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Vasectomy Reversal
- Jan 7, 2009 at 9:50 PM
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Vasectomy Reversal
What happens during a vasectomy reversal and what are the statistics for restoring fertility?
By Kathleen Blanchard, RN , Sexual Health Correspondent
Page 1: Vasectomy Reversal
Learn about vasectomy reversal
Men who have had a vasectomy might opt for a reversal. While the
procedure is most often successful, there are no absolute guarantees.
If you've made the tough decision to have a vasectomy, why would you
want to undergo a vasectomy reversal? Well, some men might want to
start a new family or maybe some men might want to have their vasectomy
reversed because they have pain in their testicles. Vasectomy reversal
surgery is complicated and it's not as easily performed as the
vasectomy. Plus, the surgery is more costly.
What happens during a vasectomy reversal procedure and what are the statistics for restoring fertility? We'll answer these questions and more in our discussion of a vasectomy reversal.
How a vasectomy reversal is done
Vasectomy reversal can be performed two ways:
One procedure involves reattaching the ends of the vas deferens (the
duct that carries sperm) back together (vasovasostomy). After your
surgeon sews the ends together, the vas deferens is then attached to
the epididimis -- the storage area at the back of the scrotum where
sperm matures. If stitching the vas deferens back together won't work,
because of damage that might interfere with potency, your doctor may
need to directly attach the sperm duct to the epididimis, bypassing the
area that is blocked (vasoepididymostomy).
The exact
procedure is decided after your surgeon gets a view of your anatomy
during the procedure itself. Until then, you won’t know which approach
is needed. It’s also possible that one side will result in a
vasovasostomy, while the other requires vasoepididymostomy.
What you should consider
Vasectomy reversal is not usually covered by insurance. If a medical
necessity exists, ask your physician to intervene on your behalf,
providing records to your insurance carrier. Post vasectomy pain
syndrome has caused some men to experience persistent discomfort. The
cause of this discomfort is unknown.
It's important to gather
success stories from your surgeon before you choose who will perform
the procedure. So, you'll want to know how many vasectomy reversals
actually worked, in addition to having all of your questions answered
and involving your partner during the consultation.
Prices vary, and can cost as much as $12,000; beginning at around $5,000.
Does vasectomy reversal work?
Over half of vasectomy reversal procedures work. The chances of adequate sperm count
decline over time. If it’s been more than 15 years since your
vasectomy, the possibility of success is still there, but the chances
are reduced. If you’ve fathered a child, your doctor will know that you
are a good candidate. Otherwise, it might be necessary for the surgeon
to perform a biopsy using a small needle inserted into the testicle.
The results can provide information about hormone levels and sperm
count.
If the goal is starting a family, your partner’s
reproductive health is an important factor as well. Optimal health of
both partners increases the chances of a positive outcome.
Learn what to expect from vasectomy reversal and more...
Page 2: Information About Vasectomy Reversal
What to expect from a vasectomy reversal
You should be able to go home the same day, unless there are unexpected
complications. Vasectomy reversal procedures are performed in the
hospital or at an outpatient surgery center and they take about four
hours.
There is a risk of bleeding, which means that it’s
important to refrain from the use of aspirin or pain medication (such
as Ibuprofen) that promotes bleeding. Do not take any supplements or
herbs. If you do take any, discuss it with your surgeon as garlic
capsules, willow bark and gingko biloba can increase the risk of
complications from bleeding. Green tea supplements can also contribute.
You can usually decide whether you prefer general anesthesia or a
spinal nerve block (epidural). Discuss the pros and cons of each with
your physician before you proceed with your vasectomy reversal.
After the procedure, you’ll need someone to drive you home and you'll need an athletic support to wear after surgery. You will also end up with a small scar on the underside of your scrotum.
Nerve damage is possible during a vasectomy reversal, which could result in chronic pain.
If sperm leaks into the scrotum after surgery, a small mass (called a
granuloma) can form and reduce your chances of reproducing. A granuloma
is a benign mass that forms in the body in response to inflammation,
bacteria, fungus or a virus.
It's important to follow your doctor's instructions to ensure a good response to the surgery.
No guarantees, so why do it?
To avoid disappointment, many men have their sperm frozen during a
vasectomy reversal. Your surgeon can identify healthy sperm by looking
under a microscope. Later, the sperm can be directly injected into your
partner’s egg, via a procedure called ICSI (intracytoplasmic sperm
injection).
It may take up to two years for your partner to
become pregnant if you decide to go the natural route. Depending on the
type of procedure performed, sperm production usually occurs within
three to 15 months.
Your decision can be made easier through a good rapport and open communication with your doctor.
If you decide to have your vasectomy reversed, make sure you write down
all of your questions. Speak with other men who have had the procedure
-- internet forums can be very useful for this, but be wary. Check out
your physician’s health grade at healthgrades.com.
Regardless
of the unknown, it’s important to approach any decision with a positive
and open mind. Fear and stress are known hindrances to healing.
Resources:
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