Mi esposo y yo nos preguntasmos acerca de la vasectomía…

La pareja y la vasectomia

“Ya no queremos tener hijos y mi esposo está considerando la posibilidad de someterse a una vasectomía. Nos preguntamos cuáles son las ventajas y desventajas”. La Dra. Catherine Solano responde a Lauranne, de 45 años.

En primer lugar, se trata de saber qué es la vasectomía. Es una operación que se realiza en los hombres y que consiste en ligar los dos conductos deferentes situados en los testículos. Su objetivo es prevenir la presencia de espermatozoides en el semen. Después de una vasectomía, ésta ya no es fértil.

¿Cómo debemos proceder y cuáles son los plazos?

Durante la primera consulta, el urólogo cirujano entrega un folleto a su paciente para informarle sobre este método y sobre anticonceptivos alternativos. Un período de reflexión de cuatro meses es entonces obligatorio antes de la segunda consulta, lo que permite firmar un consentimiento.

¿Cómo funciona el procedimiento?

Durante la operación, realizada bajo anestesia local, el cirujano hace una pequeña incisión antes de cortar los conductos deferentes de cada testículo y luego cerrarlos. El operado puede volver a casa el mismo día.

Tres meses después, un espermograma confirma la ausencia de espermatozoides en la semilla. Durante estos tres meses, se requiere anticoncepción (condones o anticonceptivos femeninos).

¿Cuáles son las consecuencias de la cirugía?

Los espermatozoides cambian poco en apariencia y abundancia, incluso si, bajo el microscopio, no se observan más espermatozoides. De hecho, una gran parte del esperma es producida por la próstata y las vesículas seminales, órganos que continúan funcionando normalmente después de la vasectomía.

No se observan cambios en la erección, orgasmo o eyaculación, ya que los nervios y vasos que les permiten funcionar no se ven afectados por el procedimiento. Pero tenga cuidado, la vasectomía debe considerarse irreversible, porque la reparación del conducto deferente rara vez resulta en un embarazo.

La inseminación con espermatozoides congelados permite que una pareja tenga un hijo, incluso después de una vasectomía.

¿Cuáles son las “ventajas” de la vasectomía?

– Realizado bajo anestesia local, el procedimiento es relativamente inofensivo y no causa ningún efecto hormonal o farmacológico indeseable.

  • Es definitivo, permitiendo a la pareja estar serena durante mucho tiempo.
  • La pareja ya no necesita anticonceptivos (píldora, DIU, parche, implante…), con los consiguientes efectos secundarios. Por lo tanto, se libera de esta carga que, en la mayoría de los casos, sólo recae sobre las mujeres.
  • Incluso si es irreversible, es posible tener hijos después de una vasectomía. Sin embargo, es necesario haber utilizado la autopreservación de los espermatozoides antes del procedimiento.
  • Se trata de recoger los espermatozoides por masturbación y almacenarlos a muy baja temperatura en un Cecoe (Centro para el estudio y conservación de óvulos y espermatozoides). Si la pareja desea tener un hijo más tarde, la inseminación con este semen congelado lo permite.

¿Y sus desventajas?

El aspecto más embarazoso es que este gesto definitivo puede ser psicológicamente dañino tanto para hombres como para mujeres. Esta es la razón del período de reflexión estatutario de cuatro meses.

Por otro lado, una vasectomía tarda bastante tiempo en ser efectiva: cuatro meses de reflexión, luego tres meses, el tiempo de expulsión de los espermatozoides, un total de siete meses.

Esto puede parecer largo o incluso riesgoso porque se debe usar otro método anticonceptivo durante este período. También hay un pequeño porcentaje de fracaso, alrededor del 1%. Fracaso debido al sexo sin protección demasiado temprano, o porque los conductos deferentes se han repermeabilizado.

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