RISUG; IS THIS WORTH WAITING FOR INSTEAD OF A VASECTOMY?

RISUG is a procedure popularized in India which is supposed to be a reversible sterilization option for men.

When it comes to reproduction, men have it fairly easy.  They enjoy all of the fun of procreation, but don’t have to carry the baby or deliver it.  When it comes to preventing pregnancy, however, the advantage lies clearly with the fairer sex.  The one egg released every month by a woman makes an easy target for a variety of contraceptive interventions.  As a result, women have numerous choices for contraception.

** The closest thing to a male contraceptive is actually testosterone replacement which over time decreases sperm quality **

Men, on the other hand, present a greater challenge.  Driven by complex processes of the endocrine and reproductive systems, men produce tens of millions of sperm per day. To prevent pregnancy, every one of those specialized cells– think of them as DNA-packed Olympic swimmers – must be blocked, hamstrung or killed.

RISUG stands for Reversible Inhibition of Sperm Under guidance.  This is where a polymer gel is injected into the tube that carries the sperm called the vas deferens.  The concept that has made this appealing is that theoretically it is reversible, but it is not clear it really is.

Men in their 20s may be interested in such a procedure and reverse it years later.  The problem is that it is not clear that this procedure is as secure as a vasectomy and additionally is unclear if it is reversible.

When a man considers a vasectomy we cut the tube, and he usually wants to be extremely sure he will not father a child.  This RISUG procedure involves all the same dissection and surgery as a vasectomy but is not as safe as a vasectomy.

The hope is that this would be used as a male contraceptive.  Unfortunately, it falls way short.  I would not currently recommend this and reserve a vasectomy for men who are sure they don’t want children.  Alternatively, men can bank sperm in a sperm bank before vasectomy and have that available in the future if they change their mind.

Today, a no-needle, no-scalpel vasectomy is a minimally invasive procedure that can often be done with minimal pain and discomfort in the office.