Krefeld (dpa / tmn) Heiner Fischer is infertile. He speaks it openly – without melancholy, anger or shame. The 38-year-old from Krefeld made a conscious decision to do so. He had his vas deferens severed to ensure he would no longer be able to father children.
This medical procedure is called a vasectomy. “Not a big deal compared to giving birth,” says Heiner Fischer. He made the decision together with his wife. Because as a man, he feels just as responsible for contraception as she does.
Only about three percent of all men in Germany opt for a vasectomy like Heiner Fischer.
The cutting of the vas deferens beats other contraceptive methods in terms of safety by far. That says the so-called Pearl Index, which compares contraceptive methods.
A vasectomy is permanent
The big difference to the pill, condom and spiral: A vasectomy is a surgical procedure and should be regarded as the final step.
Prof. Florian Roghmann, specialist in urology and senior physician at the University Hospital of the Ruhr University in Bochum, agrees: “It is possible to go back by surgically restoring the vas deferens, but it does not necessarily have to work.”
However, the finality of the vasectomy was not an issue for Heiner Fischer and his wife. Her family feels complete with her two children. The couple wanted to find a way to have sex with each other without any embarrassment.
The operation takes around 30 minutes
But what exactly happens on the operating table? “A vasectomy can be performed on an outpatient basis under general anesthesia or with local anesthesia,” explains urologist Florian Roghmann.
The doctor makes an incision about one centimeter long on the right and left in the area of the scrotum and pulls out a section of the vas deferens. Now cut out a piece about one and a half to two centimeters long.
In rare cases, the severed vas deferens can be found again in the tissue and grow together. To prevent this, the urologist obliterates the ends of the vas deferens, ligatures them and turns them over. The wound is then sutured in different layers of tissue.
According to Florian Roghmann, complications are rare and usually do not go beyond the classic surgical risks.
Sperm analysis proves infertility
For a while after the operation, however, Heiner Fischer had to give up unprotected sex. Urologist Florian Roghmann explains: “After the vasectomy, sperm can still be found in the downstream sections of the genital apparatus. These can still be contained in the first ejaculations after the operation.”
Before unprotected sexual intercourse, infertility must therefore be proven by means of a spermiogram around one to three months after the surgical procedure.
Contraception clarified – free your mind for liberated sex
Heiner Fischer’s vasectomy was almost a year ago. He’s happy with his decision. «The sexuality between me and my wife is much more free and intense. We don’t have to think about her cycle and can get intimate with each other more spontaneously.”
Heiner Fischer doesn’t feel any restrictions or changes physically either. His body continues to produce sperm. However, they no longer get into the semen. Instead, the body breaks them down.
Heiner Fischer paid around 500 euros for the vasectomy. The health insurance companies usually do not cover the costs.
Female sterilization: how the procedure works
What can be done with men can also be done with women. They can be sterilized by cutting their fallopian tubes. As with a vasectomy, the procedure can be performed on an outpatient or inpatient basis, explains the Berlin gynecologist Martina Nagel.
Under general anesthesia, the fallopian tubes are severed over a length of one centimeter via a small incision near the navel, sclerosed and closed with a clip. The procedure costs between 600 and 1000 euros.
The operation is usually not risky, says doctor Martina Nagel. In very rare cases, bleeding, infections in the wound area or damage to the intestine or bladder can occur. After the operation, abdominal pain could occur – around a week of rest is advisable.
This intervention is also final. “It is possible to make the ends of the fallopian tubes permeable again, but there is no guarantee,” says Nagel.
The advantage of this contraceptive method: women do not have to take hormones, as is the case with the pill, for example. However, demand is low, as Martina Nagel notes.
What happens a little more often is sterilization in the course of a caesarean section, when family planning is complete. “The women are then already under anesthesia and the abdomen is already open anyway,” says the gynecologist.
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