Saturday, March 26, 2016

Options On How To Reverse Vasectomy

By Mary Williams


Vasectomy is generally regarded as a permanent contraception method. It involves the ligation of the vas deferens, an important conduit of semen (and sperm cells) to the female genital tract. The disruption of continuity means that the sperms cannot be transferred to the female genital tract and hence fertilization cannot occur. There are a number of things that you need to know if you plan to reverse vasectomy.

One of the most effective surgical techniques that have been adopted for this procedure is microsurgical vasectomy reversal. In this technique, the structures of interest are accessed using very small incisions and done with the use of a microscope. Success rates are a lot higher as compared to other techniques and complications have been significantly reduced. Two main approaches can be used. The first involves re-joining the two stumps (vasovasostomy) and the second is the joining of the vas deferens to the epididymis (vasoepididymostomy).

While numerous improvements have been made on the techniques that are used, failure is not uncommon. One of the reasons as to why this is the case is the fact that the vas deferens is a very small tube that is greatly affected by scarring once ligation has been done. The scar tissue has to be removed before the two stumps are re-joined. The two stumps may be of different diameters which serves to reduce success rates as well.

Before undergoing the surgery, one has to be evaluated by their urologist. Part of the evaluation includes determining that indeed the subject was fertile before the ligation of their vas deferens. The next important thing at this stage is to find out if any sperm antibodies exist within the semen. If found, the probability of ending up with a pregnancy is next to nil and assisted reproductive options should be sought.

Research shows that success rates may be as high as 70% to 90%. Age, is not a major determinant of who succeeds and who does not. However, the duration of time that elapses from the date of ligation does influence fertility rates to a great extent. Generally, persons who undergo the procedure within three years of vasectomy have success rates in excess of 50% while those that have it after more than 10 years have a rate that is as low as 30%.

The microsurgical procedure is regarded as being generally safe but there are a number of complications that may be encountered albeit rarely. In the immediate post-operative period, the common complications include excessive bleeding, fluid accumulation within the scrotum (also known as hydrocele) and infections. Nerve fibers may also be injured. Rare complications include deep venous thrombosis and reaction to anesthesia.

The microsurgical operation is usually done in outpatient clinics. It typically lasts between two and four hours except in cases of extensive scar tissues in which more time may be required. Since spinal anesthesia is used in most cases, one can leave the hospital on the same day the operation is performed. Pain is mild to moderate and most people resume their normal routines within about three days.

When it comes to fertility, one should bear in mind that there are two partners involved. Both have to be investigated thoroughly before a diagnosis of failure can be made. The chances of the fertility problem being attributed to the woman are highest in women older than 35 years particularly if they have never conceived before.




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