In recent years, more and more men have been getting a vasectomy. However, while this is understandable, modern family life has become more complex. As such, men do regret the decision and want it reversed. But can it?
The short answer is yes, but for some it might not be successful. Deciding to have ‘the snip’ as it’s commonly known is not something that should be taken lightly.
What is a vasectomy? It is one of a limited number of birth control methods currently available to men. It involves a non-invasive surgical procedure that prevents sperm being mixed with semen when ejaculation takes place. Stopping this prevents the sperm fertilising the woman’s eggs.
In order for sperm to fertilise, it must pass along 2 tubes called the vas deferens. The surgeon stops this mixing by cutting and blocking the tubes.
There are many reasons why men want their vasectomy reversed. They may have remarried and want children with their new wife. They may have lost a child prematurely.
Whatever the reason, it is possible to reverse the procedure, but it must be emphasised there is only a 50% chance of success. This is measured by how successful a man is in fathering another child.
The procedure basically involves reconnecting the vas deferens and there are essentially 2 different methods used.
One, called Vasovasostomy is the commonest technique; it accounts to around two-thirds of operations.
Using microsurgical techniques the surgeon will find where the vas deferens has been cut and using sutures, tie the two parts. This allows both semen and sperm to once again mix. It’s a 2 hour procedure.
The second method – Epididymostomy – is used only if a Vasovasostomy cannot be carried out, usually if there is a blockage in a tube. In short, there is no sperm present.
If this is the case, the vas deferens cannot be re-connected. Instead one end of the tube is connected directly with the epididymis, thus restoring sperm flow.
This procedure takes 5 hours and is less successful.
Unfortunately, this happens far too often (about 2 to 3% of the time with a pofsesrional reversal surgeon, more often even up to 10% or more with a less skilled surgeon). It is called “scarring over”. The vas deferens is only 3 cells wide if you put those cells side by side each other. You can understand how while healing the tube can become blocked again. Most scarring over happens between months 8 to 12 post reversal. You can only assume a man to have had a successful reversal WITH sustained fertility if he has good counts 18 months post reversal. Different things cause scarring over. Ejaculation too soon post reversal (before 2 weeks) can leak sperm between the stitches and cause irritation that leads to scarring. A poor reconnection by the reversal surgeon can lead to scarring. Using too large of stitches leads to scarring. And just being a “fast healer” tends to make a man scar more. Sometimes, it just happens. Some men do everything right and it happens; some men don’t follow their doctor’s instructions and they are fine and have wonderfully normal counts. It’s a roll of the dice. What do you do now? Sometimes a round of predisone and use of anti-inflammatory medicines can open up a narrowed vas deferens. Otherwise, you will need another reversal. This time, bank some sperm at the time of reversal just in case he scars over again. Also, use of anti-inflammatories and a course of antibiotics for the first weeks post reversal has been shown to help reduce scarring over. And use of vitamin E post reversal seems to help reduce it as well. GL