Improve Your Vasectomy: What Is It And What Is Its Effectiveness? With These 14 Simple Tricks
Philosophy Of Vasectomy More and more couples are looking for an alternative method of contraception to female contraception or condoms, so vasectomy has become a frequent reason for consultation. “It is the most frequent urological intervention in Spain, it is estimated that approximately 100,000 men undergo this surgery each year. The age of the patients who undergo this intervention is variable, with the usual range being between 25 and 50 years. As such, there is no age limit to perform this procedure once the age of majority is reached, ”Juan Ignacio Martínez Salamanca, member of the Spanish Association of Urology (AEU), tells CuídatePlus.
“At the Puigvert Foundation (Barcelona), of the patients who consulted in the last 10 years to undergo vasectomy, only 0.08% decided not to undergo it; that is, a very low percentage. The reason seems to be that when a man comes to the consultation, this technique has already been reported in various ways (especially the internet and / or acquaintances who have done it) and the decision is mature, “says Josvany René Sánchez Curbelo, deputy of the Andrology Service and head of the Cabinet for comprehensive attention to sexual and reproductive health of the aforementioned medical center. According to a study carried out at the Puigvert Foundation, the average age of the men who requested this contraceptive technique was 42 years, with a range that ranged from 27 to 59 years.
“Vasectomy consists of sectioning the vas deferens, some tubular structures that have the function of transporting sperm from the epididymis to the ejaculatory ducts. In this way, we prevent sperm from being evacuated along with the seminal fluid during ejaculation, “explains Martínez Salamanca. Said differently by Sánchez Curbelo: “In this barrier male contraceptive method, through a simple surgical procedure, the sperm exit from the testicle is interrupted by cutting, ligation and cauterization of the vas deferens.”
The expert from the Puigvert Foundation points out that “although there are usually small differences in the way in which professionals perform a vasectomy, basically the fundamental difference is that there are those who use a single skin incision and others, two incisions (one each side of the scrotum). ”Next, the AEU member explains in detail the two types of vasectomy techniques available:
The traditional technique consists of a double incision, one in each hemiscrotum, which allows the vas deferens to be located on each side to be ligated and sectioned. Once cut, additional techniques such as cauterization of the lumen of the canal and interposition of tissue between the two remaining ends can be performed to minimize the risk of recanalization; that is, that the two ends are rejoined spontaneously. Finally, it is checked that there is no bleeding and some points are placed on the skin to close the incision.
Other ways to perform this procedure are with a single vertical incision in the midline of the scrotum or the “no scalpel and no needles” technique, in which both ducts are removed using a fine forceps that externalizes them, without the need to make an incision. on the skin. The rest of the procedure is similar to the traditional technique. These techniques must be performed by expert urologists and present a better aesthetic result and a lower complication rate, in addition to less pain and a much faster recovery.
Vasectomy is a very effective technique, with a recanalization rate (spontaneous union of the ends of the sectioned ducts that allows sperm flow again) less than 1%, “says Martínez Salamanca.
“This is a contraceptive method with a very high percentage of efficacy,” emphasizes Sánchez Curbelo, warning that “in approximately 0.39% of cases, mobile sperm could appear in the three-month control seminogram; which would be related to a technical failure and would have to be revised. Herein lies the importance of doing the control seminogram after vasectomy. ”
How long does it take to be effective? That is, until how long after the operation should another contraceptive method be used in sexual intercourse? “This is a very important thing to keep in mind. The time it takes to reach azoospermia (absence of sperm in the seminal fluid) can vary between 10 and 350 days from the intervention, the average being approximately 80 days. In routine clinical practice, a control seminogram is performed three months after the intervention to analyze whether azoospermia has been achieved. In the meantime, it is essential to use other contraceptive methods because it cannot be guaranteed that there will be no viable sperm until the result of the seminogram is obtained, ”replies the AEU member.
