Dohle G R, Meuleman E J H, Hoekstra J W, van Roijen H J, Zwiers W
Erasmus MC, afd. Urologie, Postbus 2040, 3000 CA Rotterdam.
Ned Tijdschr Geneeskd. 2005 Dec 3;149(49):2728-31.
Vasectomy is a simple and reliable method of contraception. Problems associated with vasectomy include inadequate patient information, complications of the procedure e.g. infection and scrotal bleeding (4-22%), chronic scrotal pain after the procedure (2-5%) and spontaneous recanalisation with return of fertility (0.03-I12%). Later in life a substantial number of men come to regret having a vasectomy, notably those who underwent it at a young age and those without children of their own. After 10 years 2.4% of vasectomised Dutch men have a refertilisation procedure (usually a vasovasostomy) because of the wish for children in a new relationship. Since vasectomy is an elective procedure and not done on medical indication, it requires an extensive informed-consent procedure for the patient. Insufficient information may result in inadequate follow-up, omission of semen analysis, and consequent legal procedures should complications or pregnancy ensue. Clearance after the first semen analysis at 3 months can be given if azoospermia is seen or if less than 100,000 non-motile spermatozoa are present in the ejaculate.
输精管结扎术是一种简单可靠的避孕方法。与输精管结扎术相关的问题包括患者信息不足、手术并发症，如感染和阴囊出血（4%-22%）、术后慢性阴囊疼痛（2%-5%）以及输精管自发再通并恢复生育能力（0.03%-1.2%）。在晚年，相当多的男性后悔做了输精管结扎术，尤其是那些年轻时做了该手术以及没有亲生孩子的男性。10年后，2.4%的荷兰输精管结扎男性因希望在新关系中生育而接受了恢复生育能力的手术（通常是输精管吻合术）。由于输精管结扎术是一种选择性手术，并非基于医学指征进行，因此需要为患者进行广泛的知情同意程序。信息不足可能导致随访不足、遗漏精液分析，以及如果出现并发症或怀孕而引发法律程序。如果在3个月时首次精液分析显示无精子症，或者射精液中存在的不活动精子少于100,000个，则可以给予许可。
