Family planning has been completed and partners are looking for a reliable method of contraception. If possible, one does not have to think about while devoting oneself to the most beautiful thing in the world. Time for a sterilization? The perfect method of contraception does not yet exist, therefore individual needs and living conditions have to be considered. For couples over the age of 30 who already have children or are sure they do not want them anymore, a surgical procedure for sterilization is an effective and very safe alternative to all other methods. However, this step to permanent infertility is almost always irreversible - to not regret it later, the partners should be sure that their attitude to having children does not change again. In Germany, about 1.5 million women have undergone sterilization, which corresponds to about 8% of all women of reproductive age. For men, about 3% of men are of fertile age - and rising.
Sterilization of men and women
Sterilization blocks the sperm's natural pathway, which prevents fertilization of the egg. If sterilization is in question for the couple, it is important to consider who undergoes the surgery. To take into account are age, present diseases and mental capacity. Before making a final decision, the partners should be sure to get information from a doctor about the exact procedure, risks and consequences. Counseling centers such as Pro Familia can also help.
In principle, the procedure is smaller in men, goes faster and has fewer complications. It can be performed on an outpatient basis under local anesthesia, whereas the woman under general anesthesia must be sterilized.
Vasectomy: no side effects
For most men, the decision to sterilize is easier if they know that after that the desire for sex is just as unaffected as erection and ejaculation. Since the seminal fluid consists only of a small part of sperm, their consistency, quantity and color remain unchanged. Also, the hormone production is not affected because the hormones are transported through the bloodstream. Many men even report a positive influence on their sexual life, presumably because this can develop more freely without the fear of unwanted pregnancy.
Procedure of sterilization
The sterilization of the man is almost always carried out under local anesthesia on an outpatient basis in a doctor's office or clinic. The patient must first shave his abdomen carefully. The doctor disinfects large area and puts several anesthetic injections in the groin and the scrotum. He waits a few minutes for the stun to work.
The vas deferens in the two scrotum sores are operated consecutively. For this purpose, a small section is placed in the scrotum, the vas deferens free prepared, pulled out and severed. From the vas deferens an approximately 3-5 cm piece is removed, the two ends are welded and sutured with a resorbable thread or closed with clips. Then the skin of the scrotum is sutured again. The procedure itself is painless, the first few days thereafter, it may cause slight pain and swelling.
What happens after that
Possible but rare complications are mainly bleeding, infections and adhesions. In rare cases spontaneous regrowth of the severed vas deferens can occur. Up to 12 weeks after the procedure sperm can still be present in the seminal vesicles and thus in the seminal fluid and lead to fertilization. During this time, it is theoretically possible to become pregnant despite sterilization. Therefore, the couple must prevent during this time and several samples of the ejaculate are examined in the spermogram - usually after 6, 12 and 18 weeks.
Only when two of these samples are sterile, the operation is declared successful. Incidentally, the testes continue to produce sperm, which are, however, degraded by the body and their number decreases sharply over time.
Cost assumption: health insurance vs. Pay yourself
Unlike in the past, the costs of sterilization in men today are usually no longer covered by the health insurance. This is especially true if the intervention is performed only on the basis of personal life planning. Exceptions are vasectomies that are medically necessary. Private health insurance companies usually only cover the costs if the surgery is carried out for health reasons. The cost of a vasectomy is about 400 to 600 euros.