Saturday, August 20, 2016

Basics Relating To Sterilization Reversal

By Andrew Mitchell


The use of surgical contraception options (vasectomy and tubal ligation) has increased tremendously in recent times. They are by far the most effective methods of birth control for both men and women. In some cases, however, some patients may need to reverse the procedure in a bid to regain their fertility. There are a number of things on sterilization reversal you need to know if you have plans of undergoing the procedure.

The microsurgical technique is the commonest method that is used in the restoration of fertility in men that have undergone vasectomy. The technique is so named because of the small incisions that are used during the process. Microscopes are often needed to magnify the anatomical structures that are being operated. Although other surgical techniques exist, success rates have been shown to be highest when the microsurgical approach is used.

Restoring semen flow can be achieved in two main ways. The first approach, also known as vasovasostomy, is where the two stumps left behind after vasectomy are re-joined. In the second method, the stump that joins the urethra is joined to the epididymis. This is the region in which sperm cells are stored before ejaculation. This method is thus also known as vasoepididymostomy.

This operation is largely safe with just a few complications being encountered rarely. These include, for instance, excessive bleeding, accumulation of blood within the scrotum and postoperative infections. Fortunately, these are fairly manageable. The success rate of reversal of vasectomy ranges from 70% to 90%. The operation is likely to be successfully when done within three years of vasectomy. Contrary to common belief, age is not a major determinant of success.

The surgery is considered a day case in most centres. What this means is that one can go home on the same day that they are operated. The operating time is anything between two and four hours depending on whether or not complications are encountered. Regional (spinal) anaesthesia is usually used for the procedure which ensures that the patient remains awake. Return to regular routine is immediate.

Tubal ligation works in the same way as vasectomy in women. This method of birth control is performed by cutting, clipping or cauterising the fallopian tubes that are found on either side of the uterus. While the option has for a long time been considered a permanent method of contraception, advances in surgical practice have made it possible for women undergoing the procedure to regain their fertility.

The success of reversing tubal ligation is hugely dependent on the technique that is used in blocking the tubes. Clipping, for instance, can be reversed more easily as compared to cutting or cauterizing. You will be subjected to a number of tests by your fertility doctor before undergoing the reversal procedure. This include blood tests as well as radiological imaging studies such as the hysterosalpingogram.

Failure of these procedures can be caused by a number of things. Among the commonest causes is the presence of extensive scar tissues in and around the tubes. The scar tissue may block the tubes which subsequently interferes with the movement of the ovum or the sperm cells. Another common cause of failure in men is the presence of anti-sperm antibodies. There is a need for screening for these antibodies before the surgery is undertaken.




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