Increasingly in demand, vasectomy can now be done quickly, without a scalpel

“The time had come for me to take my part in contraception. A little over a month ago, Jérôme, 51, underwent a vasectomy in the Toulouse University Hospital during an operation without general anesthesia and which will have lasted less than 15 minutes. “And I have since had a completely normal and fulfilling sex life”, assures this Tarnais, already the father of a child. A choice that he assumes and that he took after having discussed it with his companion and following the problems that the latter had encountered during the installation of an IUD.

“I knew I didn’t want more children, I knew about vasectomy and was considering it. Friends have done it, almost half a dozen, and we discussed it without taboo. Word-of-mouth compensates for the unknown side, ”continues the fifty-year-old for whom, somewhere, it is also a feminist commitment. “It’s always the women who have borne the brunt of contraception and its consequences,” notes Jérôme, who let himself be tempted by the innovative no-scalpel technique used since last September by the reproductive medicine and urology departments of Toulouse University Hospital. And apart from the “sore” testicles for ten days, nothing has changed according to him.

Under local anesthesia, a 5 mm incision

“This technique is light for the patient, but also in organizational terms. He can arrive an hour before and leave alone on his two legs. We do this vasectomy under local anesthesia, it is minimally invasive since we make a 5 mm incision, and has the same effectiveness as the classic technique under general anesthesia, “explains the professor Eric Huyghe, andrologist, whose service has already performed around fifty vasectomies thanks to this technique, which is very little used in France but very popular abroad.

However, it could make it possible to cope with the explosion in the number of requests that have emerged in recent years. While in 2015, 3,743 men used it in France, in 2021 they were 21,277. But we are still far from Canada where a third of men are vasectomized. “This is the intervention that is developing the most in our service. It must be said that we were late compared to other European countries, because of cultural issues but also legislative since it was prohibited until 2001. We are 20 years later and contraception is still assumed in 70 to 80% by the women. But today there are many men who say “I don’t want to have any more children” and resort to this permanent contraception”, underlines the doctor who hopes to be able to open a dedicated outpatient consultation.

“Switch of the contraceptive load”

To find out the objective reasons that led his patients to make this decision, Eric Huyghe questioned all those he operated on between 2010 and 2022. Of the 207 men who responded, more than half were between 36 and 45 years old. On the whole, 78% justify their choice by “a shift in the contraceptive burden” from women to men and 97% say they are satisfied to have taken the plunge.

“I have also seen it many times in consultation, among couples who have two children, the second was often an “accident”. There is also a third who has been faced with a voluntary termination of pregnancy in their couple, which is never easy to live with. For these men, this has certainly comforted them in their choice to have a vasectomy”, continues the doctor who also meets more and more patients of the “no child” movement, who do not want a child for selfish or ecological reasons. .

Motivations that remain in the minority for Erwan Taverne, co-founder of the Contraception Research and Action Group. “For me, it was the pill crisis in 2013 that led to thinking about male contraception. There was an awareness among women and they talked about it to their partners. There was an open-mindedness of the men on these questions,” insists the one whose association campaigns for the research and development of male contraceptive methods.

For several months, his group has set up sewing workshops where contraceptive underwear, also called “boulochos” or “jock-strap”, is made and which uses the thermal method worn in Toulouse for many years by the CHU andrologist, Roger Mieusset.

“In the announcements made by the government, there are always incentives for the woman to continue to carry the contraceptive load, but nothing is done for male contraception”, deplores the activist. There, used correctly, the “boulochos” device can increase body heat and thus reduce sperm production. A reversible method which is the subject of many requests, but which is struggling to find relays or support from institutions.

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