Kramer says that a doctor botched his vasectomy. In "The Chinese Woman," our friend Cosmo is concerned about preserving the Kramer name. If he was the last male Kramer, why would he go for a vasectomy? Kramer got a vasectomy for Pam in "The Soul Mate". If you remember, he walks out at the end of the episode and looks as though he is in considerable pain. As a result, Jerry and Newman run out of the surgery.