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 John C. McHugh, MD
In November 2008, Northeast Georgia Urological Associates opened a new, state-of-the-art surgical facility to provide you with an alternative the hassle of outpatient hospital procedures. This state licensed facility is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.
Since one of the largest impediments to the couple desiring a vasectomy reversal is cost, having our own facility both streamlines the process and minimizes the cost. Not having to go to a hospital makes the procedure more efficient for the patient and makes it is much more cost effective and affordable.
The vasectomy reversal patient can take comfort in knowing that the urologist and the anesthesiologist are board certified physicians and that the procedure is performed with microscopic instrumentation in an accredited facility.
At Northeast Georgia Urological Associates we have performed several thousand vasectomies in our 30 year career in Northeast Georgia. We utilize the No Needle No Scalpel technique and whether we perform your procedure in our office with oral and local sedation or general anesthesia in our Surgery Center you can rest assured we will do everything we can to make your procedure pain free.
Featured Specialist for Vasectomy Reversal in Gainesville, GA
Call Now: (770) 884-7165 660 Lanier Park Drive Suite AGainesville, GA 30501