Vasectomy is a microsurgical procedure which consists in breaking continuity of the vas deferens, i.e. the tubes that carries the sperm from the testicles. The vas deferens are severed and ligated. The procedure is considered to be the most effective contraceptive method for men, it has no negative impact on hormonal balance and does not impair sexual performance.
Ligation of vas deferens consists in breaking continuity of the skin on the scrotum and finding the vas deferens. They are then cut and their ends are coagulated. In the next step, the vas deferens are ligated with a surgical thread. The procedure takes only 30-40 minutes and is performed on an outpatient basis. Immediately after short post-procedure observation, the Patient can go home. Return to sexual activity is possible not earlier than 7 days from the treatment.
Vasectomy effectiveness is very high: that it is the most effective male contraception. The success rate of vasectomy is estimated to be 99.8 – 99.99%! No other method of contraception can boast such a high effectiveness. The Pearl index indicates how many couples in one hundred, who have used a particular contraception method, get pregnant. The value of this coefficient for vasectomy is only 0.1 – 0.15. In comparison, the Pearl index for condoms is 2-13, for withdrawal method 4-20. Of course, it has to be remembered that such a high success rate can be ensured if a sperm test is carried out. The first examination is carried out 8 weeks after the procedure, the next one – in the 12th week (only if the presence of sperms was confirmed in the first examination). Necessity to repeat the procedure is very rare: only if the presence of sperms is confirmed in the second test.
The effect of the vasectomy is male infertility. Interruption of vas deferens prevents the sperm from entering the prostate gland and then the ejaculate. It should of course be borne in mind that presence of sperms is very rarely possible in the lumen of the ligated vas deferens and in the secretion accumulated in the prostate gland. Therefore, a semen examination should be performed 8 weeks after the procedure. If no sperms are found in the semen, it is confirmed that fertilisation is not possible. If the semen does show the presence of sperms, it is necessary to repeat the test in the 12th week after the procedure. If the second test also confirms the presence of sperms, the procedure must be corrected.
A “WBS” vasectomy (PL “Wazektomia bez skalpela”) means no-scalpel vasectomy. It is considered the least invasive, safe surgical method and does not require long recovery. The procedure involves gentle removal away of the scrotal skin with a sharp instrument, without using a scalpel or extensive skin incision. At a later stage, the procedure is the same as in classic vasectomy: it consists in cutting and ligation of the vas deferens. There is no need for sutures, it is usually sufficient to apply a healing aid to the skin.
The choice of this method is associated with less invasiveness and less post-treatment pain.
The first stage of the procedure is topical anaesthesia of the scrotal skin. The next step is palpation of the vas deferens: a doctor identifies the course of the vas deferens under the skin with their fingers. The vas deferens are held at the skin surface with special forceps. The skin is disinfected and then dissected at a length of about 6 mm. It is done with special forceps. Once the vas deferens is exposed, it is brought outside and held in place. The doctor then cuts the vas deferens and both ends are coagulated. The end of the vas deferens farther from the testicle is ligated using insoluble surgical threads or a titanium clip. While the end of the vas deferens closer to the testicle remains open: this allows the sperm to escape from the testicle into the scrotum and be absorbed by the body. At the last stage of the procedure, the vas deferens are retracted into the scrotum and healing preparation is applied to the skin. After one-hour medical observation, the Patient may leave the clinic. During the first few days after the procedure, physician’s instructions should be followed and a follow-up should take place a few days after the procedure.
A vasectomy is considered a reversible procedure: if a man wants to regain his fertility, then a vasectomy reversal is performed. A vasectomy reversal is used to restore patency of the vas deferens and consists in sewing the ends of the vas deferens back together. First, small incisions are made on the scrotal skin and then the vas deferens are pulled out. We remove scarred parts of the vas deferens and then connect their ends. This restores patency of the vas deferens and allows sperm to flow again from the testicles to the prostate gland. Can a vasectomy be reversed successfully? Effectiveness of the procedure is put at around 70-90 percent. A factor that significantly influence effectiveness of a vasectomy reversal is the time at which the procedure is performed. The earlier the vasectomy reversal is performed, the better the chances of success. More than 14-15 years after the vasectomy, effectiveness of a reversal procedure decreases.
Vasectomy in no way affects hormonal activity of the testicles. This means an unchanged synthesis of the male sex hormone testosterone, which is responsible for sexual behaviour, sexual attraction or the ability to get an erection. There is no change in libido, the ability to get an erection or orgasm, and there is no change in the sensations accompanying sexual intercourse. A lot of men who have undergone a vasectomy even claim that their sex life is significantly improved: the surgery helps to get rid of the fear of unwanted pregnancy, which makes partners more open and easy-going. For such couples, frequency of intercourse may increase and the quality of erotic life improves noticeably. A vasectomy prevents the sperms from the testicles from entering the prostate gland, but this does not result in a noticeable change in the volume of ejaculate. The sperms are such a small fraction of the ejaculate that their absence does not affect the decrease in volume.
In Poland, a vasectomy is legal. More and more institutions have this procedure in their offer. This is due to the fact that the procedure does not in any way impair hormonal activity of the testicles, so it has no negative impact on health, nor is it considered by the law as a so-called permanent deprivation of fertility. Production of sperms continues, so even in case of failure of a possible vasectomy reversal, fertilisation is possible. In such a case, the testicle is biopsied and the sperms collected are used for in vitro fertilisation.
In contrast to vas deferens ligation, female tubal ligation is not legal in Poland. It is difficult to give a reason why this type of procedure cannot be performed. Tubal ligation is a reversible procedure as well, but effectiveness of such a reversible procedure is lower than in the case of a vasectomy reversal. A crucial factor may be perception of female fertility.
A no-scalpel vasectomy is performed under topical anaesthesia. It means that none of the phases of the surgery are painful: from dilation of the scrotal skin through cutting of the vas deferens to their ligation. Anaesthesia disappears soon after the procedure and slight pain may appear. The pain is so moderate that it can be relieved with over-the-counter painkillers. Due to a minimally invasive nature of the procedure, the recovery process usually runs very smoothly and is not accompanied by prolonged pain. The wound on the scrotal skin does not need to be sutured, there is no need to remove the sutures, the incisions heal very quickly. In order to improve the healing process, the man must maintain proper hygiene for a few days after the surgery and to refrain from sports and sexual activity until the wounds on the scrotum heal. If the Patient follows these recommendations, the recovery process runs very smoothly and is not painful.
Our clinic was established in 2005, thanks to which we have gained vast experience. We have performed over 30,000 procedures. We are also one of the leading training facilities for physicians and cosmetologists in Poland.
At Princesse, we use only the highest quality preparations obtained directly from manufacturers. Avoiding wholesalers, we fully reduce the risk of purchasing inauthentic or substandard products.
We have all medical devices that are needed in case of sudden complications and we employ physicians with experience not only in treating aesthetic medicine complications but also in emergency procedures.
Princesse is a modern aesthetic medicine clinic and training centre. It was established in 2005. Thanks to extensive experience and over 30,000 procedures performed to date, we have been able to select only the best procedures and equipment.
Princesse employs highly specialised medical and cosmetology staff, who continue to improve their skills by participating in seminars and conferences devoted to the fields they practice, both in Poland and worldwide.
At Princesse, we focus on naturalness and perfection as well as spectacular effects presented by models and celebrities. We believe that aesthetic medicine procedures are meant not to be a disguise, but to emphasise and highlight the strengths that each of us has.
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Cracow, Old Town
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