Vasectomy – effectiveness, reversibility and side effects of the procedure [EXPLAINED]

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Vasectomy, or cutting the vas deferens, is one method of contraception for men. The effectiveness of this procedure is estimated at 99%, therefore it is directed to men who do not want or should not have children anymore. What are the indications and contraindications for vasectomy? How to prepare for the procedure and what does convalescence involve? How much does a vasectomy procedure cost?

Vasectomy is defined in the medical community as an effective, legal and safe form of contraception for men. At the same time, a lot of controversy arises around this method, as many of its opponents mistake it for irreversible sterilization. The effects of a vasectomy, on the other hand, can be compared with those of ovarian ligation in women. What should you know about vasectomy?

Currently in many cases vasectomy is performed using a technique without a scalpel. As the name suggests, the doctor performing the procedure does not use a scalpel and does not cut the skin. Instead, he uses a special tool to grasp the previously anesthetized skin on the scrotum and gently separate its layers. The holes through which the doctor reaches into the vas deferens are only 6 millimeters. Usually, with such a procedure, you do not even need to put on stitches, because the skin sticks up on its own. After a few days after the treatment, there are no traces on the skin.

What should you know about male contraception? Check it out: A new male contraceptive. It may be available in just six months

Vasectomy – indications and contraindications

Although vasectomy is a safe procedure, the decision to perform it should be carefully considered. This decision cannot be taken lightly under the influence of temporary financial problems, illness or pressure from the partner. The decision about vasectomy should be made when the man is in a stable, stable relationship and the partners carefully considered all the arguments for and against this method. The most common indications for making a decision about vasectomy are:

1. situations when partners jointly find that their family is complete. They both do not want more children, and no other form of contraception can provide them with complete protection against unplanned pregnancies;
2. situations where a partner struggles with serious health problems and becoming pregnant could pose a threat to her life;
3. situations where in a relationship one or both of the partners are carriers of a hereditary genetic disease that they do not want to pass on to the next generation.

In order not to make a rash decision and not to regret it in the following years, it is worth considering the list of possible contraindications before the vasectomy procedure. Vasectomy is not recommended in cases of:

1. when in a relationship one of the partners is not convinced whether they want to have children in the future;
2. when the relationship is going through a serious crisis in which a breakup is being considered;
3. when a man decides to undergo surgery only to relieve his partner’s contraceptive burden;
4. when a man only temporarily does not want to have children, and in the future would like to undergo a rewazectomy to restore full fertility again;
5. when a man is very young and his adult life is just taking shape;
6. when the only reason to perform the procedure is the lack of acceptance for other methods of contraception;
7. when the decision about the procedure is the result of pressure from the partner.

It follows from the above assumptions that the decision about vasectomy should be a conscious, well-thought-out and mature decision that should be made without pressure from third parties.

You can read about pregnancy prevention here: Who’s afraid of male contraception?

Vasectomy surgery – advantages and disadvantages

Vasectomy, like any other medical procedure aimed at a serious change in a man’s body, has many supporters and opponents. Therefore, it is worth paying attention to advantages and disadvantages of vasectomy.

Most frequently mentioned advantages of vasectomy are:

1. high effectiveness of the treatment. The chances of getting pregnant are virtually zero;
2. a positive effect on sex life, improving relationships in a relationship;
3. no disturbances in the hormonal balance, which means that libido does not decrease, mood swings do not appear and body weight does not increase;
4. one-time treatment, so you do not have to worry about the lack of protection against each intercourse;
5. allows you to enjoy sex at any time;
6. allows a man to decide about contraception on his own, so he does not have to rely on his partner and her honesty in this matter.

In addition to the advantages of vasectomy, however, there are several disadvantages. Among the most frequently mentioned vasectomy defects lists:

1. vasectomy reversibility is not always effective. Therefore, it is often a lifetime decision;
2. the treatment can cause infections as well as health problems. 
3. there may be intense pain, bleeding, bruising or swelling after the procedure;
4. performing the procedure does not prevent the spread of sexually transmitted diseases, and the mere fact of periodic infertility may result in the decision to resign from additional protection with a condom;
5. high price of the procedure.

If you want to know more about male contraception read: Contraception for men

Before the procedure, the man should also shave over the symphysis and in the place where the vas deferens run. During the procedure, it is necessary to ensure proper comfort of work for the doctor, and additionally, getting rid of hair minimizes the risk of infections related to foreign bodies that can penetrate under the skin. A man can come to the vasectomy procedure alone or in the company of a loved one. Usually, the patient can go home immediately after the procedure.

For more information about HBs antigen, see this article: HBs Antigen

Vasectomy – what does the procedure look like?

The male testicles produce sperm which, via the vas deferens, reaches the penis when ejaculating. The vas deferens are about 50 cm long and slightly thicker than the pen refill, the diameter is about 3 mm, but inside the lumen is only 0,5 mm. Its walls are very thick and therefore we can feel it with the thumb and index finger, grabbing the seminal cord at its exit from the inguinal canal. Cutting the vas deferens does not deprive a man of sexual performance. He can have normal intercourse with ejaculation, except that there will be no more sperm in the sperm.

