Vasectomy is a type of surgery that prevents a man from being able to get a woman pregnant. It is a permanent form of birth control.Vasectomy works by blocking the tube through which sperm pass. The surgery usually takes no more than 30 minutes. Almost all men go home the same day. In most cases, recovery takes less than a week.
Vasectomy can sometimes be reversed, but not always. Having a vasectomy does not protect against sexually transmitted diseases, such as HIV/AIDS. Men who have had vasectomy should still practice safe sex to avoid STDs.
Vasectomy reversal is the repair of the damaged portion of the vas deferens. This is usually due to the prior vasectomy, however may also be caused by inguinal hernia surgery with mesh. A similar cause of sperm blockage occurs with an obstruction of the ejaculatory duct by cysts, stones or prior infection.
The ends of the vas deferens are put back together to bypass the blocked portion. This returns sperm to the man’s ejaculate in the vast majority of cases. The unique aspect of this surgery is the size of the repair needed. In general, the vas deferens is repaired with a suture that is smaller than a human hair. It requires skill in using an operating microscope or robotic surgery. The size of the tube sperm travel through is similar to the period at the end of this sentence. It is important to find someone who has been fellowship trained in this procedure to have the best outcome.
The return of sperm to the ejaculate is expected in greater than 90 percent of men less than 10 years after vasectomy. Factors that influence success include the time since vasectomy, age of the patient and partner, quality of the fluid found at the time of surgery, and the experience of the surgeon. A vasectomy reversal can be successful up to 20 years after vasectomy.
At the time of surgery, the fluid from the vas deferens on the testicle side is evaluated for the presence of sperm. This fluid helps the surgeon determine if a vasectomy reversal can be performed or a patient may need a vasoepididymostomy. If sperm are not present, a vasoepididymostomy attaches the vas to the epididymis to bypass any other blockages that may have developed. This decision is made while the patient is asleep, and the overall success rates with this approach are lower. The epididymal tube is even smaller than the vas deferens, requiring exceptional care for repair.