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Friday, June 29, 2007

The vasectomy reversal, part 1

Ten percent of men who have had vasectomies will, at some point in the future, decide to have a vasectomy reversal. If you are considering whether you want to have a vas reversal, you may wish to read the following.

1: All vas reversal doctors are not created equal. The vas reversal is a very challenging procedure that requires a high degree of technical expertise in order to maximize success rates. When choosing a reversal specialist, you may want to choose someone who has done many vas reversals and has specific advanced training in microsurgical technique.
2: “With the right tools, any job is easy.” This is something that my father-in-law likes to say. When it comes to vas reversals, it is certainly true. Experienced vas reversal specialists have their own special tools and instruments. The instruments are extremely delicate and fragile, so we keep them in protective cases and do not let other surgeons borrow them. Ask your surgeon to show you his instruments.
3: Success rates vary depending upon several factors. Perhaps the most important factor is obstructive interval--how many years have passed since the vasectomy was performed.
4: The vas reversal essentially involves “re-routing” the pipes. Re-connecting the vas to itself is known as a V-V, and has a > 90% success rate. Occasionally, due to a variety of factors, the surgeon will need to connect the vas to the epididymis--a procedure known as an E-V. The E-V has a ~70% success rate.
5: Success is defined a sperm returning to the ejaculated semen within 1 year after the vas reversal. Ideally, natural pregnancy follows. In cases where natural pregnancy does not ensue, couples still have the option to proceed with assisted reproduction, often in the form of a low cost artificial insemination.

If you any questions, please feel free to contact me.