Vasectomy is minor surgery khổng lồ block sperm from reaching the semen that is ejaculated from the penis. Semen still exists, but it has no sperm in it. After a vasectomy the testes still make sperm, but they are soaked up by the body. Each year, more than 500,000 men in the U.S. choose vasectomy for birth control. A vasectomy prevents pregnancy better than any other method of birth control, except abstinence. Only 1 khổng lồ 2 women out of 1,000 will get pregnant in the year after their partners have sầu had a vasectomy.Bạn sẽ xem: Vasectomy là gì
Vasectomy reversal reconnects the pathway for the sperm lớn get into the semen. Most often, the cut ends of the vas are reattached. In some cases, the ends of the vas are joined lớn the epididymis. These surgeries can be done under a special microscope ("microsurgery"). When the tubes are joined, sperm can again flow through the urethra.
There are many reasons khổng lồ unbởi vì a vasectomy. You might remarry after a breakup or have sầu a change of heart. Or you might want lớn start a family over after the loss of a loved one.
What Happens under Normal Conditions?
Both sperm & male sex hormones are made in the paired testes (testicles). The testes are in the scrotum at the base of the penis. Sperm leave sầu the testes through a coiled tube (the "epididymis"), where they stay until they"re ready for use. Each epididymis is linked lớn the prostate by a long tube called the vas deferens (or "vas"). The vas runs from the lower part of the scrotum into the inguinal canal. It then goes into the pelvis và behind the bladder. This is where the vas deferens joins with the seminal vesicle & forms the ejaculatory duct. When you ejaculate, seminal fluid và seminal vesicles mix with sperm to size semen. The semen flows through the urethra & comes out the over of your penis.
Reversals are most often done on a come-and-go basis by a urologist. Reversals can be done in an outpatient part of a hospital or at a surgery center. If a surgical microscope is used, the surgery is done while you"re asleep under anesthesia. Your urologist & anesthesiologist will talk with you about your choices.
Using microsurgery is the best way lớn vày this surgery. A high-powered microscope used during your surgery magnifies the small tubes 5 to lớn 40 times their kích cỡ. Your urologist can use stitches much thinner than an eyelash or even a hair to join the ends of the vas.
After you"re asleep, your urologist will make a small cut on each side of the scrotum. Your urologist will tryên ổn the scarred ends of the vas where they were closed by the vasectomy. Your urologist will take fluid, ("vasal fluid") from the vasal end closest to the testis. Your doctor will kiểm tra to lớn see if it has sperm in it. At this point, there are 2 types of reversal procedures you can have sầu.Vasovasostomy
If there is sperm in the vasal fluid it shows that the path is clear between the testis & where the vas was cut. This means the ends of the vas can then be joined. The term for reconnecting the ends of the vas is "vasovasostomy." When microsurgery is used, vasovasostomy works in about 85 out of 100 men. Pregnancy occurs in about 55 out of 100 partners.Vasoepididymostomy
If there is no sperm in the vasal fluid, it may mean bachồng pressure from the vasectomy caused a size of "blowout" in the epididymal tube. This "blowout" can lead khổng lồ a blochồng. Your urologist will need to go around the bloông chồng và join the upper end of the vas khổng lồ the epididymis instead. This is called a "vasoepididymostomy" and it serves the same purpose as the vasovasostomy.
Vasoepididymostomy is more complex than vasovasostomy, but the results are nearly as good. Sometimes vasovasostomy is done on one side và vasoepididymostomy on the other.
Healing should be rather quiông chồng và fairly easy. Pain after surgery is most often controlled with pills. About 50 out of 100 men say the pain after the reversal is lượt thích after their vasectomy. Another 25 out of 100 say the pain is less than after the vasectomy, and 25 out of 100 say it’s greater. Pain bad enough to lớn need medications rarely lasts longer than a few days to lớn a week.
Most men can return lớn their normal routine & light work within a week. You’ll likely be told to take it easy & not have sex for 2 khổng lồ 3 weeks. If your job is strenuous, ask your urologist when you can return to lớn work. You’ll most likely wear a jockstrap for support for a few weeks.
