Basics of Vasectomy Reversal Surgery

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Vasectomy is a method of sterilization aiming permanent contraception in men.
Vasectomy in men involves closing off the vas deferens; thereby blocking the path of the sperm.
Although vasectomy is conducted with the intention of permanency but medical science has offered man with the probability of a surgery reversal to cater to untoward incidences in life.
Several circumstances such as the death of a child, a new life partner or other reasons could lead a man to desire a vasectomy reversal surgery.
A vasectomy reversal is a surgical procedure designed to restore the flow of sperms into the vas deferens.
This technique is based on the fact that even after the sterilization, sperms are still produced by the testes.
Since the vas deferens has been blocked, they cannot exit in the usual way.
However, on each side, sperms can still enter the epididymis, which is a very long coiled tube behind the testis meant for maturation of sperms and the lowermost portion of the vas tube upstream from the obstruction imposed by the vasectomy.
During this surgery, an incision is made on the underside of the scrotum and the surgeon uses a microscope and tiny sutures to reconnect tiny and delicate tissues in the patient's testes.
This method is performed under the influence of general or epidural anesthesia.
The surgeon can use two procedures to achieve the reversal.
One method is known as vasovasostomy.
This involves stitching both ends of the severed vas deferens back together.
This is a relatively easier surgery with very high success rate.
In some cases, vasovasostomy cannot be performed.
The reason being that after vasectomy, there is a possibility of blockage in the very fine tubes of the epididymis.
This situation is roughly proportional to the number of years that have gone by since the vasectomy.
The possibility of blockage is rare if the time gap has been only 1 to3 years, but after an interval of 20 years, the odds of obstruction may be over 30 percent.
Thus, in cases of a blockage or other problem in the vas deferens, the procedure of vasoepididymostomy is conducted.
During this method, the surgeon attempts to connect the vas deferens directly to the epididymis.
However, the decision of utilizing either of the two techniques can only be taken by the surgeon, inside the operation theatre.
Post-operatively, patients can experience tenderness for up to seven days and need to refrain from sexual activity for approximately four weeks.
This surgery requires experience and proficiency.
Reconnecting and repairing the severed ends of the vas deferens is an extremely skilled and meticulous work, which requires the hand of a competent microsurgical specialist.
The effectiveness of vasectomy reversal surgery is described in terms of patency (sperm flow) and pregnancy.
The key factors contributing towards its affectiveness are the number of years since the original vasectomy, the type of surgery (vasovasostomy has better success rates) and the surgeon's knowledge and ability.
However, the couple has to give themselves a time frame of 12 months for pregnancy after a vasectomy reversal.
Vasectomy reversals are considered elective procedures and are generally not covered by insurance in the United States.
The procedure costs about $10,000 apart from the anesthesia cost.
Therefore, it is very necessary for you or your partner to think before going in for vasectomy or its reversal.
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