Tying the testicles (ligation of the vas deferens / tying of the vas deferens) – what is it about?

Ligation of the vas deferens / tying of the vas deferens (vasoligation), sometimes incorrectly called tying the testicles, is one of the ways of sterilising men. In Poland the name that has caught on is the imprecise term vasectomy, which literally means excision of the vas deferens. Some of the most modern vasectomy methods do away entirely with excising a fragment of the vas deferens, bearing in mind a possible future microsurgical reconnection of the vasa. After a fragment has been excised, the vasa may be too short. Sterilisation is a permanent – and in the case of vasectomy reversible – method of male contraception.

Ligation of the vas deferens aims to block the “tubes” carrying sperm out of the testicle, so that sperm produced in the testicles and stored during the first stage of maturation in the epididymis – cannot get into the ejaculate. The end result is the inability to fertilise a woman during intercourse.

Ligation of the vas deferens (tying the testicles) is an older and less effective way of occluding (blocking) the vas deferens. With the tying of the “testicles”, recanalisation of the vas deferens occurs quite often and sperm appear in the ejaculate. This means that in as many as 13% of vasectomies using ligation of the vas deferens, the procedure has to be performed again.

Ligation of the vas deferens / tying of the vas deferens (tying the testicles) – where is the problem?

Tying of the vas deferens – the problem is that after a vasectomy using “tying of the testicles” the man still produces sperm. The blockage (obstruction) of the vas deferens, through which sperm normally leave, means they have nowhere to go, and this can (fortunately not always) lead to various complications.

Recanalisation

One of the possible complications is so-called recanalisation, i.e. the reopening of the previously tied (externally clamped) vas deferens. This may result in sperm appearing in the ejaculate, which makes the vasectomy ineffective. Usually a repeat vasectomy then has to be performed. All over the world the doctor performing the correction usually charges no additional fee, and since the procedure is minimally invasive, patients who experienced it during the first procedure are usually not stressed by it