Next lớn pregnancy, testing the sperm count is the only way to tell if the surgery worked. Your urologist will kiểm tra your semen every 2 lớn 3 months until your sperm count holds steady or your partner gets pregnant. Sperm often appear in the semen within a few months after a vasovasostomy. It may take from 3 to lớn 15 months after a vasoepididymostomy.
In either case, if the reversal works, you should stay fertile for many years. Only about 5 out of 100 men later get scars in the reconnected part. The scars could blochồng the outflow of sperm all over again.Who Does Vasectomy Reversals?
Vasectomy reversals are most often done by urologists, but not all urologists vì chưng this type of surgery often. You should ask your urologist how many he/she has done, và to what level of success. If your urologist thinks you should have sầu microsurgery, you should ask about his/her traông xã record. This technique calls for extra training and expertise.Can All Vasectomies be Reversed?
Almost all vasectomies can be reversed. But if the vasectomy was done while fixing a hernia in the groin it may not be as easy to lớn join the ends of the vas. The ends also may not be able lớn be joined if a very long piece was removed during the vasectomy, but this is rare.Should I Have sầu a Vasovasostomy or a Vasoepididymostomy?
You can"t tell before the reversal which method is best for you. Your urologist can only find this out during the surgery. If sperm are found in the vasal fluid, then a vasovasostomy is done. If there are no sperm in the fluid, your urologist will decide what to vì chưng based on other factors. If there"s a blochồng in the epididymal tube, then a vasoepididymostomy will be needed.
If no blochồng is found, then the way the vasal fluid looks may help your urologist decide which method is best. For the most part, if the fluid looks watery, he/she will tover to bởi vì a vasovasostomy even if no sperm are found in the fluid. Fluid that looks creamy without sperm suggests that vasoepididymostomy is needed. Some patients may need a vasovasostomy on one side & a vasoepididymostomy on the other.Is Age a Factor in Conceiving after a Vasectomy Reversal?
Your age shouldn"t affect the results of your vasectomy reversal. Most men keep making sperm for many years after their partners stop making eggs. Women become less fertile starting in their mid-30s, with a major drop around age 37. Your partner should check with her gynecologist khổng lồ see if she is still ovulating before you agree to lớn a reversal.Are There Alternatives to lớn Vasectomy Reversal?
There are other ways to get your partner pregnant without a reversal. Your urologist can take sperm from your testis or epididymis using a needle or by surgery ("sperm retrieval"). But sperm taken this way can"t be used in basic, low-cost office artificial inseminations. Instead, these sperm need more complex, costly ($12,000 khổng lồ $17,000) in vitro fertilization (IVF) techniques using intracytoplasmic sperm injection (ICSI).
Most centers have sầu about 4 out of 10 pregnancy rate with IVF/ICSI if the female partner is younger than 37. The pregnancy rates are much lower if she is older. Studies show that reversals are more cost-effective sầu in reaching pregnancy than sperm retrieval & IVF/ICSI. Another plus of reversal over sperm retrieval/IVF is the chance for future pregnancies.
Your choice may be influenced by which methods your health plan covers. You might also weigh cost, years since vasectomy (and the chance of needing an epididymovasostomy), và your partner"s age.If a Vasectomy Reversal Fails, Should I Try it Again?
When done by skilled microsurgeons, success rates for repeat reversals are often the same as for first reversals. Your urologist will Đánh Giá the record of your prior surgery khổng lồ help you decide. If sperm were found in the vasal fluid then, he/she will likely do a repeat vasovasostomy, which is more likely to succeed.How Much Does a Vasectomy Reversal Cost?Will a Vasectomy Reversal Cure Testis Pain from My Vasectomy?
Very few men get pain in the testis after a vasectomy that"s bad enough for them to ask about reversal. Because these cases are rare, there aren"t many studies of groups of these men. These studies suggest that it works for most men. Still, your urologist can"t tell beforehvà if a reversal will cure your pain.