Making the cut: London doctor to retire after 18,000 vasectomies

The imminent retirement of a London doctor who has performed more than 18,000 career vasectomies could lead to longer wait times for the procedure in the next few years.

Dr. Josef Vladars has performed hundreds of vasectomies a year — quite a clip qhen you think abou it — since he started doing them in the mid-1990s.

By the time he retires next month, Vladars estimates he'll have performed about 18,500 vasectomies in the course of his career, a valuable service in a region where high demand for the procedure means men often wait more than six months.

"There really is a scarcity of vasectomy providers in southwestern Ontario," said Vladars. "We draw patients from St. Thomas, London, Chatham, Windsor and as far north as Kincardine and Owen Sound."

A vasectomy is a minor procedure, typically done with a local anesthetic, that makes a man permanently sterile.

During the procedure, the doctor cuts two tiny tubes, called the vas deferens, located in the scrotum. With the tubes cut, sperm produced in the testicles can no longer mix with semen, making pregnancy impossible.

During the procedure, which typically now takes about 20 minutes, the doctor accesses the tubes through a small opening made in the scrotum. Most men who have the procedure can return to light activity after a few days' rest.

Vladars, a Western University graduate, first learned the procedure while working as a family doctor in north London.

At first, he did a few vasectomies a week. That number grew to a few hundred a year, peaking at more than 1,200 in 2019.

"I always consider myself a family doctor first, a family doctor that has a special interest in doing vasectomies," said Vladars.

Over the years, Vladars has refined his vasectomy technique. The procedure once required a pair of incisions on either side of the scrotum. Now it typically no longer requires stitches and uses a single opening so small it's sealed with a dab of surgical glue and heals over in a few days.

One of the people Vladars trained with is the late Dr. Ron Weiss, who was sometimes given the nickname "no slice Weiss" and the "Wayne Gretzky of vasectomies.

In the early 1990s, Weiss became the first Canadian doctor to perform the non-invasive vasectomy technique, which was invented in China.

Weiss died in 2024 after a battle with cancer. During his career, he performed almost 60,000 vasectomies.

Vladars did one training session with Weiss, and it left a lasting impression.

"I spent half a day with him 20 years ago, and I learned so much from him. I'm still doing stuff I learned from him that day," said Vladars.

While the procedure is straightforward, it can also be challenging. In some patients, the vas deferens can be tricky to isolate. In patients who've had previous surgeries and procedures, there can be a higher level of difficulty.

"Every patient's anatomy is different," said Vladars.

Vladars said some men can be reluctant to get the procedure even in cases when they're sexually active but know they don't want more children.

"There are some men that just don't want people messing with that part of their body," said Vladars. "We get guys who go to their doctor, get a referral, wait two or three months to see me, do the consultation, then the day before the procedure, they cancel, they get cold feet."

As he moved into the latter part of his career, Vladars began to pass on what he learned.

He trained two other London doctors in the procedure, Dr. Steven Goldie in 2020 and Dr. Aurelia Valiulis in 2022.

"I didn't want to leave the community without someone who can do this," said Vladars.

When a walk-in clinic he worked at closed during the COVID-19 pandemic, Goldie began to learn the procedure from Vladars.

Goldie told CBC News he now performs about 800 vasectomies a year. He also has a YouTube video that lays out much of the same information he gives to patients ahead of the procedure.

Both Vladars and Goldie said London still needs more doctors trained in performing vasectomies. Patients at Goldie's clinic can wait five months for a consultation, then another two to have the surgery. Ontario's surgery wait time website reports that patients in the London area typically wait about six months.

Goldie, who praised Vladars as an excellent teacher, is training another doctor in the procedure, but it takes time and experience for even a skilled doctor to do anything close to a few hundred (or more) vasectomies a month.

"We're a bit deficient now, even with Doctor Vladars still working," said Goldie. "It's likely going to increase a bit with him retiring."