Part Seventeen: The Impact of Vasectomy on Sexual Function and an Overview of Erectile Dysfunction

◇A Guide to Caring for Your Husband's Health as a Good Wife◇

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Treatment and recuperation of common diseases

Does vasectomy affect sexual function?

The most common male sterilization procedure is vasectomy, which involves cutting and ligating the vas deferens, the tubes that carry sperm, preventing sperm produced by the testicles from being expelled through the vas deferens, thus achieving sterilization. However, the testicles are not damaged; the seminiferous tubules and interstitial cells of the testicles continue to produce sperm and secrete sex hormones to maintain normal male sexual function and secondary sexual characteristics. Therefore, concerns about losing sexual ability after vasectomy are unnecessary. On the contrary, some men who were anxious about their partner becoming pregnant before sterilization, resulting in poor sexual performance during intercourse, find that after the procedure, without this anxiety, their libido is stronger than before.

Some people worry that vasectomy will prevent ejaculation and affect sexual pleasure, but this is unnecessary. Semen is a mixture of sperm and seminal plasma, with seminal plasma, secreted by the prostate, seminal vesicles, and bulbourethral glands, making up 98% of the total volume. Vasectomy only blocks the passage of sperm, while the output of seminal plasma remains unimpeded. Therefore, ejaculation is still possible after vasectomy; the semen will simply not contain sperm. However, it's important to note that semen may still contain sperm for the first three months after the procedure. Since these sperm were already present in the distal ducts before the ligation, contraception is still necessary during this period.

However, why do some women experience varying degrees of sexual dysfunction after sterilization? The main reason is psychological factors. These women often lack proper understanding of the procedure, harbor doubts, experience post-operative anxiety, lose confidence in their sex life, and suffer from depression, leading to functional erectile dysfunction. In some cases, improper surgical procedures can cause complications such as bleeding or infection, inducing functional erectile dysfunction.

Vas deferens reversible occlusion

Reversible vas deferens occlusion is a type of vas deferens sterilization, belonging to the same category of drug-assisted sterilization methods as vas deferens adhesion occlusion. Its indications, contraindications, procedures, and intraoperative, preoperative, and postoperative precautions are basically the same as those for adhesion occlusion; the only difference is the injected medication. Adhesion occlusion uses carbolic acid, which is corrosive and, in addition to its mechanical blocking effect, causes adhesions by inducing aseptic inflammation in the vas deferens, leading to complete closure of the lumen and preventing sperm passage. In contrast, occlusion uses a polyether-type polyurethane elastomer liquid that rapidly solidifies upon injection into the vas deferens, forming an elastic embolus that only mechanically blocks the vas deferens. The advantage of the latter is that if fertility needs to be restored, simply removing the embolus restores vas deferens patency, making it more convenient than vas deferens ligation or adhesion occlusion.

While vas deferens occlusion has theoretical advantages, some problems still exist in its clinical application, and its contraceptive efficacy and re-pregnancy rate remain controversial.

Erectile dysfunction

Erectile dysfunction (ED) refers to the inability of a man to achieve or maintain an erection sufficient for satisfactory sexual intercourse. It manifests as the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse despite sexual desire. Complete ED refers to the complete inability to achieve an erection; incomplete ED refers to the ability to achieve an erection but not with sufficient rigidity for intercourse; and primary ED refers to ED that has been present since puberty. The causes of ED are numerous. Aside from a few cases caused by organic lesions of the reproductive system, most are psychological or constitutional. In men over 50, ED is often due to physiological degenerative changes. Regardless of the type, ED prevents the completion of sexual intercourse, often leading to abnormal male sexual arousal and psychological changes in the female partner, inevitably affecting marital relationships and fertility. Therefore, the diagnosis of ED must be made with caution.

Erectile dysfunction must be differentiated from other sexual dysfunctions such as premature ejaculation and nocturnal emission. Generally, it involves three steps: treatment, observation, and diagnosis. Here is a simple test: While sleeping at night, wrap a paper ring around the penis and stick it securely. Check if the paper ring breaks when you wake up the next morning. If it breaks, it means that the penis had an erection during sleep, and therefore, erectile dysfunction cannot be diagnosed. Connecting a penile measuring device would make the diagnosis more accurate.

1. Marital discord: The vast majority of psychogenic erectile dysfunction is directly related to marital discord. When couples are outwardly harmonious but inwardly estranged, lack emotional communication, distrust each other, and even develop feelings of aversion, marital discord inevitably leads to negative impacts on penile erection.

2. Systemic diseases: Diabetes and coronary heart disease can easily lead to erectile dysfunction. Diabetic patients often suffer damage to peripheral nerves and hormone secretion, thus making them prone to erectile dysfunction.

3. Mental laborers: Statistics show that a higher proportion of intellectuals suffer from erectile dysfunction compared to manual laborers. This is because mental laborers are more prone to cardiovascular disease and diabetes than manual laborers. Furthermore, people with higher levels of education generally lead fast-paced, competitive, and stressful lives, making them more susceptible to psychological problems, while manual laborers who work from sunrise to sunset are less likely to experience these issues.

4. Smoking and drinking habits: Long-term smoking can cause spasms in the penile micro-arteries, leading to insufficient blood supply and resulting in impotence. Long-term alcohol abuse damages liver function, affecting hormone secretion, and the peripheral blood vessels and nerves of patients with chronic alcohol poisoning also suffer varying degrees of damage.

5. Long-term medication: Long-term use of certain antihypertensive drugs, sedatives, etc. can also cause erectile dysfunction.