;Resize=(1200,627)&impolicy=perceptual&quality=mediumHigh&hash=664f2ead6a90046fcdaf8639de7f87b7990ef20570e82c7fed5c096093f7ef4f "Vasectomy: Especially 3 groups of men opt for it")
“Honk if you’ve had a vasectomy,” reads the tag. And indeed: every few minutes a horn sounds. US urologist Esgar Guarin operates the country’s only mobile sterilization clinic in the United States. In the States, demand for vasectomies has skyrocketed following the controversial repeal of federal abortion laws.
Admittedly, a horn would probably not sound every few minutes in Germany. But the numbers are increasing here too. There are currently around 50,000 vasectomies per year, and the trend is rising, say the Munich urologists Michael Schwab and Patrick Bössner of the “Süddeutsche Zeitung”. The two have specialized in this operation.
Vasectomies – no longer a taboo subject
Men’s self-image has changed, the Munich urologists call one explanation. “It used to be women who were responsible for contraception, now men too.”
In addition, vasectomies are now being talked about more openly, observes urologist Marc Armbruster. The specialist from Kornwestheim in Baden-Württemberg has been performing vasectomies for 15 years. “When I started, I felt like a patient would only tell their very best mate about it,” he says. “It was already a taboo subject. Now someone is more likely to come and say: ‘My neighbor recommended it, and someone at the football club did it too.’ Men talk about it much more openly.”
Vasectomy does not affect erection, ejaculate, or sex drive
The information situation has also improved. Most men now know what happens during a vasectomy, the operation to sterilize men, according to the tenor of the doctors. During the procedure, the vas deferens are severed on both sides so that the testicles continue to produce sperm, but these can no longer get into the urethra. It is then no longer possible for the man to fertilize the woman and father a child.
Compared to female sterilization, the procedure is simpler and less risky. The ability to have an erection, the feeling of pleasure and the hormonal balance remain the same. The effusion itself looks and smells the same as before sterilization.
Note: A vasectomy is different than a castration. In the latter case, the doctor surgically removes the testicles or uses hormones to stop their function.
Everyday practice: 3 groups of men in particular opt for vasectomy
The Munich urologists report from their everyday practice that three groups of men in particular come to them: The largest group is that of the “Happy Family”. The desired children are there, the parents are happy with their current child situation. Practical reasons often played a role in the decision not to have more children – the apartment is too small or there is no space for a fourth child seat in the car.
The second group is that of the separated with a new partner, whereby the men do not want another child, the doctors clarify. And the third group is that of the “classic patchwork family”. Here, both partners already bring their own children into the family and do not want any more.
And of course: “Then there are those who have no children in their life plan at all,” says urologist Bössner. These men are often in their mid to late 20s. “We talk to everyone, and there is simply no desire to have children at all.” However, they initially sent an 18-year-old who wanted a vasectomy back home. “We usually don’t do the procedure until men are over 30. So we assume that not wanting to have children is a mature decision.”
Vasectomy – this is how the OP works
There are various ways of cutting off the path of the sperm. The experts from FOCUS Gesundheit explain the two most common:
Classic vasectomy procedure: The doctor makes a tiny incision about half a centimeter to one centimeter long and exposes the vas deferens. He cuts through and shortens them by one to three centimetres, then he sews up and sews up the ends. This form of vasectomy leaves a scar. But it is so tiny that after a few weeks it can hardly be seen.
Method without a scalpel (NSV): The doctor only punctures the skin of the scrotum and spreads it open with clamps in order to get to the spermatic ducts, which he only cuts, not shortens. Complications such as bruising and wound infection are relatively rare with this procedure. The man should only rest physically (and sexually) for a few days.
Most vasectomies are performed on an outpatient basis. The operation takes about half an hour. The costs are between 450 and 600 euros and usually have to be paid for by yourself. Health insurance companies only cover the procedure if there are medical reasons.
How safe is a vasectomy?
Vasectomy has a Pearl Index of 0.1 to 0.15. This means that out of a thousand women who used this contraceptive method, only one became pregnant within twelve months. For comparison: the Pearl Index for birth control pills is between 0.2 and 0.5 (two to five women out of 1000 become pregnant), for condoms between two and twelve (two to twelve women out of 100 become pregnant). The vasectomy is therefore considered to be a very safe, but also definitive method of contraception.
Only when the vas deferens grow together again (recanalization) can the woman become pregnant despite the vasectomy. According to the Federal Center for Health Education, this is extremely rare. The probability is therefore 0.03 to 1.2 percent.
Rare side effects
According to the experts from FOCUS Gesundheit, side effects from a vasectomy are rare overall. Only one to two percent of men experience symptoms, such as a feeling of pressure in the testicles, bruising or a wound infection. With appropriate treatment, such vasectomy complications usually disappear soon. So-called sperm granulomas are usually just as harmless. These small lumps are pockets of tissue from sperm cells and are caused by pressure in the testicles, which continue to produce sperm.
A possible connection between vasectomy and prostate cancer is also being debated. According to a meta-study from 2017, the likelihood of developing it after a vasectomy could be a little higher, but this connection has not been scientifically clarified. All in all, the risks associated with a vasectomy are minimal.
Can a vasectomy be reversed?
In a reconstruction operation (so-called vaso-vasostomy), both ends of the vas deferens are sewn together again under the surgical microscope. However, success cannot be guaranteed. In addition, the vaso-vasostomy is expensive. There are several thousand euros.
Psychologist: Decisions are often more emotional
The decision to have a vasectomy is not easy for most men. Timo Storck, Professor of Clinical Psychology and Psychotherapy, says that for many it can be more difficult on an emotional level than on an anatomical or rational level – for example when someone asks themselves: “Is this a relinquishment of something that I think I should do?” could ever regret it?”
In any case, it is important not to dictate anything morally or psychologically to anyone on the subject, “because it is a very personal, individual decision that everyone should weigh up carefully”.