Katowice

Warsaw

Dr Kulik has been performing vasectomies without a break since 2013

over 11,000 procedures performed personally

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Vasectomy ZdrOva is a narrowly specialised andrological and gynaecological procedure practice. At the ZdrOva practice, Dr Robert Kulik has specialised for 11 years in performing microsurgical vasectomy operations.

Vasectomy is a surgical, reversible method of contraception for men. The procedure, lasting a dozen or so minutes, is minimally invasive, without a needle and without a scalpel, using the “keyhole” method in the “Canadian” variant; it consists in blocking the patency of the vas deferens, through which sperm normally pass from the testicles – where they are produced – to the penis. The procedure is performed under local anaesthesia using an operating microscope or very powerful surgical loupes.

The effectiveness of vasectomy

It is one of the most effective methods of contraception. The effectiveness of vasectomy is higher than the average effectiveness of all methods of blocking the fallopian tubes in women.

The procedure is performed under local anaesthesia without a needle and usually takes a dozen or so minutes. Most everyday activities can be resumed the day after the procedure.

The permanence of vasectomy

Vasectomy is a permanent method of contraception (so-called sterilisation), unless the man who has undergone it undertakes costly efforts to restore his fertility through a vasectomy reversal (an operation to suture the vas deferens back together) or in vitro fertilisation (IVF).

Vasectomy – who is it for?

Vasectomy is most suitable for a man who is certain he will not want more children. Men considering this method of contraception should take into account that a possible operation to restore the patency of the vas deferens (vasectomy reversal, vasovasostomy, vasoepididymostomy) or even in vitro fertilisation (IVF) do not always succeed. Similarly, the regaining of fertility by a woman using the so-called coil does not guarantee she will be able to conceive after it is removed from the uterus. That is why both vasectomy and the “coil” are addressed mainly to women and men who already have children.

Another group of men, rare in today’s world, for whom a vasectomy makes sense, are adult men
who often have casual, unprotected encounters with previously unknown partners – under the influence of substances that impair awareness.

Men experiencing such situations should consider taking responsibility for the possibly uncertain fate of an accidentally conceived child, of a desperate pregnant woman, often a single mother, and their own fate burdened with responsibility for the rest of their life.

Vasectomy – who benefits

The man, the woman and the children they already have all benefit.
Sex without worry is better. Just as pure honey is better than honey with a drop of tar added.

As studies show, sex after a vasectomy improves

One of the advantages of vasectomy is that it is a modern method of contraception (rather new in Poland) protecting women from the side effects of long-term use of contraceptive hormones, which very often involve a drop in libido, fits of anger and depressive moods. With long-term use of hormones, the risk of developing cancer increases. A vasectomy can free women from the need to use other methods of contraception, e.g. the intrauterine device (the coil), when these cause various complications. Some people also tolerate condoms less than well.

 

Does the vasectomy method matter?

We explain vasectomy to patients using anatomical models

Blocking the vas deferens is done all over the world with various combinations of elements. One end or both ends are closed by tying with sutures (a rather unreliable method), clamped with clips (a somewhat better method, but also rather unreliable), a fragment of the vas is excised, it is closed with electrocoagulation, and left or not left inside the spermatic cord. Different variants are used by different doctors even in the same city. Older methods are widely used even in countries where vasectomy is very popular. To be fair, it must be noted that all these methods are very effective as contraception; it is only with the older variants that the procedure has to be corrected more often and that various, usually transient, forms of discomfort occur more frequently.

Vasectomy – the so-called “Canadian method”

At ZdrOva in Warsaw and in Katowice we perform vasectomy using the no-scalpel method in the so-called Canadian variant:

1. without a scalpel (the 4-8 mm opening in the skin is made with special dissecting forceps invented by Dr Li Shunqiang)
2. without a needle.
3. It is a minimally invasive method. Its so-called “Canadian” variant, described by the centre in Quebec, is the one we use. This method carries:
   1. the lowest rate of complications and
   2. the highest effectiveness, and that is why it has been recommended by the American Urological Association.

