Vasectomy – male sterilization

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on are based on peer-reviewed research and information from medical societies and governmental agencies. However, they should not be used as a substitute for professional medical advice, diagnosis, or treatment.

What is a vasectomy?

Around the world, around 40-60 million men have already had a vasectomy.¹ The vasectomy describes the male sterilization. The two vas deferens in the scrotum are severed or clamped and the loose ends are closed. Sperm continue to be produced, but these do not end up in the semen.

Ergo: Sexual intercourse does not result in pregnancy despite ejaculation. Sterilization thus offers an effective alternative to condoms, pills, spirals and the like.

What is a vasectomy?

Around the world, around 40-60 million men have already had a vasectomy. The vasectomy describes the male sterilization. The two vas deferens in the scrotum are severed or clamped and the loose ends are closed. Sperm continue to be produced, but these do not end up in the semen.

Ergo: Sexual intercourse does not result in pregnancy despite ejaculation. Sterilization thus offers an effective alternative to condoms, pills, spirals and the like.

How safe is male sterilization?

The sterilization is the most reliable birth control method for the man. the Pearl index, i.e. the assessment measure for the safety of contraceptives, is only 0.1% for vasectomy. This means that out of 1000 couples who do not use any other contraceptive methods, only one woman becomes pregnant.

Lcan vasectomy be reversed?

Advances in microsurgery make it possible to reverse male sterilization in most cases. The severed vas deferens are reconnected. This process is called reversal

But be careful:

❗There is no certainty that refertilization can actually restore fertility

❗Refertilization is quite complex and requires general anesthesia.

❗Refertilization is very expensive. The costs are around 2000 – 5000€.

Anyone who is flirting with a vasectomy should find out more about the procedure and what it involves Advantages and disadvantages weigh against each other. A reversal is possible in principle, but involves high costs and risks – including the risk of no longer being able to be fertile!

Does sterilization affect sexuality?

Has the vasectomy no influence on your sexuality.

✔ Your desire for sex,

✔ your ability to have an erection,

✔ the feeling during ejaculation,

✔ Smell, taste, amount, appearance and consistency of your ejaculate

✔ and the production of the male sex hormone testosterone (and thus the libido) will not change.

The vasectomy can be yours sex life even improve. Because this very safe contraceptive method takes away the fear of an unwanted pregnancy and enables you and your partner to have carefree sex.

✘ Don’t be afraid of a “seed jam”. Your sperm are broken down naturally in the epididymis.

Vasectomy Side Effects: Is There a Threat of Erectile Dysfunction?

Vasectomy has no negative physical effects whatsoever on ejaculation, libido or the ability to have an erection. The widespread rumor that sterilization can cause a testosterone deficiency is also wrong according to current scientific knowledge. Nevertheless, sterilized men report erection problems again and again. That has primary psychological reasons

Why do sterilized men get erection problems?

Many men feel “less manly” after sterilization. At the so-called sterilization neurosis The man’s self-esteem suffers and he is afraid of failing in bed. The result: A vicious circle of pressure to perform, fear of failure and… erection problems.

This is especially the case if you were pressured into having a vasectomy or if you didn’t think carefully enough about the consequences of sterilization beforehand. That is why it is so important to weigh up the decision to have an operation calmly and to talk openly with your partner about your own concerns and fears.

How is erectile dysfunction treated after sterilization?

Treatment for erection problems after a vasectomy depends on many different factors. It is particularly important to know whether the erectile dysfunction had already occurred before the procedure. In addition – as with all non-sterilized men – it should be examined whether physical illnesses or the psyche are the cause of erectile dysfunction.

If erectile problems occur directly after a vasectomy, this usually has psychological causes. Discussion with your partner, professional advice and sex, couple or psychotherapy can help here. Mechanical aids that promote an erection and sexual enhancers such as Viagra and Co. have also proven their worth.

What sterilization methods are there?

the urologist is responsible for male sterilization. Vasectomy is usually performed with a traditional scalpel incision, with a laser, or without a scalpel at all. Other alternative methods are currently being developed that could make surgery superfluous in the future.⁴

The classic vasectomy with a scalpel or laser

The classic vasectomy is one outpatient surgery. The groin area and scrotum are locally anesthetized and the two vas deferens are removed through a small incision in the scrotum. A part of the vas deferens (1-3 cm) is then removed. The two ends are sclerosed and stored in different cavities of the scrotum. This is intended to prevent recanalization, i.e. the spontaneous merging of the vas deferens. The incision is closed with self-dissolving sutures. It all just takes time 10 to 20 minutes. If desired, the procedure can also be performed under short-term anesthesia.

The vasectomy “without a scalpel”

Non-scalpel vasectomy uses the same method as classic vasectomy, except that the scrotum and spermatic cord sheaths are only scratched. To the minimal incision scars a patch is usually sufficient to connect.

Sterilization without surgery – is that possible?

The American Nathaniel Fried, along with his colleagues, has one new, innovative way of sterilization developed. The vas deferens are heated by ultrasound and melted together. Fried has only tried this method on dogs so far. Before it is also carried out on men, it must be guaranteed that the high temperature cannot damage the testicles.

Likewise in development the idea is to place a kind of switch between the spermatic ducts, which can be switched on and off depending on the desire to have children. The same applies to the so-called Vasalgel, which is injected into the vas deferens and is intended to close it.

What should be considered after the vasectomy?

Regardless of the surgical technique used, you should rest for a few days after the operation sexual abstinence plan on. Sport should be avoided for two weeks if possible.

A once or twice follow-up inspection is important to check whether the expected contraceptive protection is in place. For this purpose, the semen is examined for sperm and it is checked whether the severed vas deferens have grown back together. Until then you should additionally prevente.g. with a condom.

What complications can arise from a vasectomy?

After a vasectomy occur only rarely complications on.

➔ Days after the procedure: 1-2% of men have bruising, a feeling of pressure, wound infection or inflammation of the epididymis.

➔ Months after the procedure: Knot-like tissue inclusions of sperm cells can occur, which among other things are the cause of the spontaneous fusion of the vas deferens.

➔ Long-term effects: Dissatisfaction and psychological discomfort can result, which often result in erection problems. In addition, chronic pain in the testicles can negatively affect sex life and quality of life.

Who is a vasectomy right for?

Vasectomy is a suitable contraceptive method for men who are certain that they do not want to have children (any more). the desire to have children However, it can change very quickly with life circumstances. In a new partnership, the desire to have children can suddenly arise, even if you previously ruled it out for yourself.

It is therefore very important to obtain detailed information before sterilization and to discuss the consequences of the procedure extensively with your partner. Nobody should go to a sterilization persuade or get pushed. Also, the decision should not short circuit reaction to difficult life situations such as a separation or divorce, an abortion or unwanted fatherhood.

Although it is fundamentally possible to reverse sterilization, there is no 100% certainty that fertility will be restored afterwards. In addition, refertilization is expensive and time-consuming. Therefore, the decision to undergo sterilization should be final.

According to the German Society for Urology (DGU), a vasectomy is not recommended if you are not in a permanent partnership, do not have children, are under 30 years old, are mentally unstable and if you have chronic pain in the area the testicles or has a serious general disease.

What is the cost of a vasectomy?

Unless sterilization is medically indicated or a personal choice (which is usually the case), the patient must pay for the vasectomy himself. These are usually between 400 and 500 euros.

In the reversal, i.e. the reversal of sterilization, the patient faces significantly higher costs. Since the operation lasts several hours and requires general anesthesia, the costs here are somewhere between 2000 and 5000 euros.

The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.

Isabel D White

Isabel D White

Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.

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