Why Vasectomy Is a Core Focus of My Practice | Dr. Theodore Cisu

The short answer: I focus on vasectomy because it is one of the most meaningful things I do as a urologist. It's a short procedure, but it is a big decision. I want every man who comes to me to feel informed, comfortable and unhurried, from the first conversation to the final semen test.

Written by Theodore Cisu, MD, board-certified urologist. Based on my experience caring for men considering vasectomy and the American Urological Association (AUA) Vasectomy Guideline (2026). Last reviewed November 2026.

Have questions of your own? Book a telehealth consultation with me. No referral needed.

Comfort comes first

Many men who come to see me know someone who had a rough vasectomy experience. A friend who was sore for weeks. A brother who still talks about the needle. Those stories stick, and they keep a lot of men from making a decision they already feel sure about.

So I built my approach around comfort:

• No scalpel. I make one tiny opening, about 1/8 inch, with no skin stitches.
• No needle for the numbing. A needle-free jet injector delivers the numbing medicine. Most men describe it as a quick rubber-band snap.
• Options to help you relax. Nitrous oxide, Valium or both, depending on what fits you. With nitrous oxide alone, it wears off within minutes and you can drive yourself home.
• Your music. Pick what you want to listen to. It helps more than you'd think.
• One-on-one and unhurried. I talk you through each step, and we go at your pace.

The procedure itself usually takes about 10 minutes. You're typically in and out in about 45. You can read the details in No-scalpel, no-needle vasectomy explained.

Dedicated vasectomy clinics

I hold dedicated vasectomy clinics in Charlottesville and Fishersville. Those sessions are set aside for vasectomy, so the whole visit, from check-in to heading home, is built around this one procedure. Over the years I've performed more than a thousand vasectomies, and that routine is what lets me keep the day calm and simple for you.

One trip, from anywhere in Virginia

Men travel to see me from across Virginia. To make that easier, the consultation is usually done by telehealth from home or work. Your partner is welcome to join. We cover your questions, your health history and your comfort plan, so procedure day is your only trip. See Traveling for your vasectomy for how that works.

Afterward, the semen test about three months later can be done at a local lab or with a mail-in kit, so you don't need to come back just for that.

The honest conversation about permanence

A vasectomy is meant to be permanent. I take that seriously, and I think you should too. At every consultation, we talk about where you are in life, whether this is your decision, and what would have to change for you to want a child in the future.

I don't gatekeep. I care for men with kids and men without them, and I don't need you to justify your choice. But if you're unsure, I'll tell you so, and I'll tell you that waiting costs nothing. Am I sure enough? walks through the questions I ask.

Why I don't do reversals, and why I still explain them

I don't perform vasectomy reversals. Reversal is a longer microsurgery, often not covered by insurance, and success is never a sure thing. I would rather spend my time helping men make a decision they won't want to undo.

I still explain reversal honestly at every consultation, because you deserve to know what it involves before you decide. If you want the full picture, read Is a vasectomy reversible? An honest answer.

What I hope you feel

I hope you walk out thinking, that was it? I hope you felt listened to, and I hope you never wonder whether you made the right call. That's the goal every time. You can learn more on my vasectomy page.

Frequently asked questions

Do I need a referral to see you for a vasectomy?

No. You can book a telehealth consultation directly.

Will I feel the numbing?

Most men feel a quick snap, like a rubber band, from the needle-free injector. After that, the area is numb for the procedure.

Do I need someone to drive me?

If you choose nitrous oxide alone, you can usually drive yourself home. If you take Valium, you'll need a driver.

Can I have a vasectomy if I don't have children?

Yes. I care for men with and without kids. We'll talk through permanence together so you can decide with confidence.

If I change my mind later, can you reverse it?

I don't perform reversals. I'll explain what a reversal involves so you can make your decision with the full picture.

Sources

• American Urological Association. Vasectomy: AUA Guideline (2026), Part I.

This article is for general education and isn't a substitute for medical advice. Your own questions are welcome at a consultation.