I had a vasectomy today, and it was much less unpleasant than the horror stories above.
It started with disrobing to the waist. Not a lot of surprise there. Then I lay down on a reclining table a bit like a chaise lounge. After applying an iodine swab, the nurse brought a lamp over. This had three purposes: warming up the skin to prevent shrinkage, providing light for the doctor, and festive mood lighting. I barely felt the wire-thin needle that put anaesthetic in, and occasionally managed to notice more needles that covered more surface area. It's done with local anaesthesia because as a rule, general anaesthesia is more dangerous (losing consciousness is never good for your health) and used when necessary.
I didn't feel a whole lot, although I did occasionally feel exactly as if someone were gently tugging on the little stringy bits inside. Which he was, of course. No crochet hooks involved (all of the cutting and cautery is done on the outside) -- I'm not sure how exactly he got the vasa deferentia (Latin plurals help us play!) out one at a time, but he did.
On a few brief occasions, I felt some mild pain, as if someone had put a little too much pressure on a testicle. But the doctor was very solicitous and made sure the pain faded quickly before continuing his work. This happened maybe twice and lasted no more than 5-10 seconds each time, and was easy to deal with.
The urologist explained that the funny smell I would notice was me: he had already gotten one vas out and removed about an inch of it, and was cauterizing the ends (a sort of contraceptive aglet, I suppose). It smelled a little odd, but nothing one wouldn't smell in a carnivore's kitchen. It is burnt meat, after all.
After a while, I was done: I had a bit of antibiotic ointment on a gauze pad, which I held in place with the tight briefs I'd been advised to bring. I filled the prescription for Vicodin with tregoweth driving, and by the time I was done with that, I felt level-headed enough to drive home. And if I hadn't gone to see a movie that caused lots of belly laughs, I probably wouldn't have needed the one Vicodin that I've taken so far.
The rest of it is just basic wound care. No-scalpel vasectomy creates a much smaller hole (the doctor uses sharp snips to create a hole just a few millimeters across, instead of two long cuts that require stitches), so it should seal itself within 24 hours or so. I expect to feel minor discomfort for a few days, but generally I feel quite good for a guy who's recently had bits taken out of his scrotum.
Perhaps the best part: my health insurance covers this as part of ordinary medical care (preferring to cover one minor outpatient surgery rather than pregnancy care, I suppose), so all I paid was $50. That's a few months' worth of pills there, folks. The discomfort is quite tolerable, and for those of us with steady faithful partners, it's an easy tradeoff for not having to wear a condom ever again (once the sperm analysis comes back all-clear twice).