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|FAQ about Vasectomy and Vasectomy Reversals?||
Some FAQ and information about Vasectomy and Vasectomy Reversals:
Vasectomy Reversals have become a
routine operation and
procedure over the past 20 years. This has to do with the success
rates. There are two conditions must be
satisfied for sperm to be returned to a patient's semen with vasectomy
reversal. The patient must have sperm. The sperm needs to be available
and able to go through the
reconnection and the reconnection must be impermeable.
The surgeon's goal is to accomplish a very precise circumferential
reconnection of the sperm canal sides by using
Surgeons who also practice general urology are almost always
“occasional” reversal surgeons and this is quickly revealed by obtaining
their reversal experience.
These are usually highly skilled and respected academicians either heading or teaching male infertility fellowships. Are they personally doing their reversals, or is one of their fellows (students)? You will never know for sure.
What type of anesthesia and exactly where has your surgeon chosen for
A. A vasectomy creates a blockage or “dead end” in the scrotal portion
of the vas. The sperm get to the point of blockage and can go no
further. They age and then die. The sperm degenerate and the body breaks
the sperm down into component protein molecules as it does for dead
cells elsewhere in the body. These protein molecules are then reabsorbed
in the bloodstream and are eliminated.
A. Sperm can still live in the vas upstream from the vasectomy site (in
the scrotum) for weeks to months. It could easily take between 6 weeks
to three months for these sperm to die off of get flushed out of the
reproductive tract. Men are not sterile immediately after a vasectomy
therefore you must practice contraception until there are 2 consecutive
semen analyses that have no motile sperm in them. We begin checking
semen specimens after 20 ejaculations post vasectomy.
A. While vasectomy is considered permanent sterilization it can
certainly be reversed. Roughly 5% of men who have had vasectomies change
their mind each year and want to re-establish their fertility. Options
available include vasovasostomy, reconnecting the vas at the vasectomy
site and sperm harvesting from the epididymis or testicle combined with
in-vitro fertilization. Neither of these techniques are 100% effective
so those men who may still want more children should not have a
A. Having a vasectomy should not cause any problem with erections or
libido from a physiological standpoint barring any complications. It is
possible for some men to have a psychological reaction to having their
vasectomy as they might to having any surgical procedure and that can
A. Antibodies are molecules produced by the immune system to fight off
anything that the immune system perceives as being foreign. After a
vasectomy many men begin making antibodies to their sperm that can be
detected in their bloodstream. When present, antibodies can attach to
the sperm and prevent them from moving (decrease motility) or from
penetrating an egg. It has become clear that only antibodies present on
the sperm may cause a problem in certain situations. Very few men
actually have antibodies detected on their sperm after vasectomy
A. Most men who undergo vasectomy have no difficulties but a small group
of men develop chronic testicular or epididymal pain after the
procedure. This pain can start immediately after surgery and is usually
due to a sperm granuloma (inflammation at the vasectomy site) or
infection and most cases resolve with the appropriate medical therapy.
Occasionally, pain may develop years after the vasectomy and be
exacerbated by ejaculation. This pain is thought to be the result of
back pressure building up in the epididymis and is known as an ”
epididymal blowout” or “post vasectomy pain syndrome” While it must be
stressed that these are fairly uncommon occurrences after vasectomy,
they are frustrating and difficult to deal with for both the patient and
the physician. We offer a range of treatments for these syndromes
including non-surgical treatments, vasectomy reversal, open-ended
vasectomy, and chemical sterilization.
A. An open-ended vasectomy is a vasectomy that is performed in the exact
same fashion as a standard vasectomy other than leaving the testicular
end of the vas unclipped. By leaving the proximal end open, it is
thought to reduce the back pressure build up on the epididymis and
testicle thus making a future vasectomy reversal easier and possibly
reducing the already low chance of developing post-vasectomy pain
syndrome. The problem with the open-ended vasectomy is that there is a
greater likelihood of the vasectomy not working and because the end is
open, sperm can leak out and cause a granuloma (inflammatory mass) to
form at the end of this vas. The granuloma can sometimes be the cause of
pain after a vasectomy.
A. The alternatives to permanent male sterilization include permanent
female sterilization by tubal ligation or tubal blockage and reversible
contraception with condoms, birth control pills or IUD. Many researchers
have been working on a “male pill” but none of the current formulations
are very effective or consistent.
Here are some common reasons when considering a vasectomy:
How am I different after a vasectomy?
After vasectomy, a man is unchanged except for his blocked sperm tubes.
Sperm make up about 1% of the ejaculate, so there will be no detectible
difference in volume. The testes still produce sperm, but they are
simply re-absorbed into the body.
Vasectomy does not affect a man's sex drive, masculinity, testosterone
levels or orgasm. His ability to have an erection is also fully
Furthermore, most men report that sex is better after vasectomy because
they no longer need to worry about an accidental pregnancy. With the
security and peace of mind permanent contraception brings, sex can be
more relaxed and spontaneous.
What are some of the possible risks and complications?
If you experience any problems at all, be it pain, swelling etc. see
your doctor right away to receive the appropriate treatment. Should you
believe you are not getting better after a reasonable amount of time
then always take into consideration that seeking a second opinion from a
qualified provider is a reasonable course of action.
Some men report a mild aching sensation to the scrotum for a few hours
to a few days after the procedure.
Mild bleeding into the scrotum causing small tender swelling for a few
days.(1/400). A major bleed into the scrotum causing a grapefruit sized
scrotum which will take months to heal (1/1000).
Redness and pus from the healing site opening (1/100).
Tender swelling of the epididymis, the tube connecting the vas deferens
and the testes (1/100).
A small, potentially uncomfortable, bead-like structure made of leaked
sperm that may develop at the site where the tube was cut and blocked
A very rare complication of a persisting dull ache in the testicle where the inflammation does not settle down. It may resolve on its own or may need another surgical procedure 1/1000).
Because a doctor has inadequately blocked one or both tubes, or because
one or both tubes has rejoined ( less than 1/2500).
Produced by the body in response to the absorbed sperm. The antibodies
are thought to be non-harmful but can make fertility difficult to
Other uncommon complications have been reported.
How long will it take after a successful Vasectomy Reversal to get my
What will a Vasectomy Reversal cost?
Somewhere between $4,000 to $20,000 all inclusive with $10,000 being the average in the USA. In Canada, $5,000 is the average all inclusive price.
What is the likelihood of a Vasectomy Reversal being successful and what
are the factors involved?
What happens if the vasectomy is not successful?
A failed vasectomy reversal is defined as having no sperm in the
ejaculate subsequent to the operation. These men can consider having the
vasectomy reversal repeated or another surgical procedure known as
vasoepididymostomy, or sperm extraction.
What alternatives are there to Vasectomy Reversal?
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