A Vasectomy Reversal – The Lowdown

In the formative years, a Vasectomy was regarded as a permanent form of birth control. This has since changed because breakthroughs in the medical fields attest to this fact. Micro-surgery can be credited in facilitating a vasectomy reversal. This cutting edge surgery was successfully used in the urology field in 1971 by Earl Owen.
Worldwide figures indicate that there are 40 to 60 million vasectomies annually. However; the number of individuals asking for a vasectomy reversal has been exponentially increasing. A fact attributed to divorce, death of partner or children and in certain cases increase in resources like income. It is a documented fact that, 16% of males under 70 in the United Kingdom have vasectomies. Nevertheless, upward spiralling divorce and remarrying rates of 40%, make the need to reverse the procedure.

This vasectomy reversal procedure generally, involves the re-establishment of an uninterrupted sperm flow to the urethra. Prior to this procedure being performed, biological and other considerations such as, length of time since the vasectomy, cost, medical health insurance policy, proper consultations with urologist. It involves a simple surgery ranging from 1 to 4 hours. It involves small incisions ranging between 1 to 2 cm made on the upper sides of the scrotum after being cleaned with clean water and soap normally it is scrubbed to avoid infection. There is no need for sedation however localised anaesthesia is used during the process.

Vasectomy reversals can be classified in two broad groups, depending on how they are performed. Vasovasostomy, is a restorative procedure that connects the severed vas deferens both the abdominal vas deferens to the upper vas deferens.

This normally, restores the previous sperm flow. However, this can only be performed if the surgeon determines the presence of viable sperm and there is no evidence of secondary blockage caused by pressure build-up. A vas deferens to vas deferens connection is then made .Determination of sperm viability, is done through analysis of the fluid obtained from the abdominal vas deferens(testis end). This fluid is subject to scrutiny under the microscope to establish the presence of sperms.

At times, after vasectomy, there is a build-up of sperms due to the blockage by the severed end. These sperms later on accumulate to create a secondary blockage in the epididymis where sperms are stored. In such a case, the surgeon is forced to carry out another surgical procedure termed vasoepididymostomy. He cuts below the secondary epididymis blockage and bypasses the primary severed cut to create a continuous seamless flow of sperms to the urethra.

It is of note that, when microsurgery is used, reportedly there is a 70-95 percent sperm return to semen rate. However, the patency of the sperm is not universal in all patience. Studies shows, individuals from recent vasectomy who are reversing the procedure, generally have high patency as early as three months from the surgery. This surgery is convenient since, after two to three weeks, patients can be able to do light duties as opposed to other major surgery.

This procedure’s true test of success is the number of pregnancies after the surgery. A vasectomy reversal, is a relief to couples who may have changed their minds or people seeking to restart families after personal tragedies, or circumstances and should be embraced due to its relatively high success rates.