Operative kontrazeptive Verfahren bei Männern – Vasektomie und reversibler Verschluss der Samenleiter

The sterilization of men (vasectomy) is so far the only contraceptive method apart from the use of condoms that is available to men. It is based on a permanent surgical bilateral severance of the vas deferens and should therefore be reserved for men who do not (or no longer) want children. The contraceptive safety is classified as very good with a Pearl index of 0.1–0.15. The vasectomy is mostly carried out as an outpatient procedure using local anesthesia. The general spectrum of complications corresponds to other superficial interventions, such as postoperative formation of hematomas (4–22%) or wound infections (0.2–1.5%). In rare cases specific complications are chronic testicular pain and early or delayed recanalization with renewed detection of spermatozoa in the ejaculate. The postoperative confirmation of azoospermia in the spermiogram as a control of the success of the intervention as well as its correct performance (Handbook of the World Health Organization) therefore plays a decisive role. Other procedures for partially reversible obstruction of the vas deferens, such as a spermatic duct valve or injectable polymers, are currently in various stages of scientific and clinical testing; however, reliable data on the contraceptive protection, the risks and the intended reversibility are not yet available.