This particular patient had his vasectomy 8 years before the reversal. When the area of the vasectomy site is excised fluid then emanates from the testicular side of the vas. The presence of fluid and the character of the fluid can determine the success of the reversal. In general-the shorter the time period from the vasectomy to the reversal the better the success rates are for pregnancy.
From Metrocentre Australia
From Vasectomy.com
Although vasectomy should be considered a permanent form of birth control, around 6 percent of men will eventually decide to undergo a vasectomy reversal. This procedure is done to restore a man’s fertility and allow him to father a child through natural means.
One method for reversing a vasectomy is a vasovasostomy. During this surgical procedure, the two cut ends of the vas deferens are sewn back together using very fine sutures viewed through a powerful surgical microscope. If successful, this procedure will enable sperm to flow from the testicles once again.
Several surgical techniques exist for rejoining the vas deferens. Some work better than others, but the best results are always obtained by doctors with training in microsurgical reconstruction. One of these methods is known as a two-layer vasovasostomy. Read More
Click on Image to Visit Northeast Georgia’s Vasectomy Page
Interesting Facts about a Vasectomy and Vasectomy Reversals
The First Microscopic Vasectomy Reversal?
Technical advances in vasectomy reversal mirror those in microsurgery over the past 100 years. As a discipline, microsurgery was first performed by Carl Nylen in Sweden for middle ear surgery in 1910, but grew most rapidly as a discipline in the 20th century stimulated by its success in microvascular reconstruction of war-injured soldiers.
The first microsurgical vasectomy reversal was performed by Earl Owen in 1971.
To get some idea of the size of the structures repaired, take a look at a penny. The “o” in God is approximately the diameter of the inner layer of the vas deferens (0.2-0.3 mm); the epididymal tubule is about half this size — and far more delicate. Read More from Dr. Finnerty’s Reversal Website.
So the most common complication of a vasectomy and a vasectomy reversal is a hematoma or a collection of blood, which will accumulate until the space around it has enough pressure to make it stop. It is important for the surgeon to thoroughly inspect the reversal site before finishing the reversal to detect even the slightest amount of bleeding. Using the microscope for this purpose allows for detection of bleeding that might not be noted with the naked eye.
If a hematoma occurs the usual treatment is conservative i.e. allow for it to resolve and be absorbed by the body on its own. Hematoma occurrence can be minimized by the patient following the post-operative instructions of limited activity and the use of compression underwear. It is important to stop any aspirin or ibuprofen well in advance of the procedure.
So although the two primary areas that need to heal before strenuous physical activity or sexual activity are different in character, the magic number of time is around three weeks-four weeks.
Anecdotally, I have had a patient present to my office the day after a reversal stating that he was having bleeding at the incision site. He confessed that he had had sex the night of the procedure. I reassured him the bleeding was from the skin edge and nothing to be concerned about.
This couple had a baby almost 9 months later to the day. Go figure!
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.
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.
