Vasectomy reversals refer to surgical operations that aim at undoing a vasectomy in order to restore the normal anatomy of the male reproductive system. In these procedures, two options are available; connecting vas deferens to vas deferens (vasovasostomy) or epididymis to vas deferens (vasoepididymostomy). Considering that this is a new advancement in surgery, full success may not be guaranteed.
Despite popularity of vasectomy as a contraceptive method, a few people opt for reversal. This may be linked to wanting to have children with a new partner probably after having divorced or due to death of a previous one. A couple may also wish to replace the loss of treasured child. In a few cases, reversals are carried out to relieve the pain associated with the cutting the tubes.
The mature sperms are passed along a thick muscular tube (vas deferens) to the urethra. The sperms are released from the urethra during ejaculation. In vasectomy, the communication between the vas deferens and the urethra is cut short. Despite sperms being produced by the testicles no sperm reaches the urethra, instead they wither and are reabsorbed in to the body.
Prior to the surgery, the patient is anesthetized to cut down on patient movement or interruption during the procedure. The scrotum is then cleansed by scrubbing it with cleaning solution. A small incision about one to two centimeters is made on both sides of the proximal part of the scrotum to expose the vas deferens.
A new technique of surgery has been introduced in this area. Microsurgical reversal is a method that uses state-of-the-art equipment to improve outcomes. This piece of equipment gives the surgeon great magnification and resolution of the field. The magnification that can be achieved is close to 50 times the original. This has markedly increased the accuracy of the technique.
Being one of the weakest areas in the male genital tract, the epididymis poses a great challenge to the surgeon. The site is affected by back pressure that may result in epididymal rapture and subsequent scarring and blockage. For this reason, there is need for a high level of competence on the part of the surgeon. In the event of a blockage, there may be need for the creation of a bypass that allows sperms to pass to the urethra. Vasoepididymostomy is associated with more complications than vasovasostomy.
Another common difficulty encountered in the theater is the fact that the two ends of epididymis are of different diameters. Accurately realigning these ends is not always that easy. For this reason, leakages are quite common. This in turn results in frustrations on the part of both the surgeon and the patient. Related to the same is the scarring that may take place during healing.
The measure of success of this operation is based on achievement of pregnancy. Failure may be attributed to formation of scar tissue at the site of vas deferens reconnection causing blockage. This can be taken care of by use of anti inflammatory drugs or a repeat of the surgery, depending on the circumstances. Rare complications of vasectomy reversals include infection and bleeding.
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