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Top 10 Questions and Answers about vasectomy reversal! What men - and their wives - want to know. Here is a checklist of some of the most frequently asked questions, in no specific order, and the answers that doctors provide. A man and his spouse should carefully consider what they want to know, and get clear answers to their questions, before deciding about a vasectomy reversal. Urologists encourage every couple to be fully informed and aware. The more time a couple spends on becoming educated about a vasectomy reversal, or any procedure, for that matter, the more reasonable expectations and satisfaction they will have from the procedure. The following Questions and Answers may be helpful as a checklist to what is commonly asked by others. Compare this list with your concerns, and explore the other pages of this Web site for additional information and topics of interest. Always discuss your issues with the doctor of your choice. #1 - What is a vasectomy reversal? A vasectomy reversal is a microsurgical procedure performed by a urologic surgeon to reverse sterility caused by a vasectomy. It is not an uncommon choice, as approximately five to ten percent of the half million men who opt for vasectomy each year later elect to have the vasectomy reversed. A vasectomy reversal is performed by microsurgically reconnecting - in either single or multiple layers - the cut ends of the vas deferens, the small tubes that carry sperm from the man's testicles. The fine sutures used are no thicker than a human hair. The rejoined vas can again become a passageway for semen to be ejaculated at orgasm. This procedure is known as a “vasovasostomy,” which is indicated if sperm is detected in the fluid inside the vas after initial incision. At times when a blockage (causing increased pressure in the epididymis) is suspected, the blockage must be bypassed in an alternate reversal procedure known as a “vasoepididymostomy.” #2 - Which type of vasectomy reversal is more successful? Rates of “success” depend on very different criteria. The most common type of reversal, the vasovasostomy, has statistically greater chance of success than does the more complex vasoepididymostomy. The chances of successfully impregnating your partner are very dependent on time, and the quality of your sperm. A vasectomy reversal has the greater chance of success if the vasectomy was performed more recently. As time passes, the statistical likelihood of a pregnancy following a vasectomy reversal declines. The most significant decline occurs at 15 years or more where pregnancy rates are typically about 30%. The more recent the vasectomy, the greater likelihood of success. Also, over time, the body's natural response to accumulated (not ejaculated) sperm in the testicles may result in damage to the shape, number and motility of sperm. The potency (number and quality of sperm released in seminal fluid) are just as important as the patency of the connection [ See ANATOMY & TERMS ]. A physical examination prior to surgery can sometimes indicate which type of surgery you will have during a vasectomy reversal. #3 - How much time does the procedure and recovery take? Microsurgical vasectomy reversal is more time-intensive and complex than a vasectomy. The vasovasostomy procedure may take several hours, and the need to perform a vasoepididymostomy may lengthen the time of the procedure further. Both usually involve general or regional anesthesia, which typically adds time to the recovery period. You will want to discuss this topic with your doctor for specifics, but here are some general guidelines. Including the paperwork and preparation, the entire outpatient procedure may take about five hours or more. Most of the routine recovery takes about four weeks. This begins when you are taken to a recovery area until you are fully awake and your doctor determines that it is safe for you to travel. Remember: You will need someone to drive you home. Follow all your doctor's instructions. You can expect to remain on bed rest for at least the first 24 hours following reversal surgery. Your doctor may advise you to use an ice pack on the scrotal area for one to two days and keep all activities to a minimum for at least four to five days. You may be advised to avoid heavy lifting or physical exertion for three to four weeks. You should not attempt ejaculation for up to 30 days. Schedule an appointment with your doctor within that time period. Your doctor may request that you provide semen specimens periodically until your seminal fluid contains a normal sperm count. Do not ejaculate for two to three days prior to each semen analysis following surgery. #4 - How effective is a vasectomy reversal? Depending on the changes following the vasectomy, the time that has passed since the vasectomy and the experience of the surgeon, about 40 percent to 75% percent of all men can expect to father a child again, but not immediately. The success rate is significantly higher in couples who have had children together already. Sterility is not instantly reversed after surgery, nor is fertility instantly restored. It often can take several months, and in some cases over a year before the vasectomy reversal can