After the announcement of the free vasectomy campaign of the Ministry of Health (Minsa), which will be from November 14 to 18, some myths related to the effects of this surgical intervention have resurfaced. Therefore, in this verification article we are going to disprove a false belief that this surgery causes "sexual impotence" in men who opt for this contraceptive method. We consulted with specialists in the matter, who ruled that out.

Vasectomy does not cause "sexual impotence"

The medical journal Jama Network defines vasectomy as a method of birth control and a "surgical sterilization procedure for men to prevent future fertility." He points out that it consists of cutting and blocking the vas deferens, which transports sperm from the testicles to the urethra. Once the intervention is done, the sperm cannot travel through the duct, so the man does not fertilize the woman's egg again.

"It's a myth," urologist Mariano Cuentas assured Verifier of La República after being asked if this intervention causes "sexual impotence." For the expert, "sexual impotence" is the colloquial term for erectile dysfunction that consists of the lack or absence of an erection in men due to the difficulty of filling the cavernous bodies of the penis with blood. He explained that this condition is associated with different factors such as age (the older, the higher the risk) and pathologies such as diabetes, metabolic syndrome, high blood pressure, etc.

He ruled out that the procedure produces any adverse event in the sperm and assured that it is a "minimally invasive, but irreversible" surgery unless the patient undergoes another surgical procedure. “You can put that cut back together, recanalize that cut, recanalize the vas deferens. That surgery is called a vasovasostomy, which is much more expensive, complex and sometimes unsuccessful, ”he specified.

Along these lines, the urologist José Medina also assured that it is false that vasectomy produces erectile dysfunction, a term that, according to him, is known as "sexual impotence." He argued that the surgery consists only of cutting and tying the vas deferens, whose only function is "to allow the passage of sperm from the testicles (where they are formed) to the outside."

“Nothing else is touched. So it is not related to the erection because when a vasectomy is performed it does not touch any nerve that is involved in the erection, nor does it decrease the production of testosterone, which is the hormone that is directly involved in the erection. That is why there is no relationship between erection and vasectomy, ”he settled. He also emphasized that he does not present any kind of risk against the male's sexual function either.

He asserted that erectile dysfunction is caused by several factors: stress mainly in young people and other conditions such as high cholesterol and triglycerides and low levels of testosterone that can occur in older people. He even said that "as you age, your erection naturally decreases."

For his part, the urologist Carlos Milla pointed out that vasectomy is the most effective contraceptive method and denied that it produces "sexual impotence." He mentioned that the causes of this condition are multiple and of a different nature, such as hormonal, and that it can affect young people or elderly people.

According to the expert, there is a certain difference between “sexual impotence” and erectile dysfunction: “The first basically focuses on the rigidity of the penis during sexual intercourse. Erectile dysfunction is a more general term, which not only evaluates that, but also other characteristics of the erection. However, he also denied that vasectomy causes erectile dysfunction in the patient.

“When would it have to produce an erectile dysfunction? When the innervation (transmission of nervous stimuli) is affected, that is, the nerves that innervate the penis (...) but that is very rare because these nerves are not architecturally or anatomically at the level where the vas deferens is ligated” , accurate.

And what happens to the sperm after a vasectomy? Milla explained that a "cell apoptosis" occurs, which refers to "programmed cell death." “Spermatozoa are not released and continue to form, but they are no longer expelled. So, since they are no longer expelled, the same body degrades it and converts it into nutrients, ”he assured. Thus, he ruled out any negative effects on these male sex cells.

On the other hand, we did not detect studies that reveal “sexual impotence” or “erectile dysfunction” due to the application of this method. To the contrary, the evidence shows favorable results from vasectomy.

A 2005 report concluded that "there were no cases of erectile dysfunction related to the surgery" and that this intervention caused "a positive impact on sexual function, especially sexual desire and satisfaction, in the majority of men." Another review article from 2020 stated that several evaluations confirmed “that men after undergoing a vasectomy experience markedly improved erectile function, orgasms, and sexual satisfaction.”

"Our findings suggest that sexual problems are not more frequent among vasectomized men than among non-vasectomized men," determined research published in 2010.

Urologist Carlos Milla clarified that the person is not "immediately" infertile after the procedure, since he can count on a "reserve" that continues to generate sperm. To ensure that the patient no longer contains these male sex cells in the semen, he indicated that it is necessary to carry out a control three months after the vasectomy by means of a spermatogram.

He also addressed the existence of types of vasectomies: with a scalpel, without a scalpel or with a laser. He explained that these can influence the speed of recovery, that is, some can generate a much faster recovery than others. But he stressed that, regardless of which one is chosen, infection or inflammation of the wounds must be avoided with the medications and methods indicated by the doctor.

Who can undergo vasectomy?

For the urologist José Medina, they must be people of legal age who, by personal decision, no longer want to have children or more children, since it is a "definitive procedure, whose reversal will not be easy." In fact, he assured that from the first to the fifth year (if the surgery has been done) the possibility of reversal is 90%; from the fifth to the tenth year, it is 50% and if it is more than 10 years, it is less than 10%.

The specialist commented that to every patient who seeks to have a vasectomy, he first asks if he meets the age range (25 to 30 years) and then asks personally if he already has children or not. If the patient has children, for the expert, he is a candidate for vasectomy, but if it is a 20-year-old, he wants to give him more detailed information about the method.

In addition, he added that there is an informed consent document, which is signed by the person. "There it is clearly stated that the patient has been explained that the possibility of reversing the vasectomy is not so simple, that it is a definitive method and that the patient has undergone these conditions," he said.

The Minsa family planning health technical standard indicates that vasectomy is “male voluntary surgical contraception” and that “no medical condition” prevents it from being performed. However, it includes “medical considerations” for certain patients who have a medical condition. Likewise, it presents “requirements” for before its intervention that can be reviewed here. Some of these are that the person is of legal age and not less than 25 years old "due to the high risk of repentance", that they complete "the desired number of children", receive "two prior guidance/counseling sessions".