Vasectomy Reversal Procedure

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Vasectomy and Pregnancy

By Inder Walia

Post Vasectomy fertilization is a possibility! Renewed patency is bliss for some and an impediment for others. The risk is low but cases of pregnancy after vasectomy have been recorded. Several studies conducted to map the incidence of pregnancy after vasectomy vary by a few numbers. One study revealed only 3 cases of pregnancy out of 3,178 vasectomized men who were tested. The point to remember is that even if no sperm is found in a semen analysis post vasectomy reversal, it does not completely rule out the presence of motile sperm, which may later contribute to pregnancy.

The reasons behind pregnancy after vasectomy could be technical error, the reopening of the occluded passageway that carries sperm or the presence of residual motile sperm in the seminal vesicles even after vasectomy. The restoration of the sperm channel may happen early or late. An early recanalization (spontaneous reconnection of the vas deferens) may be detected in the post-vasectomy specimens. However, late recanalization is said to occur when several post vasectomy specimens do not show any sperm, which is discovered years after when the pregnancy has already occurred.

The above discussion relates to natural vasectomy reversal, which may not always come as a pleasant surprise! Thus, it is recommended to continue using contraceptives such as birth control pills for at least six months post vasectomy. This is because a minimum of twenty ejaculations after vasectomy have been found to contain viable sperm. On the other hand, there are couples, which after vasectomy may be desirous of more children and that chance pregnancy may not happen to them. Thats where the Vasectomy reversal procedure by a specialist comes into the picture!

Vasectomy reversal pregnancy rates are defined by factors such as the success rate of complicated epididymal surgeries that have to be conducted on most reversals. Besides, the sperm count, quality and fertility has also been noticed to decline progressively with the years after vasectomy. However, reversals performed even 20 or more years after vasectomy have known to succeed after epidiymal surgeries. Besides, new techniques of microsurgical epididymal surgery are contributing to an increase in the success rate of pregnancy after vasectomy reversal.
There are several success stories of pregnancies after vasectomy that have brightened the lives of several people. Success rate varies with the methodology used, the experience and expertise of the vasectomy doctor and the years between vasectomy and the reversal attempt. It takes an average of 12 months, and at the most 2-3 years between vasectomy reversal and the pregnancy to occur. Thus, if you decide to have another child years after vasectomy, youve got hope. So do millions of people across the globe who want to grow their families. Vasectomy reversal helps you achieve the delight, happiness and pleasure of parenthood!

Article Source: http://EzineArticles.com/?expert=Inder_Walia
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Vasectomy Reversal

Vasectomy-Reversal-Overview-Things To Know

By Inder Walia

Excellence in the medical field is represented now and again, when health is restored, lives are saved, new lives are brought forth and more. Some call it miracles, some call it magic and some just ascribe it to the advancement of medical science. Today Vasectomy reversal is possible! Nothing less than a miracle, it is a gift of science to mankind.

Vasectomy is the most effective long-term contraceptive method. It is conducted in the first place when an individual makes the decision of not wanting to father any more children in his remaining life span. However, different reasons such as remarriage, untimely demise of a child, desire to become a father etc, may trigger the need of vasectomy to be reversed. Twenty years ago the idea would have been unthinkable. However, today it is not only possible but millions of people find their lives enriched by the squeals of little babies, thanks to vasectomy reversal!

Before going in for a vasectomy reversal, it is advisable to be armed with a thorough understanding of the procedure, various surgical techniques, vasectomy risks, post vasectomy complications and recovery details. The procedure of conducting a vasectomy reversal is called a vasovasoctomy in medical terms. This is a kind of outpatient microsurgery conducted usually by a urologist, under the influence of local, spinal, epidural or general anaesthesia.

The first point to consider when deciding upon the micro-surgical reversal technique of vasovasostomy is the selection process of a vasectomy reversal doctor. Surgeons with extensive training in microsurgery and who perform many vasectomy reversals each year, obtain the best results.

Now to answer the main question- how is vasectomy reversal conducted? Vasovasostomy is essentially a two-step procedure. The first thing the surgeon needs to ascertain is the availability of sperm by examining a drop of fluid removed from the testicular end of vas deferens. Depending on the kind of sperm found, the appropriate type of microsurgical reconstruction needs to be performed.

