[Vasectomy: indications and implementation in historic perspective]. / Vasectomie: indicaties en uitvoering in een historisch perspectief.

ABSTRACT

Approximately 35,000 vasectomies were performed in the Netherlands in 2004. Although vasectomy may be looked upon as the most reliable method of contraception (risk of pregnancy in the first year 0.08-0.15%), realistic preoperative counselling about possible complications such as haemorrhage (5%), wound infection (5%), and haematoma (14%) and long-term consequences such as the wish for renewed fertility (2.6% of the men opt for vasectomy reversal), the delayed achievement of sterility (4% three months after vasectomy), chronic scrotalgia (5%) and the risk of recanalisation (0.28-00.5%) is of utmost importance. Moreover, the couple should be convinced that vasectomy can only be considered successful if less than 100,000 non-motile sperms per ml are demonstrated by a certified laboratory in a post-vasectomy semen analysis. As an alternative for vasectomy, several clinical studies to assess the value of male hormonal contraception are currently in progress.