Tag Archives: general anesthesia vas reversal

Vasectomy reversal-check for sperm at home!

vasectomy

A common question for the couple having had a microscopic vasectomy reversal is, “When should we check for the presence of sperm?” (As discussed elsewhere this will tell you two things: one that the testicles are now producing sperm and that the vas deferens is open i.e. the repair was successful.)

Although is a patient who had a vasectomy a relatively short time before the reversal may have sperm on the first ejaculate, the most fruitful time to check for sperm is in the three to four month range. In some it may take longer than that. The time frame depends on the time between the vasectomy and the reversal with the longer time interval resulting in a longer time for sperm to return.

Because most of our patients are from out of town, we often get calls as to how they check for the presence of sperm without having to come back to Gainesville. The two options would be to submit a specimen to the local hospital lab to be examined under a microscope which can quickly and easily be done but at some expense or a couple could use the kit provided by spermcheck.com. This kit has become a nice alternative to the post vasectomy patient who wants to assure sterility but would prefer not to have to give a specimen and then take it to the doctors office to be examined.

Even though the kit is to check for successful vasectomy, the presence of sperm for the post reversal patient would indicate things are on the right path to pregnancy. It would not indicate a specific number just presence or absence of sperm. A formal semen analysis would be required for the sperm parameters of count and motility. The minimum number of sperm to achieve pregnancy is usually 20 million with at least 40% having good forward motility.

 

Georgia Vasectomy Reversal-UK Video

This video is actually a nice primer to microscopic vasectomy reversal giving the patient an idea of what things look like during the procedure. Reminds me of listening to a Beatle interview back in the day.

Can a vasectomy reversal be done under local anesthesia?

Just because something can be done doesn’t mean that it is the way you’d want it done.

Yes. The scrotal skin and the nerves that innervate the testicles and vas deferens can be infiltrated with short and long acting anesthetics for very good control of pain. Oral medicines similar to what is used in “sedation dentistry” can be used as a sedative to further make non general anesthesia possible for a vasectomy reversal.

Why doesn’t everyone do it this way? Because the procedure usually lasts 2-3 hours some patients might not be comfortable lying still for that long. As well, because the operative microscope magnifies the operative field so much, small movements dramatically change the area seen and the focus settings. This in turn results in the surgeon having to readjust the microscope and in turn make procedure last longer. One might add that the occasional adjustments hamper the surgeon’s ability to do a quality repair of the vasectomy.

Another reason that a patient and the doctor might prefer local anesthesia with oral sedation is cost. Having general anesthesia must be done in a facility and that in it self adds an expense and then there is the anesthesiologist and the supplies necessary for general anesthesia.

The advantage to the patient with general anesthesia is that he is put to sleep and then wakes up and the procedure is done. For the surgeon he has had the advantage of not being concerned or dealing with a patient moving and having to readjust the microscope.

So in the end it becomes about patient and surgeon preference, and cost. At Northeast Georgia Urological Associates we believe we have the best of both worlds.

Because we own our center the added costs for a facility and anesthesia is minimized resulting in a very cost effective reversal without compromising safety and comfort by utilizing a  board certified anesthesiologist in an accredited surgery center.