[Vasectomy: indications and implementation in historic perspective].

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.