Vasectomy Reversal – Patient Education
A vasectomy reversal is a need-driven decision with far reaching consequences for the opting male. Regardless of the reason behind a vasectomy reversal, what is clearly understood is that parenthood becomes an issue of critical importance.
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From the humane point of view, a Vasectomy Reversal is all about making babies, becoming fathers and raising families, once again. A successfully conducted vasectomy reversal is a sure indicator that one could become a happy and proud father very soon.
The reasons for opting for a Vasectomy Reversal, needless to say, are all very personal. Divorce, remarriage, rise in economic status, loss/fear of loss of heirs/children or even a resurgent desire of having toddlers tottering around the house once again, could prompt a rethink and second thoughts.
What is certain is that for those who decide upon a Vasectomy Reversal, fatherhood and parenting is something that assumes great importance and has connotations that are emotional, social, psychological and financial.
The deciding factors for a successful Vasectomy Reversal are – the condition of the person opting for the Vasectomy Reversal (especially the time elapsed since Vasectomy) and the experience (number of successfully performed surgeries) and skill of the doctor or microsurgeon performing the procedure.
Vasectomy Reversal Statistics
Vasectomy Reversals are opted by 6 -12% of vasectomized males. Successful reversals have been performed on men as far out as 29 to 42 years from their vasectomy. But the general opinion is that the shorter the gap from an earlier Vasectomy, the greater the chances for success.
Studies also indicate that it can take from six to eighteen months to impregnate the spouse, provided she is medically fit in terms of health and within the age parameters essential for reproduction. Which means a lot of relevant tests need to be conducted on couple to correctly evaluate the factors conducive for conception.
There have been a number of exceptional couples who have conceived within a very short time after a Vasectomy Reversal, almost within the first week after recovery. There are also those who have succeeded 2-3 years after a reversal.
Vasectomy Reversal Procedures
Vasovasostomy is the Vas to Vas reconnecting procedure, which is carried out under conscious sedation, after ensuring the presence of sperm in the Vas closest to the testicle and in the epididymis.
Urologists may use a ‘modified one layer’ to reconnect the ends of the Vas. Microsurgeons also use this method circumstantially to produce better results under high magnification that allows for finer, smaller sutures.
The two-layer vasovasostomy is preferred by many microsurgeons who micro-surgically suture both the inner and the outer layer surface of the Vas. The highest success rates have been observed using the formal multi-layer technique, even though the formal multi-layer using 10-0 or 11-0 sutures is also more challenging and time consuming.
With microsurgery both methods result in the return of sperm to semen in 75 – 97 percent of patients and pregnancy occurs in 30 percent to 75 percent of female partners, depending upon the length of time from the vasectomy until the reversal.
In the absence of sperm in the fluid sample from the Vas, it is ascertained if there is a break in the tube in the epididymis. Any tear in this single, continuous tube could result in a blockage, necessitating a more complicated, lengthier and skilled technique called a vasoepididymostomy.
This procedure bypasses the blockage in the epididymis by connecting the upper end of the vas to the tube in the epididymis, above and beyond the point of the blockage.
Under this procedure, in 60 – 80 percent males sperm returns to the semen and 20 percent to 40 percent of their partners experience a pregnancy.
Cases where both procedures – vas to vas on one testicle and vas to epidydymis on the other – become necessary are not uncommon.
Recovery from Vasectomy Reversal procedures is fairly quick. Men folk are back to work within a week. Pain in the post-op phase is not severe and easily controlled with oral medication. Surgery is carried out in an outpatient setting. Opting for a fully accredited Vasectomy Reversal center with a Board Certified Andrologist, Anesthesiologist and cordial and competent support staff ensures greater success.
While the cost of Vasectomy reversal varies from center to center and state to state, it is always more sensible to opt for an all-inclusive package that covers all tests pre and post-op. In fact some centers even offer travel and stay arrangements for out station patients.