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Hurts? Will I lose manhood? Ultimate Guide to Vasectomy

Hurts? Will I lose manhood? Ultimate Guide to Vasectomy

If you've been considering trading a condom for a vasectomy, you're in luck. Science has been in charge of banishing false myths about a technique that today is revealed as safe, simple and reversible. All this, without breaking the virility. This is how it is described in a review of 300 operations carried out in Spain, where it is also stated that the first national survey on this technique, presented in the year 2000, indicated that it is the most practiced urological surgical intervention in the country, estimating that 100,000 men per year they voluntarily submit to it. It has been difficult for it to prevail, since until the 70s it was prohibited for sterilizing purposes by the work and grace of the religious and social beliefs of the time.Does it hurt? Will I lose my manhood? The Ultimate Vasectomy Guide Does it hurt? Will I lose my manhood? The Ultimate Guide to Vasectomy

To a lesser extent, even today it continues to arouse passions: according to the experts consulted, it continues to be disliked by the most conservative sectors of the Church. Something that clashes with reality, since it has even surpassed tubal ligation (female contraceptive surgical technique), in the words of Dr. Josep Miquel Viladoms Fuster, urologist and andrologist at the Teknon Medical Center (Barcelona): "Spain It is among the six countries in the world where more vasectomies are performed than tubal ligations; the other five are New Zealand, the Netherlands, Canada, England and Bhutan." The reason for its success, in the opinion of the urologist, is that it is financed by public health and that it is simpler than tubal ligation. But, what does it consist of? Is there a way back? Is virility lost?... Three doctors who are experts in this technique clarify doubts.

Only 30 minutes

A vasectomy basically consists of preventing sperm from reaching the seminal fluid (ejaculate). To do this, the surgeon cuts and seals the two vas deferens through which they circulate and which communicate the testicles with the prostate. "It is performed under local anesthesia, lasts approximately 30 minutes and does not require hospitalization," explains Dr. Luis García Reboll, head of the Urology Service at the Hospital de Sagunto (Valencia). The doctor insists that ejaculation is maintained: "The amount ejaculated comes from the prostate, seminal vesicles and periurethral glands. While the part of ejaculate from the testicle (5-10% of the total) is not emitted, it is retained and reabsorbs," he clarifies.

Currently there is a new surgical technique, much faster and with fewer complications, in which a scalpel is not used. A WHO report, where it is compared with the traditional one, says that with vasectomy without a scalpel the procedure is shorter and the resumption of sexual activity is faster. "Patients are grateful that the surgery does not have stitches, that the wound closes spontaneously in 72 hours and that inflammation and postoperative pain are minimal," explains Miquel Viladoms, a pioneer in performing it in Spain. The only downside, in the words of Dr. Reboll, who has performed more than 2,000 no-scalpel vasectomies, is that not many urologists do it.

Vasectomy vs ligatures

Does it hurt? Will I lose manhood? Guide The Ultimate Guide to Vasectomy

Surgery to sterilize men is less aggressive than that for women, says Dr. Viladoms: "When performed without a scalpel, it only takes 15 minutes (half that of the traditional technique), while tubal ligation in The woman may require an hour in the operating room, she needs general anesthesia and hospital admission; it is more expensive and more annoying, and the complications are worse". As for the difficulties of vasectomy, Viladoms explains that they are almost non-existent: "The most frequent are hematoma and infection, but no-scalpel surgery eliminates them almost completely."

Profile of the man

According to the Clinical Guidelines of the European Association of Urology on Vasectomy, there are no absolute contraindications to undergoing a vasectomy, only relative contraindications: absence of children, young age (less than 30 years), a serious illness, no current relationship and pain in the scrotum. But, in practice, what profile of a man does she demand? "It is usually requested by young men, between 30 and 45 years old, married or with a stable partner, from any profession, and with an average of two children. It is generally recommended to any man with a partner of childbearing age, without distinction, since it is the safest and most economical male contraceptive technique in the long term", specifies Dr. Luis García Reboll.

Who also qualifies that they must be informed, given their definitive nature, that there are alternatives to restore fertility: microsurgical vasovasostomy (to make the ducts patent again) or sperm extraction by puncture of the seminal tract (epididymis ) or testicular biopsy, although the results are not 100% effective.

Man's fears

Dr. Natalio Cruz, national coordinator of andrology of the Spanish Association of Urology, cites two great fears of men when undergoing a vasectomy: fear of pain and the loss of virility. "Both are false myths," he reiterates. As he explains, virility is not affected because the surgery does not touch the mechanisms that intervene in the erection, the ducts that transport the semen are simply manipulated. "On the contrary, once they are freed from the worry of a new pregnancy, the sexual relationship improves," he adds.

As for the pain, he says, it is comparable to that produced by a ball in the genitals and the patient can return to work the day after the vasectomy, as long as he does not do physical work. Dr. Luis García Reboll also adds that it does not interfere with urinary function either and that after the operation, "the patient notices slight pain in the lower abdomen for approximately 24 hours, which is relieved by wearing tight underwear; if perform physical work, we recommend between 24 and 36 hours of relative rest".

Three vasectomized patients, Juan José Morales, Isidro Antón and Felipe Ordóñez, agree that sexuality is not affected: "Relationships even improve because the pressure of fear of an unwanted pregnancy disappears," says Antón. As for pain, they also agree that it is an operation without major discomfort: "There was no pain, just a slight stinging that lasted just two days after the intervention," recalls Ordóñez.

Is it infallible?

Dr. Viladoms advises in his book Treatise on Andrology and Sexual Medicine, that the patient should be warned verbally and in writing that no technique is 100% effective. "After the intervention, some other method of contraception must be used until a semen analysis confirms azoospermia (absence of sperm). Any analysis carried out one month after the vasectomy that shows motile sperm implies recanalization and the vasectomy must be repeated," he warns. . The risk that after a vasectomy some sperm may pass through the ducts is minimal, says Dr. Natalio Cruz: "In 1 in 10,000 cases it can happen because a suture comes off, but if it is well done, it is safe." .

Does it increase the risk of cancer?

There are studies that have linked vasectomy with prostate and testicular cancer, but in both cases, new studies have dismantled the myth. A New Zealand study in 2002, which interviewed 2,150 men between the ages of 40 and 74, concluded that vasectomy did not increase the risk of prostate cancer, even after 25 years or more. And in another important study, conducted with more than 73,000 men, no increased risk of testicular cancer was observed after vasectomy. "To date, there are no conclusive studies that correlate vasectomy with prostate or testicular tumors," concludes García Reboll.

What if I regret it?

If you regret the decision, there is a way back. With rare exceptions, it is a reversible technique. There is even a study that says that the passage of time after a vasectomy does not affect the recovery of fertility as much as previously believed. The key to successfully reversing vasectomy in a high percentage of cases, according to urologist Natalio Cruz, lies in the fact that vasovasostomy has improved, that is, the technique that manages to rejoin the vas deferens to reestablish blood flow. the sperm.

"In the last two years, I estimate that the demand to recover fertility has multiplied by four because better results are now obtained with this technique thanks to the fact that it is performed with a surgical microscope that increases the surgeon's vision", Explain. The urologist Luis García Reboll also confirms this increase in demand, but qualifies that although it is possible for sperm to pass in approximately 85% of cases, this percentage of pregnancies is lower.

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