What is Vasectomy?

Vasectomy is a male birth control method in which the sperm-carrying ducts are cut and tied with a simple and reliable operation, preventing the passage of sperm into the semen. It is a simple and low-risk operation performed under local anesthesia by making a 3-5 mm surgical incision on the upper-lateral sides of the testicular sacs called scrotum. 5% of couples of reproductive age are protected by this method. The rate of preference is directly related to socioeconomic and sociocultural level.

The most important thing to know before choosing vasectomy is that although it can be corrected surgically later, it should be considered a permanent birth control method. Although it is possible to stitch the sperm ducts back end to end after vasectomy, both the success of the repair process and the possibility of achieving pregnancy after repair decrease as time goes by. In this context, before the vasectomy procedure, it should be discussed with the patient whether he is sure of his choice and whether he has enough information about alternative birth control methods.

To whom can it be applied?

According to Law No. 2827, adopted in our country in 1983, it can be applied to all men over the age of 18, with their own consent, or with the consent of their spouses if they are married.

To whom can it not be applied?

In the guidelines published by the European Association of Urology in 2012, it was emphasized that vasectomy should be considered an irreversible procedure and it was reported that there were no drawbacks for the procedure. However, there are conditions that relatively restrict its application, such as the applicant not having any children, being younger than 35, not having a spouse, and having chronic pain in the testicles.

How is it applied?

It can be performed under local anesthesia in a day surgery center or doctor's office.

• The sperm duct is felt under the skin over the testicle sac and is taken between the index finger and thumb.

• The sperm duct is held and fixed with the help of a special tool.

• A surgical incision of 3-5 mm in size is made with the help of special scissors.

• A part of the sperm duct is pulled out through this incision and the end parts are It is cut and tied.

No pain is felt during the procedure. A minor discomfort, such as a pulling sensation, may be felt. Because the surgical incision is so small, no stitches are required. The operation is completed in a short time of 15-20 minutes. Swelling, pain and bruising may occur in the treated area, but will resolve spontaneously within a few days.

Side effects that may develop immediately after the operation:

• Bleeding (1-2%)

• Blood in the semen (1%)

• Bruise on the skin (1%)

• Infection (0.4-2%)

• Swelling (1%)

• Congestion (1%) , A feeling of pressure and discomfort that occurs as a result of sperm accumulation in the testicles and sperm ducts and resolves spontaneously in about 12 weeks)

• A slight feeling of pain and discomfort

Side effects that may occur late;

• Chronic pain (1-2%)

• Increasing with ejaculation testicular pain (0.1%)

• Granuloma (66%, a hard, sometimes painful pea-sized swelling that occurs as a result of sperm leaking into the tissue space from the interrupted sperm duct. This swelling is not dangerous and is usually is dissolved by the body)

• Spermatocele (cyst formation in the structure called epididymis, located in the upper part of the testicle, where sperm cells mature)

• Hydrocele (fluid accumulation between the membrane structures surrounding the testicle)

• Antibody formation against sperm due to disruption of the blood-testis barrier (60-80%)

• Re-canalization (Re-establishment of sperm duct continuity by spontaneously coming together of the cut sperm duct ends over time. In this case, the possibility of pregnancy increases as sperm cells will be expelled with semen. It is a very rare condition)

Unfounded concerns;

• It does not negatively affect sexual desire and masculinity.

• It does not affect the male hormone called testosterone.

• It does not cause permanent damage to sexual organs.

• It has no negative effects on ejaculation and erection.

• The amount of semen does not decrease. Sperm cells make up 3% of the semen volume. the rest It consists of fluids produced by the organs called prostate and seminal vesicles, which provide nutrition to the sperm.

• Although there are concerns that it increases the risk of testicular cancer and prostate cancer, it has not been scientifically proven.

• It does not increase the risk of heart diseases.

• It does not cause serious pain.

Is it reversible?

Vasectomy should be considered an irreversible birth control method. Corrective operations are difficult and often have a low chance of success.

What are alternative birth control methods?

• Birth control pills and implants

• Intrauterine devices

• Diaphragm

• Condom

• Contraceptive gels or creams

• Tubal ligation (for the female partner)

After vasectomy What happens to the sperm?

After vasectomy, the testicles continue to produce sperm. Like other cells of the body that are renewed every day, sperm cells break down and are eliminated by the body when they die.

Is vasectomy 100% effective?

Nothing other than abstaining from sexual intercourse is possible. The approach does not prevent pregnancy 100%. Although complete clearance of sperm cells from semen varies from patient to patient, it is achieved in 80% of patients after 12 weeks or 20-25 ejaculations. For this reason, it is recommended to use another birth control method until sperm analysis determines that there are no sperm cells in the semen. It has been determined that the probability of pregnancy is 00.5% even in cases where no sperm is detected in the semen after vasectomy.

What should be taken into consideration after the operation?

Vasectomy does not cause sexually transmitted diseases. It does not provide protection against!

• Pain, bruising and swelling may develop after the operation. For this reason, painkillers and anti-inflammatory drugs are used.

• For the first 24 hours following the operation, it is recommended to support the scrotum and apply cold intermittently.

• Bath can be taken the day following the operation.

• After 72 hours following the operation In cases such as persistent severe pain, sudden increase in swelling, continuation of bleeding and high fever, the nearest health institution should be consulted without delay.

• For the first 7 days, strenuous activities other than daily routine activities are not recommended. .

• Sexual activity can be started 7 days after the operation. However, another birth control method should be used in case there is sperm in the semen.

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