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Vasectomy, an increasingly popular method of male contraception, is appealing because of its simplicity, reliability, and effectiveness. However, its irreversible nature can sometimes lead to regret among patients. To address this, European experts, including Belgian teams, have developed a tool to predict potential regret following the procedure.

Performed under local anesthesia, vasectomy involves cutting and tying the vas deferens, which is responsible for delivering sperm from the testicles. This method offers permanent contraception without affecting the sexual drive or performance. Although it provides a viable alternative to female contraceptive methods, which are often more complicated, the irreversibility of a vasectomy makes it a risky choice, particularly in the event of a change in personal or family conditions.

The Study

The Cliniques Universitaires Saint-Luc in Brussels and Université Catholique de Louvain in Namur, both in Belgium, contributed to a major European multicenter study. Coordinated by a panel of 52 experts involved in male health, the study assessed 1200 men who had undergone vasectomy in the past 15 years.

The study was conducted in three stages. Initially, the experts identified 17 factors that could be associated with postoperative regret. These factors ranged from the patient’s age, perception of gender roles in contraception, level of education, and impulsiveness. These factors were then analyzed in the patients included in the study before being integrated into a decision-making algorithm.

Five of the risk factors were significantly associated with the risk for post-vasectomy regret: Age less than 35 years at the time of vasectomy, high impulsivity score measured using the Barratt Impulsiveness scale, low level of education, misunderstanding the concept of “definitive nature” of the procedure, and patients relying on female contraception. Three of these factors, along with two “sine qua non” conditions, were used to build the decision algorithm.

The goal was to provide a simple and practical decision-making tool for preoperative consultations. If the risk score was 4 or higher, the healthcare professional is required to inform the patient about the possibilities of information on sperm cryopreservation options before vasectomy. A score of 7 or higher suggests delaying the procedure to give the patient additional time to reflect.

This scoring system is not designed as a selection tool but rather as a guide to support informed choices.

This story was translated from MediQuality.