Vasectomy is considered as permanent contraception method for men. It involves the cutting of an important sperm conduit known as the vas deferens. When this happens, the sperms can no longer reach the urethra and the female genital tract (hence no fertilization can occur). Advances in surgical techniques have made it possible to reverse vasectomy enabling affected men to achieve fertility once again.
One of the most effective surgical techniques that have been adopted for this procedure is microsurgical vasectomy reversal. In this technique, the structures of interest are accessed using very small incisions and done with the use of a microscope. Success rates are a lot higher as compared to other techniques and complications have been significantly reduced. Two main approaches can be used. The first involves re-joining the two stumps (vasovasostomy) and the second is the joining of the vas deferens to the epididymis (vasoepididymostomy).
While numerous improvements have been made on the techniques that are used, failure is not uncommon. One of the reasons as to why this is the case is the fact that the vas deferens is a very small tube that is greatly affected by scarring once ligation has been done. The scar tissue has to be removed before the two stumps are re-joined. The two stumps may be of different diameters which serves to reduce success rates as well.
Before undergoing the surgery, one has to be evaluated by their urologist. Part of the evaluation includes determining that indeed the subject was fertile before the ligation of their vas deferens. The next important thing at this stage is to find out if any sperm antibodies exist within the semen. If found, the probability of ending up with a pregnancy is next to nil and assisted reproductive options should be sought.
Research shows that success rates may be as high as 70% to 90%. Age, is not a major determinant of who succeeds and who does not. However, the duration of time that elapses from the date of ligation does influence fertility rates to a great extent. Generally, persons who undergo the procedure within three years of vasectomy have success rates in excess of 50% while those that have it after more than 10 years have a rate that is as low as 30%.
The microsurgical procedure is regarded as being generally safe but there are a number of complications that may be encountered albeit rarely. In the immediate post-operative period, the common complications include excessive bleeding, fluid accumulation within the scrotum (also known as hydrocele) and infections. Nerve fibers may also be injured. Rare complications include deep venous thrombosis and reaction to anesthesia.
The operation itself is usually done on an outpatient basis and typically lasts between two and four hours. Spinal anesthesia is typically used which means that one can be discharged from hospital on the same day. The resultant pain is mild and can permit resumption of normal routines within three days or thereabout.
Fertility is an issue that affects two people; the man and the woman. If pregnancy is not achieved, both should be investigated before a diagnosis of failure is made. Fertility problems should be suspected in woman who are above thirty five years who have failed to conceive in spite of engaging in regular sexual relationships with a fertile partner.
One of the most effective surgical techniques that have been adopted for this procedure is microsurgical vasectomy reversal. In this technique, the structures of interest are accessed using very small incisions and done with the use of a microscope. Success rates are a lot higher as compared to other techniques and complications have been significantly reduced. Two main approaches can be used. The first involves re-joining the two stumps (vasovasostomy) and the second is the joining of the vas deferens to the epididymis (vasoepididymostomy).
While numerous improvements have been made on the techniques that are used, failure is not uncommon. One of the reasons as to why this is the case is the fact that the vas deferens is a very small tube that is greatly affected by scarring once ligation has been done. The scar tissue has to be removed before the two stumps are re-joined. The two stumps may be of different diameters which serves to reduce success rates as well.
Before undergoing the surgery, one has to be evaluated by their urologist. Part of the evaluation includes determining that indeed the subject was fertile before the ligation of their vas deferens. The next important thing at this stage is to find out if any sperm antibodies exist within the semen. If found, the probability of ending up with a pregnancy is next to nil and assisted reproductive options should be sought.
Research shows that success rates may be as high as 70% to 90%. Age, is not a major determinant of who succeeds and who does not. However, the duration of time that elapses from the date of ligation does influence fertility rates to a great extent. Generally, persons who undergo the procedure within three years of vasectomy have success rates in excess of 50% while those that have it after more than 10 years have a rate that is as low as 30%.
The microsurgical procedure is regarded as being generally safe but there are a number of complications that may be encountered albeit rarely. In the immediate post-operative period, the common complications include excessive bleeding, fluid accumulation within the scrotum (also known as hydrocele) and infections. Nerve fibers may also be injured. Rare complications include deep venous thrombosis and reaction to anesthesia.
The operation itself is usually done on an outpatient basis and typically lasts between two and four hours. Spinal anesthesia is typically used which means that one can be discharged from hospital on the same day. The resultant pain is mild and can permit resumption of normal routines within three days or thereabout.
Fertility is an issue that affects two people; the man and the woman. If pregnancy is not achieved, both should be investigated before a diagnosis of failure is made. Fertility problems should be suspected in woman who are above thirty five years who have failed to conceive in spite of engaging in regular sexual relationships with a fertile partner.
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