- Is vasectomy reversible?
- Can vasectomy fail?
- Common questions
Contents
What is a vasectomy?
Vasectomy is a simple, semi-permanent surgical sterilization procedure. In some cases there is a reversal, but for safety, surgery is considered a permanent contraceptive method that cuts the channel that connects the testicles with the urethra, thus preventing the sperm from joining the semen.
Thus, it is not possible for pregnancy to occur even without other contraceptive methods.
Vasectomy does not prevent a man from ejaculating or having erections – so it does not affect sexual performance. It simply makes sperm transport unviable. This is also why it is important to point out that, despite being extremely effective in preventing pregnancy, vasectomy does not prevent the transmission of sexually transmitted infections (STIs).
Until a few years ago, it was said that the procedure was irreversible. With current technologies, most cases – about 90% of them – can be reversed. However, as this is not possible in some, the smart thing is to treat the procedure as permanent.
This is pertinent, because the reclosing of the canal can be expensive and laborious, in addition to requiring new surgery.
Vasectomy surgery: how does it work?
Vasectomy can be performed by the urologist and is a simple and quick procedure.
Semen consists of three components. A liquid that is secreted by the prostate (an organ that is below the bladder, near the end of the rectum), another liquid secreted by the seminal gland (which is located behind the prostate) and finally by sperm, produced by the testicles .
The fluids that come from the seminal gland and the prostate serve to protect sperm during their journey through the female reproductive system, which is hostile to male reproductive cells because of its acidity (pH).
The process begins in the testicles, which carry the sperm to the prostate through the vas deferens , a channel that connects the two organs. There, mixing with the rest of the liquids takes place.
Vasectomy is the procedure for cutting the vas deferens. Surgery is mildly invasive. A small cut is made in the skin of the testicle, through which the vessel is pulled and cut. The tips of the vase can be tied, cauterized or other procedures can be performed to prevent them from coming together spontaneously.
The process is repeated on the other testis and then the cut is closed. The surgery is done with local anesthesia or sedation and there is no need to make the patient unconscious.
With the cut made, the sperm cannot follow the path to the prostate, but the rest of the semen fluids can follow the path through the urethra.
What happens to sperm?
Even after the vas deferens are cut, the testicles continue to produce sperm. They accumulate inside the cut duct and the pressure stops production.
After that, the sperm are destroyed by the immune system and reabsorbed.
Who can have a vasectomy?
Legally, in Brazil, voluntary sterilization surgery, whether for men or women ( sterilization ), can only be performed by those who are over 25 years old or already have at least two living children, or when there is a risk to the life or health of the woman or baby (law number 9263/96).
Legally there is also a need to have at least 60 days between the manifestation of the desire to perform the vasectomy and the procedure, seeking to avoid early sterilization and regret
As for contraindications, they do not exist. Vasectomy is a simple and minimally invasive procedure. Its only effect is to create a physical barrier for sperm, so there is no situation in which it is specifically contraindicated.
Postoperative: what is the recovery time from the surgery?
It depends on what your intention is. It is possible for the man to return to work on the same day as the surgery is extremely simple and not very invasive. However, some activities may require a little more rest and medical recommendations are different.
But the general recommendation is that if you need to make light efforts or go to work, it is good to wait at least 48 hours. If you need to push, it is recommended to wait around 5 days.
Recovery from surgery can be painful. The scrotum may have pain and swelling due to the cut, but these symptoms should go away in approximately 7 days. Rest is recommended and follow the doctor’s instructions.
It is recommended to wait 7 days – the average time for the vas deferens to heal and there are no pressure problems after surgery. But, old sperm can be stored in the seminal vesicle or in the prostate, so it is more appropriate to wait at least 30 days to not be at risk of pregnancy.
Even after the operation, this reserve is still there and needs to be eliminated to guarantee the effects of the surgery. In general, after a few days or 8 to 10 ejaculations, this reserve runs out and is no longer replenished, since the vessel is cut.
The recommended thing is to wait for the result of the sperm test, which is done a few days after the surgery, to analyze the effectiveness of the procedure.
Advantages of vasectomy
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There are several advantages to the vasectomy procedure. Some of them are:
Safety
The main advantage of vasectomy is its high safety. The chances of pregnancy after a vasectomy are practically nil. While the condom is 98% effective, the vasectomy reaches 99.86% effective in the first year.
Although 1.86% difference does not seem like much, the important thing is to look at how much is left . With a condom , there is a 2% chance of pregnancy. With vasectomy that chance drops to just 0.14%. The chances are more than 10 times lower. And that is in relation to the first year after surgery. The more time that passes, the safer it gets.
Tranquility
Vasectomy gives tranquility to those who do it. Children are a big responsibility. Since the procedure is safe and considered one of the best methods of preventing pregnancy, making errors in the use of other methods of contraception are no longer a concern.
Disadvantages of vasectomy
The procedure has its disadvantages. Some of them are:
Irreversibility
Although the irreversibility of a vasectomy is no longer a reality as in the past, there are still cases in which it cannot be performed. In addition, the reversal procedure is difficult, expensive and is not offered by SUS, unlike the vasectomy itself. Therefore, it is important to make sure that you really want to do the procedure.
