."
"It's supposed to focus your mind."
"It isn't working."
"What would you suggest?"
"I don't know. How about a Playboy centerfold?"
"You'd get an erection and I wouldn't be able to operate."
"Under the circumstances, I doubt that'd be an issue."
"True."

That's when he snips my left one, and I instantly have a new understanding of testicular discomfort.

"Whoa, whoa, whoa! That really hurt!"
"Did it? I'm sorry. You have a lot of scar tissue around the tube. Did you get a good, swift kick to the nuts as a kid?"
"My father was principal of my high school."
"I see. Anyway, the worst is over. We'll just cauterize this…"

A puff of smoke appears from below my peripheral vision (always disconcerting when it comes from the groin area), and that's it. I'm done.

"Sit up and swing your legs over the side of the table," Dr. Weiss instructs me. "How do you feel? Can you stand up?"
"I think so."
"Pull up your athletic supporter, slowly, and then your pants. You should wear the supporter for about a week after surgery. Take it easy today and tomorrow. Ease back into your schedule over the next week. You'll heal in about a month. Call my office at the first sign of trouble. Now, go rest for fifteen minutes in our waiting room. My assistant will get you a Sprite or Pepsi. Which do you prefer?"
"Do you have diet?"
"Are you diabetic?"
"No."
"The sugar is medicinal."
"I'll have Pepsi."

And so I find myself, newly snipped, sipping Pepsi through a straw and wondering whose bright idea it was to put a vasectomy clinic in a basement, at the bottom of a very, very steep stairwell.

This thought hadn't occurred to me, coming in.

Post-Op
There's a lot to be said for a bag of frozen peas. That athletic supporter has also become my new best friend.

It's been six days since my surgery, and recovery is much better than advertised. Dr. Weiss told me to expect a little of everything: some pain, some swelling, maybe a bit of bruising. I have none of these.

My discomfort was in the extreme when that anesthetic wore off. Hence, the jock strap and anti-inflammatories. I've been easing back into my daily routine — no sex for one full week, no exercise, no heavy lifting — and it's made a world of difference.

I'm a little tender, sure. This is surgical post-op, after all. But I'll live.

Parting Remarks
In the United States, doctors perform about a half million vasectomies each year. That means about one out of every six men over the age of 35 has had his package snipped. Compare this to one out of every four women who opt for female sterilization, and one out of every two women who use oral contraceptives.

North American family planning research conducted over the past decade indicates that women play a primary role in the decision to have a vasectomy. Among couples who choose vasectomies, women are more likely to discuss the procedure with their partners before their choice is made.

In my opinion, vasectomy is a very small price to relieve our spouses of their lifelong dependence on sometimes dangerous and often unreliable contraceptives. Insofar as family planning is concerned, vasectomies are infinitely more reliable than condoms, sponges, the rhythm method, or those nasty little medieval torture implements called IUDs. Vasectomies are also easier to perform than female sterilization, and much less painful.

Birth control is just as much a man's responsibility as it is a woman's. A man volunteers for his duty. He doesn't expect her to shoulder the burden on her own, and he certainly doesn't wait for her to ask. Again. And again.

My one regret is that it took me this long to do the right thing.