be counted a success. [ SUCCESS ] If the reversal is not ultimately successful, and no sperm comes through, other options remain. Fertility might be restored in a second operation, or “reversal re-do.” Sperm may be surgically retrieved for use with in vitro fertility, or you may choose to have your sperm harvested during reversal surgery and banked for possible in-vitro fertilization. In cases where sperm is coming through the new connection, but the quality is poor, or pregnancy is not being achieved, artificial insemination may increase the odds of pregnancy. If necessary, in-vitro fertility can be performed using the ejaculated sperm as long as there are even only a few live sperm in the semen #5 - Will my sex life, or genital appearance, be affected? An effective vasectomy reversal simply allows sperm to rejoin the seminal stream during ejaculation and should not affect your sexual drive, your ability to have an erection and orgasm or your ability to have and enjoy sex. Sperm is only a small fraction of the total liquid in your semen. The amount of fluid, intensity - even color and texture - does not appear to change once your seminal fluid again contains sperm. Postoperative scars are generally nothing to worry about. The scrotum generally heals very well. Although the incision site may be larger than for a vasectomy, it is still fairly small and may be difficult to detect on an unshaven scrotum. In the case of a large gap from a vasectomy, a vasectomy reversal may result in the testicles sitting higher in the scrotum. This is rarely perceptible and rarely results in any long term discomfort. A vasectomy reversal, like a vasectomy itself, does not affect or inhibit you physically in any way. The best way to avoid postoperative anxiety or sexual problems is to talk openly with your doctor about your concerns, and what you can expect, following your reversal surgery. #6 - What is the cost of a vasectomy reversal? A vasectomy reversal is not inexpensive and the cost will vary between practices, states and the procedures used. Hours of microsurgery, general anesthesia and the services of an anesthesiologist are some of the reasons that a reversal is more costly than a vasectomy. Patient financing for elective surgery may be a helpful option for some families. Please contact our billing office for an explanation of all our payment options. Most insurance plans do not cover the cost of reversal surgery, which can range from $6,000 to $8,000. This is, however, less costly, and is considered more natural and potentially more effective than assisted reproductive techniques (ARTs) that rely on aspirated sperm and in-vitro fertilization. #7 - What about risks or complications? There are risks and potential complications with any medical procedure and you should ask your doctor to go over these with you carefully. While microsurgical vasectomy reversal is a complex and delicate procedure, it does not pose a high-risk for serious complications. Postoperative pain following your reversal surgery should not be much greater than what you experienced following your vasectomy. Your recovery period is longer, however, and you should promote your healing process by not doing more or resting less than your doctor advises. Depending on your physician's preference, antibiotics may or may not be prescribed following a vasectomy reversal, but you may expect that antibiotics will be prescribed if you develop a fever, increasing tenderness or swelling at the surgical site. Adequate rest, the generous use of an ice bag, and non-prescription pain relievers as directed by your doctor, usually result in complete and uncomplicated recovery. #8 - Are there factors concerning my vasectomy that can influence the success of a reversal? The success of reversal surgery often depends on the type and amount of damage done to the vas tubes at the time of your sterilization surgery. Vas deferens that were simply cut and returned to the scrotal sac are easier to rejoin later. Clipping the ends of the vas increases the degree of damage the tubes sustain. Cauterization following cutting of the vas produces a highly effective vasectomy, and thus may pose a somewhat greater challenge to your chances of a successful reversal. The presence of a sperm granuloma is associated with less of a chance of a blockage of the epididymis occurring on that same side of the sperm grauloma, thus reducing the risk that a vasoepididymostomy would be required. #9 - How long will I be in the hospital? A vasectomy reversal is normally a same-day, outpatient procedure. You needn't expect to be in a hospital if your physician uses an outpatient surgical center. You can go home after your doctor determines that you are able to travel safely. #10 - How soon can I start having sex after my reversal surgery? You should not attempt erection or ejaculation during your recovery period. At the most, you may have to wait about a month before you are comfortable and recovered enough to be ready for sex. In Summary:
This article was taken from www.vasectomy.com Associated URL: http://www.vasectomy.com |
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Associated URL: http://www.vasectomy.com |
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