Does not protect against sexually transmitted infections (STIs)
Unlike condoms, vasectomy is not able to offer protection against sexually transmitted infections (STIs). The method is effective for preventing pregnancy and just for that . Therefore, even if you have had a vasectomy, when having sex with someone you don’t know well, it is important to use a condom.
SUS vasectomy
The Unified Health System (SUS) offers vasectomy free of charge. But you must remember the conditions for the procedure. You must be at least 25 years old or two children alive.
In addition, it is necessary to wait 60 days between expressing the desire to have the surgery and actually having it, so that you have time to think about it and make sure that you will not regret it.
Risks of vasectomy
Vasectomy is an extremely safe procedure. The main associated risks are infections due to cutting, bleeding, inflammation in the vas deferens due to pressure from the accumulation of sperm, and bruising on the skin.
However, these three effects are extremely rare and temporary, with pain on recovery being the main risk factor:
Post-vasectomy pain syndrome
Post-vasectomy pain syndrome can affect 5% to 33% of men who have the operation. The weakest, short-lived pain is more common while severe pain that lasts for more than three months is very rare.
It is caused by the accumulation of sperm and testicular pressure. Treatment options for the syndrome are:
Vasectomy reversal
The reversal causes the sperm to pass again.
Open vasectomy
Open vasectomy does not cauterize or close the vas deferens, allowing sperm to exit and be absorbed by the tissue.
Denervation
Denervation is a procedure that removes the nerves in the region affected by the pain of the post-vasectomy syndrome. The procedure is invasive, but its results are satisfactory and in the few times that it does not eliminate the pain, it reduces it considerably.
Price: How much does a vasectomy cost?
The operation, in private clinics, can cost around R $ 3000.00. However, it is a procedure made available by SUS free of charge.
How effective is a vasectomy?
Vasectomy is considered to be the safest method of contraception. Only 1 in every 1000 women becomes pregnant in a relationship with an operated man, and this usually happens because of the reserve of sperm, which disappears in a few days, or because of the extremely rare late failure .
Late failure can happen long after vasectomy, when the vas deferens recanalize alone. This is very rare as the procedures usually prevent this by cauterizing the vessels or positioning them in such a way that spontaneous recanalization is impossible.
Is vasectomy reversible?
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In some cases, yes . But as a guarantee, it is good to treat vasectomy as a permanent procedure. Reclosing the vas deferens is not always enough to restore fertility and, even after reversal, pregnancy can be difficult.
This is because, after the procedure, the man’s body can start producing antibodies that attack sperm. That’s because sperm production does not stop, but they are not eliminated by ejaculation and the body needs to destroy them when they accumulate. Thus, fertility is reduced after a vasectomy even if it is reversed.
The rate of infertility gets higher as time goes by since the surgery. 3 years after vasectomy, the pregnancy rate is around 76% while after 15 years it reaches only 30%.
In addition, due to the high pressure in the duct, it is possible that, after a few years, there is fibrosis, which is a healing of the region. This means that even after the vessel is rewired, the sperm cannot pass through.
In this case, another surgery can be done to remove the piece of the vas deferens that was connected to the testicle, connecting the other part directly to the epididymis , the tube that originally connected the testicle to the vessel. The problem is that this surgery is much more complex, difficult and expensive than simply reconnecting the vessels.
So, especially after a few years of surgery, it can be very difficult to perform the reversal.
Can vasectomy fail?
Yes , but it is very rare. Vasectomy is the most effective contraceptive method, with almost 100% effectiveness. The very few cases where there are failures are due to a natural reconnection of the vas deferens, which can happen if the surgeon does not take precautions against it, or in cases where the 30-day period without unprotected sex after surgery is not respected. .
However, precautions are often taken with the use of duct cauterization, for example. So it is a very reliable method.
But it is important to take into account that, in the first days after surgery, there may be sperm that have already passed through the cutting area, so it is necessary to wait a while before having unprotected sex.
Common questions
Does the vasectomy leave you impotent?
No ! The only effect of surgery is infertility. If the procedure is performed properly, by a good professional, there is no risk of impotence.
How long after a vasectomy can I have intercourse?
It is possible to have sexual intercourse around 7 days after surgery. However, to avoid a possible pregnancy, wait 30 days after the operation before having sex without using other contraceptive methods.
The vas deferens, as well as the prostate and seminal vesicle, may have sperm that got there before surgery. These sperm will not be replenished in the next few days, but will go on to the next ejaculations.
They usually take 30 days or around 10 ejaculations to be completely eliminated.
It is recommended to wait for the sperm count, which should be done some time after the vasectomy. So you can be sure that there are no risks of pregnancy.
Does vasectomy affect the hormonal load?
No ! The hormones produced by the testicles go into the bloodstream directly through the organ’s blood vessels and do not depend on the vas deferens for this.
Vasectomy causes prostate or testicular cancer?
Studies indicate that no, vasectomy does not increase the risk of cancer .
Does vasectomy prevent ejaculation?
No . Most of the semen’s composition comes from the prostate and seminal vesicle. There is a possibility that the semen texture is slightly different, a little more liquid, but the difference is small.
You have learned that vasectomy is extremely simple and the most effective contraceptive method, in addition to being permanent and in most cases irreversible. Share this text with your friends so that they learn a little about this procedure!
