Trill, that's interesting re the cauterize & fold method. That's what my DH had done, but they were still happy to do it under a local because DH asked. But the Dr seemed to derive a bit of amusement from it all ... some of my DH's colleagues are pretty tough dudes, and that Dr does dozens of vasectomies every month for them, but those guys sure aren't queuing up for the local anaesthetics.