Vasectomy Reversal: Frequently Asked Questions
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Open AllClose All- Why do people usually undergo vasectomy reversals?
- Men usually undergo a vasectomy reversal because they have remarried and wish to start a family with their new partner. Sometimes, however, couples who have had children and then decide to undergo a vasectomy, change their minds and feel that they would like to have additional children. Approximately 11% of men in the United States choose to have a vasectomy, and 4-5% of them later have a vasectomy reversal.
- How likely is it that my vasectomy reversal will succeed?
- Using modern microsurgical techniques and equipment, the success rate for vasectomy reversal is now quite good. The most powerful predictor of the success of a vasectomy reversal is the duration of time that has passed since the original vasectomy was performed. The more years since the original vasectomy was performed, the more likely an obstruction will have developed in the epididymis gland. Having said that, many successful vasectomy reversals have been performed when more than 20 years have passed since the original vasectomy procedure was done.
- Do surgeons who perform vasectomy reversals receive special training in this procedure?
- Many urologists perform both vasectomies and vasectomy reversals. Microsurgical vasectomy reversal, however, is a highly specialized surgical procedure and there are a limited number of fellowship training programs in the United States that provide additional training in this microsurgical reconstructive technique. Following the completion of his Urology residency training, Dr. Meacham completed a one year fellowship in Male Reproductive Medicine and Surgery at Baylor College of Medicine in Houston, Texas. During his fellowship, Dr. Meacham received specialized training in vasectomy reversal and other microsurgical reconstructive procedures. He has further refined his surgical technique while performing several hundred vasectomy reversals during his sixteen years of clinical practice.
- Does a man ever get "too old" to have a vasectomy reversal?
- No. Although age may affect male fertility, men may father pregnancies well into their senior years. Although the time since a man’s original vasectomy may affect on the success rate of vasectomy reversal, many men in their 40’s, 50’s and 60’s undergo successful vasectomy reversal and father children. While the decision to have children is a serious step in the lives of any couple, older men often make exceptionally good fathers and a vasectomy reversal has allowed many couples to experience the joys of parenthood.
- If I had my vasectomy several years ago, am I still producing sperm?
- Men produce sperm throughout their lives. Following a vasectomy, the testicles continue to produce sperm. Because the sperm cannot leave the testes and enter the ejaculate, they eventually die and are reabsorbed by the body. When these sperm have been reabsorbed, new sperm are reproduced and the cycle continues. Following a successful vasectomy reversal, sperm are once again released into the semen and leave the body during ejaculation.
- Will a vasectomy reversal be painful?
- Although a vasectomy reversal is usually somewhat more uncomfortable than the original vasectomy, it is not a particularly painful procedure. Men usually report they have moderate discomfort for a few days following the procedure, after which they have little if any pain. After surgery, the patient should stay off his feet as much as possible for three or four days, to minimize swelling and discomfort.
- What kind of pain medication is usually prescribed after a vasectomy reversal?
- Dr. Meacham usually prescribes Vicodin or a similar mild narcotic pain medication, to relieve discomfort in the first few days following a vasectomy reversal. Usually, men need only small amounts of pain medication following a vasectomy reversal because it is not an especially painful procedure.
- What type of anesthesia is used during a vasectomy reversal?
- Dr. Meacham performs vasectomy reversals using either general anesthesia or a regional block such as a spinal anesthetic. Both types of anesthesia are extremely safe and the recovery from either type of anesthesia is rapid. Before surgery, patients discuss anesthesia options with Dr. Meacham and the anesthesiologist, who provide the type of anesthesia that the patient prefers.
- What kind of suture material is used to reconnect the vas deferens during a vasectomy reversal?
- In order to reconnect the vas deferens to itself or to the epididymis gland, an extremely fine nylon suture is required, so small that it is difficult to see with the naked eye. Dr. Meacham uses a surgical microscope to handle the suture material with ease and precision.
- How does the surgeon manage to reconnect something as small as a vas deferens?
