Is it a good idea to get a vasectomy and a circumcision together? my urologist said he can take care of my foreskin while hes down there, its painful

Up to you: Vasectomies are typically done in the office with a small amount of local anesthetic. Freehand circumcisions are best done (in my experience and opinion) under anesthesia on an outpatient basis.

Can work.: I've done about 20 adult circumcisions under local while working in south africa, and know of many, many more done same way. Anaesthesia, control of bleeding and post-surgical results were fine. However, discuss with your urologist the pro's and con's of general vs. Local and then decide.