Under one vasectomy one understands the severing of the man's vas deferens with the aim of permanent infertility. The main reason for the intervention is the patient's wish for contraception without the aid of other aids or medication. The vasectomy rarely leads to complications and is usually much less risky than the sterilization of the woman.
What is the vasectomy?
In a broader sense, vasectomy in medicine refers to the surgical removal of a vessel from the body. The narrow term of vasectomy (or its equivalent Vasoresection) describes the sterilization of men as a method of permanent contraception.
The procedure is now part of the standard repertoire in urology. Under local anesthesia or while the patient is in twilight sleep, the doctor cuts the spermatic ducts in the scrotum, which are located in the spermatic cords. In the classic vasectomy, the skin on the scrotum is opened with the help of a scalpel, but there is still an alternative to this type of operation: The skin can be pierced with a needle and the resulting hole carefully stretched in order to reach the vas deferens, which are then used special clamps are exposed.
The advantage of the classic method lies in the good visual control over the entire operating field. The needle method only punctures the skin so that it usually heals on its own and in many cases a shorter regeneration process can be expected. With exceptions where there is a medical indication, the vasectomy is one of the patient's desired services that are not reimbursed by health insurance companies and are therefore to be billed privately.
Function, effect & goals
The main area of application of the vasectomy is the patient's wish for permanent sterilization and the associated consequence of avoiding pregnancy during sexual intercourse without additional contraceptive measures such as condoms. The men often undergo the procedure for their partner as well: If family planning has been completed or no children are planned for other reasons, sterilization of the man is a solution that is often carried out if the woman would like to avoid taking hormones.
The safety of contraceptive measures is quantified with the so-called Pearl Index, which indicates the number of unwanted pregnancies that occurred despite contraception in 1000 couples within one year. With 0.1, sterilization has the second best value of all possible contraceptive methods after the woman's hormone implant, which is why this operation is often the ideal solution if you do not want to have children. For many couples, safety also affects sexual intercourse, which - without additional contraceptives and, above all, without fear of a possible pregnancy - can be particularly carefree.
This security of male sterilization comes from the complete severing of the vas deferens. This blocks the natural way for the sperm into the ejaculate, so that fertilization is no longer possible. To make sure that the operation was 100 percent successful, the ejaculate is checked for sperm about two to three months after the vasectomy. Until then, men, whose hormone production is not affected by the procedure, are advised to take contraceptive measures during sexual intercourse. The operation is one of the routine urological interventions. It is usually carried out on an outpatient basis, either with local anesthesia of the genital region or with twilight sleep.
The incisions (in classic vasectomy) are made either in pairs on the right and left or as a central incision. A small piece - about one to three centimeters - is removed from the vas deferens to prevent the sperm from flowing through. Instead, these are absorbed by the body. The remaining two ends of the respective vas deferens can either be obliterated or they are turned over and sutured with a thread that cannot dissolve by itself.
Risks, side effects & dangers
The risks of vasectomy are very low - especially when compared to sterilizing women, which can be associated with more frequent complications. During the procedure and afterwards, pain can usually be milder and can be relieved with medication. Post-vasectomy pain in the epididymis area, believed to be irritation of nerves or unnatural pressure on the epididymis, is observed in up to eight percent of cases.
Other possible but rare complications are the formation of hematomas and the formation of infections in the surgical area. Side effects with regard to the fears often expressed by men, such as a lack of libido, reduced erectile function and the inability to experience orgasm, are unfounded. The professionally performed vasectomy has no influence on any of these processes, so that love life is unrestricted and - due to the no longer necessary contraceptive methods such as pills and condoms - often much more relaxed.
Since the vasectomy does not affect hormonal production either, a new check for sperm in the ejaculate (due to a possible recanalization of the vas deferens) is necessary no later than one year after the operation. However, this is very rarely the case. The persistent sperm formation is also the reason why - which is often aimed at with a new partnership - a refertilization, i.e. the reversal of the operation realized with the help of microsurgery, has a good chance of success. The chances of successful re-fertilization and thus a pregnancy of the partner are particularly good if the procedure is carried out in the first five years after the vasectomy.
