La vasectomia è una procedura chirurgica eseguita come metodo di controllo delle nascite negli uomini. Consiste nella resezione dei tubicini (vasi deferenti) che portano lo sperma dai testicoli. Cerchiamo insieme di scoprirne qualcosa in più.
La vasectomia funziona?
E’ una delle forme più efficaci di controllo delle nascite: ogni 10.000 interventi di vasectomia si calcolano solo 15 gravidanze non volute, funziona cioè 33 volte più del contraccettivo orale. Gli esiti negativi possono derivare da una errata procedura chirurgica o dalla non aderenza al post operatorio (occorre aspettare tre mesi prima di avere un rapporto sessuale libero). Il meccanismo di azione è semplice. Gli spermatozoi, necessari al concepimento, si sviluppano nei testicoli, all’interno dello scroto. Lo sperma viene immagazzinato in un tubo collegato a ogni testicolo (epididimo). Con l’eiaculazione gli spermatozoi dall’epididimo, attraverso il dotto deferente, arrivano al liquido seminale, con cui si mescolano a formare lo sperma. Questo a sua volta viaggia attraverso l’uretra per poi fuoriuscire. In pratica, lo sperma fisiologicamente è formato da spermatozoi e liquido seminale. Dopo una vasectomia, gli spermatozoi non si mescolano più perché vengono tagliati i vasi necessari al loro passaggio nel liquido seminale. I testicoli continueranno a produrli, ma saranno riassorbiti dall’organismo.
Come avviene l’intervento chirurgico?
La vasectomia è di solito eseguita da un urologo chirurgo, ovvero un medico specializzato nel tratto urinario maschile e nell’apparato riproduttivo. Si può fare in un centro di chirurgia ambulatoriale o in ospedale. Le tecniche per eseguire questo intervento sono due e si svolgono in anestesia locale. Con il metodo tradizionale, il chirurgo effettua dei piccoli tagli nella scroto per accedere ai vasi deferenti. Ne effettua una piccola resezione e ne rimuove una parte. Per il secondo testicolo si effettua la stessa procedura o si passa dalla medesima incisione. Basteranno un paio di punti per richiudere il tutto.
La metodica più moderna non prevede l’utilizzo del bisturi: un piccolo foro viene praticati tramite un ago nello scroto e da lì estratto il vaso deferente che a quel punto verrà parzialmente rimosso. Anche in questo caso le due estremità saranno poi richiuse o legate. Non servono punti di sutura sullo scroto. Dopo una vasectomia, la maggior parte degli uomini va a casa, il giorno stesso e nell’arco di una settimana potranno riprendere tutte le normali attività.
Tuttavia, la vasectomia non è efficace subito. Bisogna attendere che gli spermatozoi rimanenti nello sperma vengono tutti eliminati. Questo richiede da 15 a 20 eiaculazioni, o circa 3 mesi. In questo contesto andranno usati altri metodi contraccettivi. 1 uomo su 5 continua ad avere spermatozoi nello sperma anche oltre questi termini: per loro l’attesa sarà quindi più lunga. Importanti in tal senso i controlli post operatori.
I rischi
Anche se la vasectomia è un intervento abbastanza semplice oltre che altamente efficace è importante sapere che può comunque comportare dei rischi chirurgici e non. Dopo l’operazione la maggior parte degli uomini lamenta fastidio, ecchimosi e gonfiore, che in genere passano in un paio di settimane, ma se l’ematoma non passa ed è particolarmente doloroso o se si sviluppano febbre ed arrossamento scrotale è importante rivolgersi al proprio medico.
Altri piccoli e rari rischi post operatori sono:
- Formazione di un grumo nello scroto (granuloma). Si sviluppa da spermatozoi che fuoriescono dai vasi nel tessuto
- Dolore ai testicoli che non passa (sindrome di dolore post vasectomia e si verifica in circa il 10% degli uomini.)
- Fallimento vasectomia. C’è un piccolo rischio che la vasectomia non riuscirà. Questo può portare a gravidanze indesiderate. Il rischio di fallimento dipende da una serie di fattori. Ad esempio, alcune tecniche chirurgiche hanno più probabilità di errore rispetto ad altre, oppure potrebbe capitare che le due estremità dei vasi deferenti ricrescano insieme.
- Rischio di rimpianto. La vasectomia può essere una buona scelta per gli uomini e / o coppie che sono certe di non volere più figli.
La vasectomia non influenzerà l’attività sessuale ed il desiderio come pure non influirà sulla capacità di avere un’erezione o di eiaculare sperma. Non si noterà una differenza nella quantità di sperma eiaculato. Studi scientifici hanno dimostrato a differenza di quanto si poteva credere nel passato, come la vasectomia non aumenta il rischio di tumore alla prostata o ai testicoli nell’uomo. Al contempo però non preserva dalle malattie a trasmissione sessuale.
La vasectomia è reversibile?
Nella maggior parte dei casi, se ci si ripensa, la vasectomia può essere invertita: le estremità tagliate dei vasi deferenti vengono ricollegate chirurgicamente. Oppure, una estremità dei vasi deferenti è collegata alla parte del testicolo dove sono memorizzati spermatozoi maturi. In questo caso può essere necessaria l’anestesia totale. Può essere necessario attendere anche dai 12 ai 18 mesi prima di poter avere una gravidanza, ma non sempre questo avviene.
Altri post che potrebbero interessarvi:
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