[Vasectomy: criteria of choice or protocol?]

The authors describe the experience of a medical staff specialized in welcoming, advising and realizing vasectomies on patients, and this according to a particular method in which traditional preliminary criteria of age, fatherhood and autoconservation are substituted by a continuous effort to listen and advise patients over a long period of time. 1385 cases have been selected over a period of one to ten years. The socio-demographic analysis defines an "ideal-type candidate": he is a middle or upper white collar; aged 37; married; he has fathered more children than the average and at a younger age than the average; and he has used up every well-tried means of contraception. The only technical variation observed was the length of the resected canal. The more widely defined failure rate can be evaluated at 2.3% of the 1426 cases. This failure rate appears to be linked with the size of the resection, too small (less than 5 mm) during two years. This caused the repermeabilization through granulomas, histologically authentified, of half of the observed cases that failed over a period of twelve years. The psychosexual consequences, analyzed through questionnaires, are judged satisfactory and confirm the possibility for the authors to accept vasectomy demands in a humanistic perspective, conciliating individual autonomy and safety in selecting candidates.