The second step is to meticulously place sutures to sew the two ends of vas deferens. The channel within the vas deferens, which carries the sperm flow, is only 0.2 to 0.3 millimetres in diameter, which is roughly the size of a pinpoint. Thus, the procedure is to be carried out under a microscope that makes for better visualization, magnifying structures 20 times their actual size. This helps avoid imprecise suture placement. To ensure a leak proof connection, one-layer, two-layer or even three layer sutures may be drawn.

The majority of men who undergo vasectomy have epididymal blowouts, which are caused due to build up of pressure in the epididymis, the tube that carries sperm from the testicles to the vas deferens. The increased pressure results in a leak. The procedure used to suture epididymal blowouts is called Microsurgical Vasoepididymostomy.

Vasectomy reversal has been known to have successfully worked for patients up to 30 years following vasectomy with pregnancy occurring as early as a few months post reversal. If a vasectomy reversal is not successful due to scarring at the surgery site or imprecise suture placement or any other reason, it does not entail a complete loss of hope to reverse vasectomy. Redo vasectomy reversals have been conducted all over the world with considerable success.

Vasectomy reversal is a lifeline that has brought hope, joy, and laughter into several hearths and homes, and it shall continue to do so until science comes up with a new technology to replace this one. Till then, vasovasostomy is every vasectomized mans best bet to become fertile again.

Article Source: http://EzineArticles.com/?expert=Inder_Walia
http://EzineArticles.com/?Vasectomy-Reversal-Overview-Things-To-Know&id=416373

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Vasectomy Reversal

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Vasectomy Reversal

How Much Down Time to Expect

Patients must use greater caution following vasectomy reversal than following vasectomy, even more so following VE vs. VV . Depending on the surgeon’s protocol, patients may return to work 4-21 days following the procedure.

Basics of Vasectomy Reversal

After vasectomy, sperm are still made by the testes, but since the vas tubes have been blocked, they cannot exit in the usual way. On each side, sperm can still enter the epididymis (the very long coiled tube behind the testis where sperm normally become mature) and the lowermost portion of the vas tube upstream from the obstruction imposed by the vasectomy. After vasectomy, the very fine tubes of the epididymis can become blocked. There are two possible explanations for this.

In the epididymis, white blood cells in the normal testicular circulation ingest and recycle the trapped sperm. This increased white blood cell activity is a chronic inflammation by definition. Inflammations can lead to scarring, and scarring in a very fine tube like the epididymis can cause obstruction. For example, inflammation of the liver (hepatitis) can cause scarring of the liver (cirrhosis); inflammation of joints (arthritis) can cause scarring with stiffness and decreased range of motion. The longer the duration of the inflammation, the greater the likelihood of scarring and obstruction, and this can occur in the epididymis, just as it can in any organ.

An alternative explanation for obstruction in the epididymis after vasectomy is that pressure increases upstream from the vasectomy site and can cause a “blowout” in the fine tubes of the epididymis, resulting in leakage of sperm and local inflammation and blockage.

Whatever the explanation for the obstruction in the epididymis (scarring or blowout), its likelihood is roughly proportional to the number of years that have gone by since the vasectomy. After an interval of only 1-3 years, the epididymis is rarely blocked, but after an interval of 20 years, the likelihood of secondary obstruction may be over 30%. Fixing the vas where it was divided at the time of the vasectomy (vasovasostomy or “VV”) will not correct the secondary obstruction upstream in the epididymis. That requires a more elaborate procedure called a vasoepididymostomy or “VE”, in which the portion of the vas tube above or “downstream” from the vasectomy site blockage is connected to the portion of the epididymis “upstream” from the secondary obstruction.

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Vasectomy Reversal

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Who asks for vasectomy reversal and why?

G Howard

Of the 76 men requesting reversal of vasectomy who were interviewed at Charing Cross Hospital between June 1978 and September 1981, 31 were still married. These men had decided to have a vasectomy during a crisis-a recent pregnancy or financial stress being the commonest reason. Most wanted another child but others wished to be “put back to normal,” and a few hoped reversal would help their marriage. Forty-five (59%) were divorced or separated and felt disadvantaged in courtship or remarriage by being infertile, many wives or partners being “desperate” for a pregnancy. A greater number of requests for reversal came from men who had been under 35 at the time of vasectomy and who were more likely to have been divorced, especially if there had been a teenage pregnancy. The risks of regret after sterilisation appear to relate to immaturity at the time of the vasectomy and to be as great for young men as for young women.

Source: Br Med J (Clin Res Ed). 1982 August 14; 285(6340): 490492.

Vasectomy Reversal