The most effective, simple, easy and relatively inexpensive way of male contraception is male sterilization (vasectomy). The operation consists in blocking the vas deferens, preventing sperm patency. The operation is performed under local anesthesia and it takes 10-15 minutes.
Currently, there are two kinds of vasectomy. The traditional way consists in layer by layer dissection of the skin and testicles in order to take out the vas deferens in the wound. Postoperative complications are not clinically expressed (not more than 1.5% of operations). A non-scalpel method consists in the release of the vas deferens by centesis (puncturing). When such an operation decreases the likelihood of developing complications, such as lack of a hematoma. In such an operation the likelihood of developing complications such as hematoma, decreases.
After sterilization it is recommended to restart sexual life in a week. Since the complete absence of sperm in the ejaculate is reached only after 15-20 ejaculations (or 3 months), during this time it should be used a condom or another contraceptive methods to reliably prevent pregnancy.
If the operation was carried out by a qualified surgeon and under aseptic conditions, the success rate of such a surgery is 100%. By this indicator, male sterilization is more effective than the female one. In addition, the safety of such an operation, ease of realization are much higher than in the female sterilization, and the cost is much lower.
Typically, vasectomy is performed with mutual consent of spouses when for social or medical reasons, they do not want to have children but there is a problem of intolerance to other methods of contraception. Also, male sterilization is performed on the basis of mental or hereditary diseases.
Generally, vasectomy is an irreversible method of contraception. However, some patients over time are willing to restore their fertility. Restoring fertility after voluntary sterilization is one of the most complex surgical procedures. And even if the surgeon is highly qualified and has a great experience, it does not guarantee the success of the operation in the following cases: long-term post-vasectomy period, advanced age of the patient, infertility of the man's spouse, the method by which sterilization was performed.
The effectiveness of microsurgical operations of patency restoration (ie, the presence of sperm in the ejaculate) is on average about 50%. However, only a pregnancy can be considered an indicator of the surgery efficiency in terms of restoring fertility.
The advantages of vasectomy:
- high efficiency (0.01 pregnancies per 100 women per year)
- permanent method of contraception
- does not affect sexual life
- simple operation performed under local anesthesia
- absence of long-term side effects
- has no effect on hormone production by the testes
- does not alter sexual function
Disadvantages of vasectomy:
- the method is permanent (irreversible) and the patient may later regret his decision
- short-term pain / discomfort after surgery
- within 3 months after the operation it is necessary to use an additional method of contraception
- risks and side effects associated with surgical intervention, particularly when using general anesthesia
- does not protect against HIV infection and sexually transmitted diseases (STDs)
Who can use vasectomy:
- men older than 35 or with two or more children
- men whose wife is forbidden to conceive due to a serious health risk because of age, number of births in the past or health problems
- men who are recommended vasectomy for medical reasons, regardless of age and children (eg, in case of inherited severe genetic diseases)
Who should not use vasectomy:
- men who do not give consent for the operation
- men who are not sure of their intentions regarding the ability to conceive in the future
Possible complications of vasectomy:
- infection of the surgical wound
- excessive swelling in the area of operation
- scrotum hematoma
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