- Because the vas deferens is so small, most vasectomy reversal surgeons use a high-powered surgical microscope. Dr. Meacham uses the latest Leica-Wild brand operative microscope, enabling him to see the vas deferens at 26 times its normal size. Combined with Dr. Meacham’s highly experienced microsurgery team, this state-of-the-art microsurgical instrumentation provides an ideal setting for a successful vasectomy reversal.
- Can a vasectomy reversal that initially succeeds close up later on?
- Unfortunately, even successful vasectomy reversals may fail over the long term. As many as one of seven successful vasectomy reversals will scar off during the two years after vasectomy reversal. Dr. Meacham recommends that couples who undergo successful vasectomy reversal consider freezing semen for future insemination procedures, in case of delayed scarring. Sperm cryopreservation services are offered through the University of Colorado Hospital Center for Fertility and Advanced Reproductive Medicine with which Dr. Meacham is associated.
- Can sperm be harvested and frozen during a vasectomy reversal?
- Sperm can be harvested during a vasectomy reversal and frozen for a possible invitro fertilization (IVF), providing fertility options for unsuccessful vasectomy reversals. The number of living sperm harvested during vasectomy reversal is limited, sufficient for IVF but not for other fertility treatments such as intra-uterine insemination. For this reason, couples who choose sperm harvesting pursue invitro fertilization if they opt to use the cryopreserved sperm. Dr. Meacham works with the University of Colorado Hospital Invitro Fertilization Laboratory Team to cryopreserve sperm for men undergoing vasectomy reversal and he routinely performs sperm harvesting in this setting.
- Can sperm harvested during a vasectomy reversal be used for "artificial insemination"?
- Harvesting and freezing sperm during a vasectomy reversal is a straightforward procedure, but these sperm can only be used for invitro fertilization procedures, not "artificial insemination". Invitro fertilization involves harvesting eggs from the patient’s partner, achieving fertilization in a laboratory setting and then transferring the embryos back to the partner. Unfortunately, the number of sperm obtained by surgical harvesting is rarely adequate for pregnancy with intra-uterine insemination or other reproductive technologies.
- What type of post-operative care is recommended after a vasectomy reversal?
- Patients should stay off their feet as much as possible for three or four days after surgery, to minimize swelling and discomfort. When a patient comes out of the operating room he will wear a scrotal support until the following morning, and for two weeks wear the support or snug fitting underwear. Patients should also avoid heavy exercise or lifting weights greater than thirty pounds for two weeks, and bicycling or horse back riding for six weeks.
- Are many vasectomy reversals performed at the University of Colorado Hospital?
- Dr. Meacham has maintained a regional referral center for male fertility and reconstructive surgery since his arrival at the University of Colorado in 1990. During that time, he has performed several hundred microsurgical vasectomy reversals. Dr. Meacham is a nationally recognized expert in the field of male reproductive medicine and surgery. He is Past-President of the American Society for Reproductive Medicine and has lectured to hundreds of urologists on the topics of male fertility and reconstructive surgery.
- Can another vasectomy be performed after a successful vasectomy reversal?
- Yes. A number of men elect to undergo repeat vasectomy following a successful vasectomy reversal and the birth of additional children, because vasectomy is a reliable birth control method. A repeat vasectomy can be accomplished by most surgeons familiar with that procedure.
- If a man has undergone an unsuccessful vasectomy reversal, is it possible to perform a "re-do vasectomy reversal"?
- Among men who have undergone failed vasectomy reversal, it is usually possible to perform repeat vasectomy reversals. A number of factors determine the success of vasectomy reversal: the amount of time since the original vasectomy, the presence or absence of an obstruction, the skill of the operating surgeon and the technical difficulty of the procedure. Because Dr. Meacham has maintained a regional referral practice in male fertility and microsurgical reconstruction, he is often referred patients who need a repeat vasectomy reversal. Although such procedures can be technically demanding, the outcome of the procedure is often favorable.
- Is a vasectomy reversal an expensive operation?
- In an effort to minimize the financial impact of vasectomy reversal, Dr. Meacham, The University of Colorado Hospital, and the Anesethiology Team have collaborated to offer a substantially reduced "package price" for surgery, anesthesia and hospital facilities. We are happy discuss the cost of a vasectomy reversal with you and would also be more than happy to send printed material regarding these issues.