The vasectomy (ligation)
Small intervention, maximum safety
"Dr. Mueller was absolutely fantastic during the procedure. All steps were impeccably enumerated so I was always kept informed..."
Vasectomy (ligation) - The optimal contraception
Once family planning has been completed, the question of optimal contraception arises for many couples. The permanent cutting of the vas deferens (vasectomy) in men offers a gentle and, above all, safe option. Vasectomy is also called ligation, vasectomy and sterilization in men.
Our experts on the subject of vasectomy
"As a general rule, a vasectomy should only be performed when family planning is truly finalized, as the procedure is not always reversible."
Contraceptive methods for men - a comparison
Compared to women, there are only a few applicable contraceptive methods for men.
Graded according to their safety, these are in descending order:
Vasectomy
Pearl index from
0.1
Condom
Pearl index from
2-12
Coitus interruptus
Pearl index from
4-18
The safety of the above methods can be expressed in figures via the so-called
Pearl index. The Pearl index is a measure of how many women out of 100 became pregnant via the corresponding contraceptive method when the method is used for one year. The smaller the Pearl index, the safer the contraceptive method.
Vasectomy is by far the safest method, with a value of 0.1 compared to 2-12 for the condom and 4-18 for
coitus interruptus. The Pearl index for the female pill is 0.1-0.9, meaning that the probability of producing a pregnancy after vasectomy is 1:2000, which is about 10x safer than the female pill. Many couples make the decision for a vasectomy together and consciously, in order to spare the woman a stressful hormonal contraception such as the pill.
Before treatment
Before the vasectomy, a preliminary consultation takes place in our practice. Here, the procedure will be explained to you calmly. Furthermore, a physical examination will take place during the preliminary consultation. After the preliminary consultation, you will be given ample time to think things over. If you decide to have a vasectomy immediately after the preliminary consultation, you will be asked to sign a surgical consent form (information sheet).
You will find the original information sheet in your vasectomy folder
. You will be given this special folder to take home with you at the end of your pre-op consultation. Read through the information sheet again at home. If you have any questions or if you would like to postpone or cancel the procedure, please contact us by phone at
+41 61 226 3000 or by e-mail at
kontakt@alta-uro.com.On the day of the operation
It is not necessary for you to be sober for the procedure. On the contrary. It is advantageous if you have eaten normally and drunk enough. The day before the procedure, we would like to ask you to shave the intimate area (base of the penis and scrotum). Hair is a potential carrier of germs (bacteria) and should therefore be removed in advance. Please bring a slightly tighter fitting pair of underpants with you on the day of the operation.
Virtual reality to relax
We have recently started offering the VR goggles for our patients. The VR goggles are a unique virtual reality concept to calm, relax, distract, reduce anxiety and pain, and create a positive mood for patients and staff. Based on scientific research and numerous scientific partnerships.
Operation sequence
Vasectomy is performed on an outpatient basis in our practice. The procedure is performed under local anesthesia (local anesthesia). As an option, alta uro anxious or agitated patients can also be given doses of nitrous oxide or, if desired, a mild sedative
(Dormicum nasal spray). The operation usually takes about 30 minutes. Complications are very rare.
Step 1
Small skin incision
on the scrotum
First, the vas deferens are palpated. This is followed by a small skin incision on the scrotum. The skin opening is performed via an incision in the middle or alternatively right and left with two incisions. This depends on the mobility of the vas deferens.
Step 2
vas deferens is cut
The vas deferens is then exposed, dissected free and cut. A section of the vas deferens is removed. Then the ends of the vas deferens are first sclerosed electrically (electrocoagulation) and then tied off with a thread (ligation). The threads in the depth dissolve after 3 months. This means that this area is palpable for a while.
Step 3
Spermatic cord ends are sunk
Finally, the ends of the vas deferens are sunk into different tissue layers. This ensures that the two ends of the vas deferens cannot spontaneously reunite and recanalize (reconnect).
Step 4
Skin opening is sutured
Finally, the small skin opening is closed with a skin suture, which is performed with self-dissolving sutures. This means that the stitches do not have to be removed. The same procedure is performed on the opposite side.
After the procedure
If the procedure was performed under local anesthesia only, you should take a short rest in the practice. After this, you may go home immediately and independently. However, please note that after the application of this nasal spray, for safety reasons, you will have to spend some time in the practice after the procedure in any case and may not actively participate in road traffic. Therefore, please ensure that you are accompanied home by a companion after the operation.
After the procedure
If the procedure was performed under local anesthesia only, you should take a short rest in the practice. After this, you may go home immediately and independently. However, please note that after the application of this nasal spray, for safety reasons, you will have to spend some time in the practice after the procedure in any case and may not actively participate in road traffic. Therefore, please ensure that you are accompanied home by a companion after the operation.
The first days after vasectomy
It is advisable to schedule the procedure so that you can take it easy for three to four days after the operation. You should refrain from strenuous sports and sexual intercourse for one week. In addition, you should wear tight-fitting underwear for the first week after the operation. This will prevent uncomfortable traction on the testicles and counteract the formation of a hematoma (bruise) and/or swelling.
Complications of vasectomy
The procedure is gentle and complications are very rare. Nevertheless, bruising or wound infections may occasionally occur. To ensure that you are fully informed, a detailed explanatory discussion will take place prior to the procedure.
Post-treatment spermiogram
About 3 months after the operation, an examination of the seminal fluid (a so-called spermiogram) is performed.
This can be used to ensure whether infertility is present and the operation was successful. A second examination is recommended 4 months after the vasectomy. If this spermatogram also does not detect any sperm, further contraceptive measures can be dispensed with. In general, approx. 25 - 30 sperm excretions are necessary until all sperm have been expelled from the draining seminal ducts.
