November 25th, 2015
A vasectomy is intended to be a permanent procedure, but microsurgical techniques have been developed that have allowed restoration of fertility through reversal of a vasectomy. If you are considering this option, you should know that the success rate is variable. It depends upon several factors, including the skill and expertise of the urology surgeon who initially performed the vasectomy and the expertise of the urology surgeon who will attempt to reverse the procedure.
Special training is required for urologic surgeons who perform vasectomy reversal, which require ability to use microsurgical techniques under a surgical microscope. The vas deferens is a tiny structure, only 0.4 millimeters, and the surgeon must be able to visualize the structure well in order to successfully reverse a vasectomy. Your urologic surgeon will not be able to determine before surgery whether you require a vasovasostomy, which is a simpler procedure, or a vasoepididymostomy, which connects the vas deferens directly to the epididymis. When choosing a surgeon, it is critical to ensure your surgeon has had experience performing both procedures. A study of men with unsuccessful vasovasostomy procedures revealed that almost fifty percent of those men had obstructions that should have been bypassed by the vasoepididymostomy procedure.
Another factor that influences whether or not the vasectomy removable will be successful is the length of time since the original vasectomy. This is probably the most critical factor to consider when estimating the chance of restoration of fertility. With the development of microsurgical techniques for vasectomy reversal, most studies show current success rates for vasectomy reversal ranging from 82 to 89 percent if performed within 15 years of vasectomy. However, the rate of conception dropped to 44% at fifteen years.
Men who have had other surgeries in the groin, including earlier attempts at vasectomy reversal or hernia repair, may develop scar tissue that can obstruct the vas deferens, preventing success.
After vasectomy reversal, at least two cycles of sperm production must occur in order to have a normal amount of healthy, motile sperm in the semen. Good nutrition, and avoiding heat or trauma to the testicles will help promote health sperm production. If you had a normal sperm count before your vasectomy, you are more likely to return to a normal sperm count that will permit conception.
No one can determine in advance if the vasectomy reversal procedure will have a successful outcome, with restoration of fertility. However, if you are considering a vasectomy reversal procedure, you should consult a urologic surgeon to determine if you have any conditions that might decrease your chance for success. A careful review of important factors that influence restoration of fertility will allow y our physician to help you make an informed choice about whether or not your should attempt the procedure.
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