A vasectomy s performed on men who want to opt for sterilization as a permanent form of contraception. The procedure entails the severance of the vas deferens tube. This in turn blocks the flow of sperm out of the urogenital opening. Although vasectomy is a permanent form of contraception, there is scope for the surgical reversal of the procedure. A man may consider vasectomy reversal in case of remarriage, the death of a child etc.
The vasectomy reversal procedure, as the name suggests is the exact opposite of the original surgery and is intended to restore the flow of sperms into the vas deferens and through it to the urogenital opening. The technique is based on the principle that a sterilization operation does not stop the production of sperms. They are still produced inside the testes but since the vas deferens in either blocked on severed; they cannot make their way to the urogenital opening and from there to the vagina of a man's partner. However; these sperms do enter the epididymis which is a long coiled tube that stores the sperms till maturity. These sperms subsequently enter the lower portion of the vas deferens, however due to the obstruction created by the vasectomy procedure; they cannot flow upstream.
In the vasectomy reversal surgery a tiny incision is made on the underside of the scortum and a tiny microscope is inserted which is then used to free the ends of the vas deferens and reconnect the tiny and delicate tissues in the testes with thin sutures. A vasectomy reversal can be performed under general or epidural anesthesia. Depending on your specific condition; the surgeon can use one of two procedures to reverse vasectomy. The first method is relatively simple and is called vasovasostomy. This procedure entails stitching together the two severed ends of the vas deferens. This procedure is relatively easy so it has a high success rate. Thus type of procedure is usually conducted when the original vasectomy surgery has not been conducted too long ago.
The second procedure is called vasoepididymostomy; this type of surgery is conducted when vasovasostomy is not possible. Generally; this type pf procedure is required when a lot of time has lapsed since the vasectomy surgery. In many patients; there is a possibility of blockage in the tiny tube of the epididymis; the possibility of such a situation is directly proportional to the number of years that have lapsed since the vasectomy. This situation does not arise if the time gap between the two procedures is between one to three years; however, if more than ten to fifteen years have lapsed since the surgery; the chances of a blockage may be as high as 30%. And if such a blockage is found during the surgery, the surgeon will take the call to conduct a vasoepididymostomy instead of vasovasostomy. However; this decisions can only be taken during the surgery and there is no way to find out about the blockage before hand. In this procedure, the surgeon will not join the two ends of the vas deferens rather he/ she will try to connect one severed end of the vas deferens directly to the epididymis thus bypassing the blockage.
Regardless of the type of surgery conducted, the patient will experience tenderness for a week and he will be advised to refrain from sexual activities for at least a month. The vasectomy reversal surgery requires exceptional surgical competence and proficiency; it is certainly not easy to reconnect the two ends of the vas deferens and the procedure has to be conducted meticulously and with the utmost accuracy; and this calls for the expertise of a skilled and experienced microsurgical specialist. The success of the procedure is determined in terms of potency; that is the flow of sperm and eventual pregnancy. Usually it can take between 8 months to a year to get pregnant after the vasectomy reversal procedure. Since the procedure is elective, your insurance policy will not cover it; however, you may be able to find clinics that offer payment plans.
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