In this sense, Daniel Moreno Mendoza, attached to the Andrology Service of the Puigvert Foundation, points out that, “generally, it takes between two and three months to verify the efficacy of the vasectomy because we calculate that it is the time necessary for the patient to perform about 30 ejaculations. During this time, it is recommended to continue maintaining the contraceptive method that is commonly used because there is a risk of pregnancy. After this time, a seminogram will be performed to ensure that there is no risk of pregnancy. After the seminogram the patient can stop using the method of contraception ”.
Vasectomy: What Is It And What Is Its Effectiveness? Doesn’t Have To Be Hard. Read These 11 Tricks Go Get A Head Start.
Yes, the experts indicate that the vasectomy is reversible by means of surgical techniques that allow the union of the two ends of the vas deferens (vasovasostomy) or of the vas deferens with the epididymis (vasoepididymostomy). The main factor determining the success of this intervention is the time since the vasectomy was performed. Its effectiveness in the recovery of fertility can vary from more than 90% when performed within three years after the vasectomy to 30%, if 15 years have passed since the vasectomy.
Given the simplicity and speed of the procedure, it is usually an outpatient surgery, so the patient goes home after the intervention. The anesthesia used is usually local, anesthetizing the skin of the scrotum and the spermatic cord. In this way, the patient does not have to feel pain during the procedure, although it is true that the prick to place the anesthesia is inevitable. After a few seconds of infiltration of the local anesthetic, you will not feel any discomfort, say the experts consulted.
Sánchez Curbelo specifies that despite the fact that “the anesthesia used in almost all cases is local, there is a very small percentage of men who request general anesthesia or local anesthesia plus sedation through the administration of intravenous medication.”
Regarding local anesthesia, the head of the Puigvert Foundation’s Cabinet for Comprehensive Care for Sexual and Reproductive Health states that “there are those who apply local anesthesia using a pressure anesthesia injector that allows its administration without the need to prick any needles” .
Recovery of patients is very fast, highlight the experts in male sexual health. “Being an outpatient procedure, patients can resume their normal lives after surgery. The most common is the presence of mild to moderate pain in the testicular region, which usually subsides with oral pain relievers. The recommendable thing is to avoid intense physical efforts and to load weight in the first 24 hours after the intervention to avoid bleeding. Logically, contact sports should be avoided in which there is the possibility of suffering a blow to the genital area for approximately two weeks ”, summarizes Martínez Salamanca.
As for surgical wounds, to avoid infection they only require good hygiene of the area during the shower with plenty of soap and water, keeping them clean and dry and avoiding covering them with gauze or dressings. In the event that stitches have been placed, it is normal that they are made of a resorbable material and they detach themselves after three to four weeks after the vasectomy.
Moreno adds that, generally, a relative rest is recommended for 48 hours after surgery. In addition, you must always have ice ready to apply local cold to the testicular level those first two days. In these first hours it is important that the patient does not make physical efforts or physical activity, especially should avoid riding a bicycle. Regarding postoperative care, the specialist in Andrology recommends using a scrotal jock. Sexual intercourse should be avoided between 10 and 15 days after surgery.
No type of surgical procedure is without complications, however simple it may be. That said, Martínez Salamanca mentions that “the rate of complications is low (less than 5%) and they are usually mild, the most frequent causes being hematoma and infection of the surgical wound or testis and / or epididymis (orchiepididymitis) . In the long term, it is noteworthy that chronic testicular pain may appear in less than 1% of patients. It is important that the patient knows the possible complications derived from the procedure and that they resolve the doubts that they have with their urologist ”.
Moreno adds that “exceptionally, a reattachment of the vas deferens can occur naturally or due to surgical failure. In such a case, the problem will be detected when the first semen analysis is performed. ”
Many patients ask when they come to see if they will have erection problems after surgery. A vasectomy only interrupts the path that sperm must go through for expulsion. It is not a castration, so the testicle will continue to perform its normal endocrine function.
There is no relationship between vasectomy and erectile dysfunction or libido deficiency. After the vasectomy, the patient will continue to have the same sexual potency that he had before surgery.
Perhaps the most frequent myth is that after a vasectomy there is no ejaculation. This is not true, the volume of seminal fluid generated is similar to that of before the vasectomy, but without the load of sperm.