Vasectomy & Vasectomy Reversal
Vasectomy is a minor procedure in which the drainage of sperm out of the testicle is interrupted. The result is an ejaculate that is without sperm. Importantly, the production of testosterone and erectile function is completely unaffected by vasectomy. With the exception of abstinence, vasectomy is the most effective form of birth control. Only 1-2 women out of 1000, will get pregnant the year after their partner has a vasectomy. For a conventional vasectomy, 1 or 2 small cuts are made in the skin of the scrotum to reach the vas deferens. The vas deferens is cut and a small piece may be removed, leaving a short gap between the 2 ends. Next, the urologist may sear the ends of the vas, and then tie the cut ends with a suture. These steps are then repeated on the other vas, either through the same cut or through a new one. The scrotal cuts may be closed with dissolvable stitches or allowed to close on their own.
As the name implies, vasectomy reversal is a surgical procedure to re-establish the flow of sperm out of the testicle and ultimately out of the penis. This requires delicate microsurgery. A high-powered microscope used during your surgery magnifies the small tubes 5 to 40 times their size. 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 trim 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 check to see if it has sperm in it. At this point, there are 2 types of vasectomy reversal procedures you can have: vasovasostomy and vasoepididymostomy.
Vasoepididymostomy is more complex than vasovasostomy, but the results are nearly as good. Sometimes vasovasostomy is done on one side and vasoepididymostomy on the other. Success depends on multiple factors paramount of which is the time from vasectomy. The further out from the vasectomy you are the lower the chance of successful reversal.