Vasectomy. Questions and answers


06. 10. 2023

At a time when there is a great deal of talk about the side effects of hormonal contraception, one of the possible alternatives for preventing unwanted pregnancy is vasectomy. This increasingly popular method of contraception is performed by MUDr. Jan Mokriš, FEBU, urologist at Canadian Medical, AFI clinic.

Interest in vasectomy has been increasing recently

It’s linked to couples’ awareness of the possibilities of contraception. In Western countries vasectomy is far more widespread than here, it’s a common method. However, in comparison with the situation roughly ten years ago, when vasectomy was practically never spoken about in this country, it’s now obviously far more in the public awareness these days. Although a large section of the male population here still holds the opinion that contraception is the woman’s responsibility and refuses to consider the option of vasectomy, there are men here who are aware that hormonal contraception has a large number of side effects and frequently limit the woman. Both partners should share the responsibility, and so if a couple decides to address the issue of contraception it’s good to know that vasectomy is one possible choice. What’s fundamental is that vasectomy represents a far cheaper option than surgical sterilisation of women.

The criteria for performance of a vasectomy

A man who decides to undergo a vasectomy must meet the criterion of responsibility, older than 21 years, he should be given sufficient instruction concerning the surgical procedure and the connected matters at least 14 days before the operation and sign an informed consent form, in which the procedure, its risks and benefits are described in detail.

What awaits men who decide in favour of vasectomy?

First of all a comprehensive interview. The client’s condition of health and the reasons why the client has decided to undergo the procedure are assessed, another integral component is a physical examination and an examination of the exterior genitalia. In practical terms, if the man has no fundamental contraindications such as bleeding, if he does not take any drugs which dilute the blood, then there is no reason to examine him further and the surgical procedure can be conducted. For a number of days after the operation it is recommended to avoid physical exertion, but this need not place any limitation on ordinary activities or employment. Three months after the operation it is recommended to perform a semen analysis. Only after the performance of the semen analysis, which demonstrates the absence of sperm in the ejaculation, can the operation be considered to have been successful.

How exactly is the surgery performed?

It’s a short surgical procedure of approximately 30 minutes on the scrotum under local anaesthetic. In the operation the natural flow of sperm upon ejaculation is simply prevented by cutting off the vas deferens, which is the tube that transports sperm out of the testicles.

What then happens to the sperm?

Men are often put off the idea of a vasectomy by the idea that their testicles will swell up due to an accumulation of sperm. These fears are completely unfounded. The size of the testicles remains the same after a vasectomy, even though sperm are still generated – the only difference is that they are not discharged in the course of the ejaculation but gradually undergo biodegradation, thus they break down and are absorbed. In this the hormonal function of the testicles, together with the attendant sensitivity etc. remains unaffected.

Does a vasectomy have any influence on a man’s sex life?

There’s no need to fear any “side effects” in this respect. The ability to ejaculate, libido, erection – all of this remains. Only the amount of the ejaculation (which does not contain sperm) is smaller, by approximately 40 percent.

Are there any potential risks of vasectomy?

The risks can be immediate and delayed. Immediate means that this is a certain surgical, even if minimally invasive procedure, and so there is a risk of bleeding in the wound or infection. Although these complications occur to a minimal extent, in only two percent of cases, it is necessary to know about this. A long-term so-called “side effect” may be a certain amount of discomfort in the area of the cut vas deferens – the patient may find sensitive area known as a granuloma, nevertheless these complications are also not common, it concerns ten percent or less of clients after a vasectomy.

What if a man who has undergone a vasectomy later decides he would like to have another child?

In this procedure the man does not lose his sperm, only their transport is cut off. Practically speaking, the man therefore has two options. The first is known as anastomosis, in which both ends of the cut vas deferens are connected and thus the physiological, normal discharge of sperm in ejaculation is renewed. This is a more time consuming procedure and cannot be performed in outpatient conditions, and the success rate is 50–60 percent. It’s certainly a more complicated operation than a vasectomy. If this operation is not successful, another option is what is called microsurgical expiration of sperm or taking of a sperm sample under a microscope and their insertion in vitro into the egg of the partner. Artificial insemination is subsequently performed. 

MUDr. Jan Mokriš, FEBU, urologist at Canadian Medical

He graduated from Charles University, Faculty of Medicine in Plzeň with a degree in general medicine and he later gained his experience at the urology clinic in Thomayer University Hospital in Prague, where he worked from 2012 to 2018. He specialized mainly in functional urology and provided urological care for patients of the spinal unit at the Rehabilitation Institute in Kladruby. He has been part of the Canadian Medical team since 2015. He has dedicated to providing comprehensive preventive care in regards to the full spectrum of urological diagnoses and preventive care for men's health. As part of Canadian Medical, he also performs surgical procedures such as minimally invasive scalpel-free vasectomy or surgery on the male external genitalia.

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