I had it done after my second. The doc that cut me was the same one that did my dad, so that helped a bit on the trust factor. The actual surgery wasn't too bad. Local anasthetic around the gonads (a bit of a sting, but nothing too bad), and a bit of somewhat uncomfortable tugging. I spent the entire time reading Time magazine and chatting with the doc about the kids. Total time: about 45 minutes.
The aftermath? Well, imagine getting kicked in the nuts about 1,000 times, then having to walk it off. That's about how it feels for the first three days after. You ain't gonna be doing any heavy lifting for a few weeks either. Those puppies are gonna be big, bruised and swollen too (imagine the worst case of blue balls, and multiply it by about 100). Most of the discomfort goes away after about 3-5 days, so it's really not all that bad. Everything returns to normal after about two weeks, and you'll have to go back in about 4 weeks after with a semen sample so they can see if there's any floaters in there. Repeat that two weeks after, and you're ready to get it on again!
I wouldn't be too worried about the process. If you have a male doctor do it, I think is better...only for the fact that he has first-hand knowlege of the, uh, sensitivity of the area.
-- B