Vasectomy Reversal
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Vasectomy Reversal

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Vasectomy reversal is a safe, delicate microsurgical procedure that is growing in availability and popularity.

WHO IS THIS FOR? - Who typically would consider having a vasectomy reversal?

ANATOMY & TERMS - Illustration of the male anatomy and a list of terms with helpful definitions.

HOW IT'S DONE - What are the basic surgical steps in a reversal procedure?

RISKS & COMPLICATIONS - What are the general risks and possible complications in the near and long-term?

ALTERNATIVES - How does a vasectomy reversal compare with alternatives available to a couple?

AFTER YOUR REVERSAL - A guide to the days and weeks that follow a vasectomy.

All about vasectomy reversal.

A vasectomy reversal is a microsurgical procedure performed by a urologic surgeon to reverse sterility caused by a vasectomy. VR is performed by microsurgically reconnecting - in either single or multiple layers - the cut ends of the vas deferens, the small tubes that carry sperm from the man's testicles. The fine sutures used are no thicker than a human hair. The rejoined vas can again become a passageway for semen to be ejaculated at orgasm. Surgical success is indicated if sperm is detected in the fluid inside the vas after initial incision. At times when a blockage (causing increased pressure in the epididymis) is suspected, the blockage must be bypassed in an alternate reversal procedure known as a "vasoepididymostomy."

An effective vasectomy reversal simply allows sperm to rejoin the seminal stream during ejaculation and should not affect your sexual drive, your ability to have an erection and orgasm or your ability to have and enjoy sex. Sperm is only a small fraction of the total liquid in your semen. The amount of fluid, intensity - even color and texture - does not appear to change once your seminal fluid again contains sperm.

Although a vasectomy should be regarded as permanent, advances in microsurgery have resulted in surgeons being able to reverse the procedure, and restore fertility, in many cases.

The technical name for a vasectomy reversal is a vasovasostomy. This is surgically performed by reconnecting the previously cut ends of the vas deferens to rebuild an open vas channel for sperm to again become part of the man's ejaculate.

Each year, a number of men elect to have a reversal of their vasectomy, often because of a change in their lives, such as having a new spouse through remarriage, and the desire for a second family, or a change in family planning goals within the same marriage. The reversal procedure is performed for about 50,000 men each year; a number that is growing with the more widespread availability of the procedure, reduced cost factors, and the training and experience of more surgeons who perform it.

The likelihood of successfully restoring an open vas channel involves many factors, but can be as high as 97 percent if the original vasectomy was performed less than three years previously. Success is also measured in terms of the reversal leading to pregnancy, which can be as high as 76 percent according to some studies.

However, these rates of success are lower as more time passes from the date of the original vasectomy. For those individuals who had a vasectomy over 15 years previously, these chances fall to 71 percent likelihood of restoring the vas channel, and 30 percent likelihood of a subsequent pregnancy.

Nevertheless, a reversal procedure is one of the most cost-effective procedures that couples may want to consider before other options.

A vasectomy reversal is considered to be comparatively safe, but it is a more delicate and involved microsurgical procedure than a vasectomy. Typically, it is performed on an outpatient basis in a surgical center and requires no overnight hospital stay.

The surgery, usually performed by a urologist, requires the aid of a microscope in a procedure that can take several hours. The vas deferens that are to be rejoined are about the size of a round shoelace. The inner channel which must be precisely aligned is about one third of a millimeter in diameter and the tiny suture material used in the procedure is nearly invisible.

When vasectomy reversal fails

Many men choose to have their sperm frozen, ensuring during vasectomy reversal procedures. During the surgery, your doctor will identify healthy sperm using a microscope. Later, a procedure, known as intracytoplasmic sperm injection (ICSI) can be used to directly implant your sperm into the egg of your partner. Vasectomy reversal is considered a failure if no sperm is found after twelve months. You should choose well-trained Urologist who has a record of success to perform your surgery.

Alternatives to Vasectomy Reversal


For those wishing to avoid the reversal of a prior vasectomy, either for standard In Vitro Fertilization (IVF) or for advanced IVF procedures involvng guaranteed gender selection, we are able to offer MESA (Microsurgical Epididymal Sperm Aspiration), TESA (Testicular Sperm Aspiration) or PESA (Percutaneous "no incision" Sperm Aspiration). These procedures involve our board certified fertility Urologist aspirating sperm directly from testicular structures at the same time that the eggs from the female are obtained.

The recovered sperm are then used to inseminate the waiting eggs. Fertilization and pregnancy rates approach the same levels achieved with successful vasectomy reversal procedures with minimal or no incisions. This procedure is most appropriate for couples interested in one or perhaps two additional children. "Extra" sperm obtained from the aspiration in excess of that needed for the initial egg insemination may often be frozen and cryopreserved

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