The procedure itself is not complicated, it takes less than an hour and is performed under local anesthesia. The doctor cuts the skin, then the vas deferens, then sutures and the patient can go home. He should have sex with a condom for three months after the procedure, as there may still be sperm in his genitals. After that, sperm tests are performed twice to confirm that they are definitely not already in the ejaculate.

More information about sperm and male semen can be found here: Sperm – what it is, structure, life expectancy, male fertility

Immediately after returning from the procedure, you should take a shower, remove the dressing applied after the procedure and do not put on any new dressings. If the patient feels pain after the procedure, he can take painkillers. Many doctors prescribe them to their patients, but those kept in a home medicine cabinet are usually sufficient. There are no contraindications for driving a car immediately after the procedure. However, you should refrain from intense physical exertion. Specialists also advise patients to refrain from, or at least limit, sexual intercourse during the first week.

Semen analysis should be performed 8 weeks after the procedure. In case of doubt at the 8th week examination, the examination should be repeated 12 weeks after the vasectomy.

You can learn more about semen analysis in the article: Semen analysis – course, preparation, price

It is expensive too revasectomy surgery, i.e. connections of the severed vas deferens. Vasectomy can be performed for about 2. PLN, for the connection of the vas deferens, you have to pay over ten times as much. It is a very complicated procedure performed with the use of a special microscope that allows for the fusion of small vessels. Fertility after surgery may return after a year. Sometimes you have to give a patient steroids to demobilize the antibodies.

However, the effectiveness of the procedure, depending on the centers performing it, ranges from 40% to 70%. In Poland, where experience in this regard is limited, it may be as high as 10%. Effectiveness of revasectomy it depends on the patient’s age, sperm quality and the time elapsed since the vasectomy.

What is oligospermia? Check it out: Oligospermia – reduced sperm count in semen

Vasectomy and sexual activity

Vasectomy does not affect male sex drive or erection. After a vasectomy, male sex hormones are produced as before, and the appearance, smell, and quantity of semen remain the same. The only difference is the lack of sperm in the ejaculate. Some men, however, experience post-operative stress related to the thought that they will probably never have children again. This results in a lower sense of masculinity, which in turn can translate into negative experiences in the bedroom. If your mental problems persist for too long, it is worth visiting a psychologist, as in some cases this can result in depression or another serious disorder.

What influences the reduction of libido? Read: Decrease in sex drive

Vasectomy and Polish legal regulations

In Poland, there are no legal regulations directly related to the use of sterilization as a consciously chosen contraceptive method. Article 156 of the Criminal Code states that whoever causes serious damage to health in the form of depriving a person of sight, hearing, speech, reproductive ability, is subject to imprisonment from one year to 10 years. Some Polish urologists believe that the vasectomy procedure is illegal. Eugeniusz Siwik, a gynecologist, has a different opinion, who wrote on the website of his clinic that:

Vasectomy as a reversible method of contraception has never been and is not prohibited or punishable in Poland. The Polish law and constitution guarantees you, the citizen, both the right and the obligation to make informed decisions about your health. The ability to procreate is an individual good and does not belong to society, but to a specific man.

However, elsewhere on the clinic’s website, where the doctor answers the most frequently asked questions, he writes:

It should be taken into account that the vasectomy procedure is permanent. There are gentle procedures to restore the patency of the vas deferens, but it is uncertain whether sperm flow will be restored and the pregnancy will be as before. The probability of a success may depend very much on individual circumstances, including the time since the vasectomy was performed.

If we are seriously considering vasectomy, it is best to assume that it will be a permanent change. Hence, opinions on the interpretation of the provisions are not clear-cut. If the vasectomy is considered a permanent procedure, it is illegal from the legal point of view and, as urologists emphasize, even a written consent of a patient who suddenly changes his mind and takes the doctor to court will not protect the physician from a 10-year prison sentence. Therefore, many of them believe that a change of law is needed in this regard.

Vasectomy and its side effects

Vasectomy is a simple procedure, but you may experience side effects after it has been performed. The complications that occur after vasectomy are:

1. swelling at punctures or cuts;
2. bleeding and hematoma in the scrotum. The hematoma may absorb several weeks, but this problem affects only 2% of all cases;
3. bruise on the scrotum;
4. the presence of blood in the semen;
5. scrotal pain which usually wears off after 2 days. Some patients experience pain in the scrotum for several days, so doctors prescribe painkillers to their patients;
6. inflammation and the development of infections and infections of the testicle, epididymis;
7. late recanalization, i.e. restoring the continuity of the vas deferens;
8. semen granuloma, which are irregularly shaped sperm lumps;
9. post-vasectomy pain syndrome, which is manifested by dull pain in the epididymal area. In cases of severe pain, it is necessary to remove the epididymides, re-vasectomy or revasectomy;
10. single studies indicated that vasectomy increases the risk of developing prostate cancer or testicular cancer. However, current research has not shown this link. 

For more information on prostate cancer, see this article: Prostate Cancer

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