Questions about the vasectomy

Vasectomy is the safest method of contraception. (Failure rate in the per thousand range)

The procedure is performed under local anesthesia. About 2 small cuts on the scrotum on both sides a short section of the vas deferens are removed, verschagft the ends (coagulated), repeatedly with a thread prevented, sunk, sutured. The skin sutures are self-absorbent (do not need to be removed).

After the operation, the seminal vesicles / prostate downstream of the testes (see sketch) must be emptied of the remnants of the spermatozoa.

This is the case after about 20 – 25 ejaculations and lasts about 2 months. After about this period, semen investigations take place; if no more spermatozoa are found, this is the proof of fertility. Only then may contraceptive measures during sexual intercourse be avoided!

In exceptionally rare cases, coalescence of the suppressed sperm duct ends leads to renewed fertility. Therefore, it is recommended to have a re-examination for spermatozoa after 1 year, thus increasing the certainty that fertility will continue to be absent in the future. However, there is no 100% certainty.

Unfortunately, there is no subsidy for birth control and sterilization by the health insurance companies. The costs for the procedure and the sperm examinations are to be borne by the patient according to the private medical fees.

No medical intervention is completely free from complications. Despite the utmost care, complications may occur during or after the procedure, which may necessitate further treatment (very rarely in the hospital).

occasionally: Infections (0-15%) in the wound area, usually good to treat with antibiotics. Germ contamination into the bloodstream (sepsis) is extremely rare.

Infrequently: Pain (0-5%) after the procedure is possible, rather than classified as low, the usual painkillers help very well. Scarring of the nerve branch in the vas deferens rarely causes sebum neuralgia, and surgical correction is rarely required.

Bleeding / rebleeding (0-15%): minor bruises in the wound area (bruise) heal by themselves. Very rare major bruising may need to be treated in the hospital.

rarely: epididymitis / testicular abscess, especially after previous illnesses possible, by the administration of antibiotics and cooling envelopes the inflammation usually stops spontaneously. Hospital treatment (surgery for abscess) is extremely rare.

rare: nodular connective tissue proliferation due to leakage of spermatozoa into the surrounding tissue (sperm granuloma) or foreign body reaction to the suture (filament granuloma). In the case of persistent symptoms (pain), a correction operation is extremely rarely necessary.

unsightly scar: thick beaded scar, ev. discolored (scar tissue / keloid) extremely rarely requires corrective surgery.

Violation of blood vessels: with the risk of insufficient blood flow to the testicle and testicular shrinkage (atrophy) is extremely rare.

allergic reaction: the local anesthetic is very rare, severe allergic reactions with circulatory collapse / shock and inpatient treatment in the hospital are classified as extremely rare.

Yes, with modern microsurgical techniques, a patency rate of approximately 80% is expected within 10 years of vasectomy.
Pregnancy rates after reoperation are lower, at about 60% (as the female factor is also responsible for conception).

There is no entitlement to sick leave. It is advisable to stop working after the procedure (time balance) as the risk of swelling / rebleeding is greatest in the first few hours.

After a hassle-free operation, you can go back to work the next day without any problems.

No.

Is not recommended.

There is currently no scientific evidence for the increased occurrence of prostate cancer. Also the hormone balance does not change as a result of the procedure, so no changes in potency and sexual desire (libido) are to be expected.