Vasectomy Reversal

An increasing number of men are presenting themselves for treatment who have had a vasectomy. Due to changes is their lives they may want to have a child or more children. This is a factor that occurs more often than in previous years. Consequently, there is an increasing demand for the reversal of a vasectomy. And there are possible treatment solutions.

A vasectomy reversal is a treatment that could be performed. It is a surgical procedure that could restore the flow of sperm which goes through the vas deferens. It is usually performed by an experienced microsurgeon. The Microsurgeon will use specialized instruments such as an operating microscope, amongst others. This procedure is so delicate and intricate that the sutures used in a vasectomy reversal are so small. It is literally finer than a human hair.

 

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Types of Vasectomy Reversals

There are two types of vasectomy reversals namely a vasovasostomy and a vasoepididymostomy. The former, vasovasostomy, is the operation most frequently performed for the vasectomy reversal procedure. With this procedure the microsurgeon will stitch together the cut ends of the vas deferens.
Consequently, the success rates may vary. Factors affecting the success rates post vasectomy are:

  • The age of the man
  • The presence of antisperm antibodies
  • Time elapsed since the vasectomy
  • The age of the woman

The option of reversal of vasectomy is not one that we would encourage. Depending on the ‘definition’ of a successful reversal, many patients will have sperm in the ejaculate after a reversal of vasectomy. HOWEVER, for the purpose of viability, a vast majority of ejaculates after a reversal will not result in adequate quality of sperm production for natural conception to occur. So a fertility treatment may have to be administered for conception to take place.

Sperm aspiration followed by ICSI would be the ideal treatment option in this instance.

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