On the day of the operation, you will receive sample sets from us for submission of a spermiogram to Viollier ART and a so-called collection slip. After about 3 months you can make an appointment at Viollier ART. By this time, 25-30 ejaculations should have occurred.
The contact details for the delivery of the spermiogram are:
Andrology ART Basel, Bethesda Hospital ART for Infertility,
Gellertstrasse 144, 4052 Basel, on the 1st floor
Phone :
061 317 5905About 4 days after delivery we have the result of the spermiogram. You can discuss this with us during a telephone consultation with your attending physician. Together with your doctor you will then determine the further procedure.
The second sample set is intended for another spermiogram. We will then send you the corresponding collection form by mail. Important! Please take the current collection form with you on the day of delivery and present it to the staff of Viollier ART. This is the only way to ensure that the costs for the spermiogram can be billed to our practice.
FAQs
When should a vasectomy be performed?
In principle, a vasectomy should only be performed if family planning is really finalized, since the procedure is not always reversible.
Influence on your sexuality?
Vasectomy is not castration (removal of the testicles). Impairment of sexuality after vasectomy is extremely rare and usually has psychological causes. Nevertheless, the rumor persists that erectile dysfunction can occur or testosterone levels can drop after a vasectomy. There is no scientific evidence for this.
Is the "non-scalpel vasectomy" gentler?
The name is a little misleading, because even with this method you can not do without a small "cut". In "non-scalpel vasectomy" the vas deferens is palpated from the outside and fixed with a special clamp. Then the skin is carefully punctured, usually with a special sharp instrument, and then spread. The vas deferens thus exposed is then pulled out of the scrotum. The procedure that follows is identical to the normal vasectomy. This method promises fewer complications, but nevertheless the risks of the procedure are comparable to the classic vasectomy.
At what point is vasectomy effective?
Caution. Immediately after the vasectomy you are still capable of procreation! Therefore, you must absolutely continue to use contraception after the vasectomy.
Do I still have ejaculation after vasectomy?
After vasectomy, men continue to ejaculate because most of the seminal fluid is formed in the
prostate and seminal vesicles. The volume of ejaculation changes only minimally (about 5%). This is not perceived during ejaculation.
Does vasectomy promote prostate cancer?
This question arose in the 1980s, when scientists were looking at risk factors for the development of prostate cancer. Initially, studies showed that there could be a link between vasectomy and prostate cancer. In the meantime, however, these results have been refuted in more recent and very thoroughly conducted studies. Consequently, at the present time, there is no evidence that vasectomy is a risk factor for the development of prostate cancer.
Is the vasectomy painful?
No. In experienced hands, you should not feel any pain during the vasectomy. For anxious patients* we can use nitrous oxide at the beginning of the operation for further calming and pain control. The gas is inhaled through a special mask. The effect is rapid. The sensation of pain is decisively dampened. Once the local anesthetic has been administered, most patients do not require nitrous oxide.
Do I have pain after vasectomy?
Once the local anesthetic has worn off, slight pain may occur. Here, a painkiller can be taken if necessary. Increased sensitivity to touch of the testicles is also not uncommon in the first few days after the procedure, but usually disappears quickly. If necessary, a mild painkiller (e.g. Dafalgan, Brufen) can also be taken.
Vasectomies are final?
Vasectomy is a procedure that permanently leads to infertility. In principle, therefore, vasectomy should be performed only when the man or the couple are really sure that family planning is complete. However, life circumstances and plans can change. Thanks to the advancement of microsurgical techniques in recent decades, a reversal of vasectomy, known as vasovasostomy, now shows a very high success rate.
Physical rest
It is important that you take it easy for the rest of the day after the operation. This especially reduces the risk of post-operative bleeding. Local cooling, preferably with a gel pad, is also recommended. For about 10 days you should take it easy physically and avoid sports, cycling and sexual activity.
When can I take a shower?
Showering is allowed as early as the next day after the procedure. However, avoid strong rubbing as well as intensive use of soaps and shower gel in the surgical area. Dry yourself well after showering. A full bath is possible again after one week.
When can I have sexual intercourse?
Sexual intercourse is possible again one week after vasectomy.
Does a vasectomy protect against sexually transmitted diseases?
No. A vasectomy does not protect against sexually transmitted diseases.
Who can I contact in case of emergency?
Should severe swelling, increased redness, severe pain, fever and/or chills occur, please contact us immediately. The doctor on duty at our practice can always be reached for emergencies via the Merian Iselin Klinik switchboard on 061 305 1111, even outside opening hours. Please also do not hesitate to contact us directly if you have any further questions.
What is the cost of a vasectomy and how is it made up?
Vasectomy is a self-pay service, i.e. the compulsory health insurance does not cover the costs. However, it is worth asking, because some insurance companies give a small subsidy. If you have a supplementary insurance, it often covers a large part of the costs. It is worth asking.we charge a flat rate of 980 CHF. This package price includes everything: Preliminary consultation with preliminary examination, operation and assistance, dressing material, any emergency presentations, as well as 2 examinations of the seminal fluid (spermiograms).
In the best hands
"I felt I was in the best of hands right from the start. Everything is just right here. Thank you very much. I can only recommend it to everyone. My quality of life has improved enormously since the operation."
Top advice
Top advice friendly staffTop doctors. Very clean modern facility.
I recommend this practice 100%.
Great service
The service and support was absolutely great. I can only recommend altro uro AG.
Member of the Swiss Society of Urology
Member of the Quality Register of the Swiss Society of Urology
Certified cooperation partner of the German Cancer Society
Certified medical advice center of the German Continence Society
