The most effective and simple method of male contraception is male sterilization (vasectomy). The essence of the operation is the intersection of the vas deferens, which prevents the passage of sperm. The operation is performed under local anesthesia for 10-15 minutes and the patient goes home the same day.
There are currently two options for vasectomy.
The traditional method is a layer-by-layer dissection of the skin and testicular membranes to bring the vas deferens into the wound and cut them. Postoperative complications are not clinically pronounced (no more than 1.5% of operations).
The “scalpelless” method is the release of the vas deferens by pushing the skin apart in a blunt way. With such an operation, the likelihood of complications, in particular the appearance of a hematoma, is reduced.
After sterilization, it is recommended to start sexual life in a week. Since the complete absence of spermatozoa in the ejaculate is achieved only after 15-20 ejaculations (or after 3 months), condoms or other methods of contraception should be used during the first time after the operation during sexual intercourse to reliably protect against pregnancy.
The success of such a surgical intervention is 100%. In addition, the safety of such an operation and the ease of its implementation are much higher than that of a similar manipulation performed on a woman. And it will cost men less.
Usually, a vasectomy is performed with the mutual consent of the 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, or the spouses want a 100% guarantee of the reliability of the method.
Indications for male sterilization are mental and hereditary diseases.
When agreeing to such an operation, factors such as the presence of a full-fledged family, the presence of children, as well as the age of the man (vasectomy for young people is not recommended) should be taken into account. In Ukraine, unlike Russia, there is no law prohibiting vasectomy for men under the age of 35 and without two children.
A man must firmly decide that such a method of contraception for him and his partner will be the most acceptable, since after such an operation it is difficult to restore fertility (the ability to fertilize). As a rule, vasectomy is an irreversible method of sterilization. However, some patients after a certain time wish to restore fertility. This is a common occurrence in remarriage, the death of a child, or the desire to have another child.
Restoration of fertility after voluntary sterilization is one of the most complex surgical operations. And even if the surgeon is highly qualified and experienced, this does not guarantee the success of the intervention in the following cases: a long period after a vasectomy, an elderly patient, the presence of infertility in a spouse, the sterilization method itself.
The effectiveness of the microsurgical operation to restore patency (i.e., the presence of spermatozoa in the ejaculate) is on average about 50%. However, only the onset of pregnancy can be considered an indicator of the effectiveness of the operation to restore fertility.
This married couple will also be able to give birth to a child using assisted reproductive technologies (fertilization “in vitro”) spermatozoa obtained by puncture of the testicle or epididymis. And besides, before a vasectomy, we recommend that men cryopreserve sperm for this case.