This variant consists in:

1. not placing sutures or clips on the vas deferens itself, but only coagulating (thermally shrinking) the end leading to the penis. This ensures very high effectiveness, measured by the rate of procedures that have to be repeated because of the presence of sperm, and
2. bringing the open end of the vas deferens coming from the testicle outside the sheath of the spermatic cord and leaving it there. This ensures that so-called “chronic testicular pain” almost never occurs:
   • because the sperm produced have an outlet and
   • they exit into a place where no nerves run (in the cord, alongside the vas deferens and blood vessels, many nerve fibres run). There they are absorbed, just like all dying and unneeded cells in the body.
3. The opening in the sheath of the spermatic cord, which contains the testicle and through which the vas deferens runs, is closed with a special clip or with a suture.

This variant was listed first among three others in the Guideline Statements, point 7). PDF

Which vasectomy method is best?

Vasectomy effectiveness depending on the method used.
The American Urological Association carried out an analysis of all available scientific publications printed between 1949 and 2011. About 70 researchers analysed the results of several thousand papers. It turned out that the conflicting reports on the effectiveness and various complications of vasectomy result mainly from the method used to perform the procedure. The oldest methods, consisting in cutting and tying both ends of the vas deferens, carry the highest failure rate. In some centres the need to correct the procedure because of the constant presence of sperm in the ejaculate reached 13%. Of course, the pregnancy rate with these methods still remains very low. Such centres simply perform a usually free “correction” when the semen analysis after the procedure shows it was ineffective. The American Urological Association recommends using the Open Ended method, with the open testicular end brought outside the sheath of the spermatic cord (FI, fascial interposition) and cauterisation of the segment leading to the penis (thermal cautery).

Needle-free anaesthesia

For anaesthesia during a vasectomy in Warsaw (as well as in Katowice), a special device is used that injects the anaesthetic without the need for a needle. That is why a vasectomy is a painless procedure. The sensation accompanying the delivery of the anaesthetic resembles “being flicked with a rubber band”. Unlike anaesthetic given with a normal needle, it works immediately (there is no need to wait for the drug to spread into the surrounding tissue). Many patients describe the discomfort during the procedure as far less unpleasant than a visit to the dentist.

Men who are afraid of a vasectomy should watch these films:

Is a vasectomy the same as castration?

Of course not!
Castration is a procedure consisting in the removal of the male sex gonads (the testicles). It leads to many serious changes in the individual subjected to it. In the past it was used on boys who were to look after a harem, or who were to sing in the opera. Such practices are not used in today’s civilised world. Only in the case of testicular cancer is amputation of the testicle necessary. If one testicle has not been removed, the man is still fertile and still produces androgens. Only in the case of bilateral tumours is it necessary to amputate both testicles, and that could be called castration. In such cases other glands (the adrenals) take over the production of male sex hormones.

Incorrect or imprecise terms (names) for vasectomy

There are many incorrect and misleading terms for the vasectomy procedure.

Our locations

We perform vasectomies in Warsaw and in Katowice

Vasectomy in Warsaw

In Warsaw the ZdrOva practice is located at 6 Floriańska Street, unit U-4

Address: ul. Floriańska 6, unit U-4, 03-707 Warsaw

tel: 607 776 777

HOW TO FIND US

The building at 6 Floriańska Street is so large that one big wall adjoins Floriańska Street. It took its postal address from that street. Its other, even larger wall adjoins Jagiellońska Street.

Our clinic is on the Jagiellońska Street side.

The entrance is straight from the pavement.

It is best to enter the address 03-707 Warsaw, ul. Jagiellońska 32 into your GPS navigation. This is the building opposite the entrance to ZdrOva.

Vasectomy in Katowice

In Katowice the ZdrOva practice operates on the premises of the NL-Clinic at 68 Obroki Street

Address: ul. Obroki 68, 40-833 Katowice

tel: 607 776 777

How to get there:

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