Stick and a burn for entry. Like dental anesthesia. It's not great. After that, the biggest thing is that nut kicking sensation can occur if the surgeon is tugging. I use a lot of lidocaine on entry and also at the vas to prevent this. Typically well tolerated and I consult every patient before hand to do an anatomy check. Skinnier guy with the boys hanging? Easy peazy and well tolerated. Big boy and the boys are close to the body? the target is hard to get to and requires more pulling to bring the testicle down and identify the vas. Can cause nut kicking sensation.
In general most patients do great after their first or second xanax (take one on the way. Take the other on arrival. I've had some patients sleep during the procedure, crack jokes, etc. All sound like they've had a beer or two as their wives are getting them back to the car)
