Vasectomy Reversal in San Jose, California (CA)

Choosing to have a vasectomy is a big decision, and so is deciding to have it reversed. Often, a man who has a vasectomy does so because he is done having children or does not want to father children. Later on, however, things may change—perhaps he has remarried, is restarting a family after the loss of a child, or simply has had a change of heart. Whatever the reason, a vasectomy reversal can be performed and, in most cases, end in his fertility being restored.

During a vasectomy, the tubes that transport sperm from the testes and out of the urethra (vas deferens) are severed then obstructed via sutures or electrical cautery to prevent fertilization. In order to restore fertility through a vasectomy reversal, the cut ends of the vas deferens tubes are reconnected or are connected to the epididymis (the reproductive organ where sperm matures). If successful, sperm will return to the ejaculate and result in pregnancy.

Reversals are performed with general anesthesia and done in an ambulatory surgery center or outpatient area of a hospital. After the patient has been anesthetized, the surgeon (a urologist) will make a tiny incision on both sides of the scrotum in order to access the vas deferens. Once they have been pulled through the cuts and isolated from the scrotal sac, the scarred ends of the vas that are blocked are removed. To see if the fluid inside the end closest to the testicle contains sperm, the surgeon will take a fluid sample. If sperm is present in the fluid, this means there is no blockage between the testicle and the site in the vas from which the fluid was taken. This too means that there is no blockage in the epididymis. With this knowledge, the surgeon can perform a simpler type of vasectomy reversal, known as vasovasostomy, whereby the cut ends of the vas can be reconnected to reinstate a pathway for sperm. A microsurgical approach is considered best, as it may result in the restoration of sperm to the semen in up to 95 percent of patients and pregnancy in up to 75 percent of their partners.

If sperm is not found in the fluid sample, there may be a break in the epididymal tubule, which is often due to a backup of sperm caused by the original vasectomy. A break can result in a blockage, and this means the surgeon will need to do a more complicated technique called an epididymovasostomy, whereby the urologist must bypass the blockage by connecting the upper end of the vas directly to the epididymis, but above the obstruction. Success rates and pregnancy rates are lower with this technique than they are with a vasovasostomy.

With either technique, however, though the vasectomy reversal may be successful (meaning sperm has returned to the semen), pregnancy rates differ and largely depend on the skill of the surgeon as well as the length of time from the vasectomy until the reversal. For some who’ve had a reversal, it may take only a few months for pregnancy to occur, but for others it may take a year or more.

Following a reversal, your urologist will perform a semen analysis every couple of months until your sperm count becomes stable or pregnancy has been achieved. Sperm usually appears in the semen within a couple of months, but for some it may take up to 15 months. The latter typically occurs in men who’ve had an epididymovasostomy. Once sperm returns the semen, the man can be fertile for many years. 


About S. Shawn Gholami, MD

What is a Vasectomy?

Vasectomy is one of the most simple, safe, and effective methods of birth control. Over 500,000 vasectomies are performed each year in the United States. Vasectomy is a minor office procedure during which the small tubes carrying sperm from the testicles (vas deferens) are divided on each side of the scrotum. In order to decrease the risk that the tubes will re-connect, a small segment of the vas is usually removed and the ends are cauterized. Cutting these tubes does not affect the strength of erections, sexual desire, the size of the testicles, or a noticeable change in semen volume. The procedure takes roughly 10-20 minutes to perform and is done through a very small skin opening (2-3 mm) that is virtually invisible after it heals.
Vasectomy should be considered permanent and not a means of temporary birth control. However, vasectomy reversal is successful in up to 75% of men if undertaken in the first 10 years after the procedure is performed.

Dr. S. Shawn Gholami is an internationally recognized expert in the field of minimally invasive urology. He is one of the early pioneers in performing surgery using laser and robotics thereby minimizing risk and morbidity to his patients. Dr. Gholami has been training novice urologists and sharing his expertise worldwide since 2000. His passion for innovation and leadership is demonstrated in his work.

Dr. Gholami specializes in minimally invasive BPH prostate procedures, innovative treatment of erectile dysfunction, non-invasive treatment of sexual problems, non-scalpel vasectomies, cosmetic circumcision, and hormonal and testosterone replacement for men’s health.

Shahram S. Gholami, M.D., is one of the few physicians in California skilled in minimally invasive procedures that include “scar-less” techniques, lasers and laparoscopy. By being skilled in state-of-the-art techniques, Dr. Gholami offers his patients more choices for the treatment of urologic disease.

Featured Specialist for Vasectomy Reversal in San Jose, CA

S. Shawn Gholami, MD

Urologist

Call Now: (408) 883-3146
2460 Samaritan Drive
San Jose, CA 95124

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