tag:blogger.com,1999:blog-28018550645602748042024-02-20T05:23:23.650-08:00vasectomy reversalgriyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-2801855064560274804.post-4002435822636713982008-07-29T22:44:00.001-07:002008-07-29T22:44:48.941-07:00Vasectomy reversalThe surgery is more difficult than the original vasectomy because the tube that carries sperm from each testicle to your<br />semen (vas deferens) must be sewn back together or attached to the epididymis. The surgery usually is done on an outpatient<br />basis — without an overnight stay at the surgery center or hospital. Doctors can perform this surgery in one of two ways:<br />Vasovasostomy (vas-o-va-ZOS-tah-me). With this procedure, the surgeon sews the severed ends of the vas deferens back<br />together. However, sometimes this isn't possible and a more complex surgery is needed to restore the flow of sperm. Vasoepididymostomy (vas-o-ep-ih-did-ih-MOS-tah-me). This surgery attaches the vas deferens directly to the epididymis, the<br />coiled tube on the back of each testicle where sperm matures. A vasectomy can cause blockages or a break in the vas deferens<br />or the epididymis. This surgery is used when a vasovasostomy won't work because sperm flow is blocked. The vas deferens is<br />connected to the epididymis above the point of blockage. You probably won't know ahead of time which technique is needed. The surgeon will make the decision during the operation. You<br />may need a combination of the two surgical techniques — a vasovasostomy on one side and a vasoepididymostomy on the other.<br />What can you expect during the procedure?You may have general anesthesia to make you unconscious during the surgery. Or, your surgeon may use an epidural, spinal or<br />local anesthetic. In any case, your anesthesia will need to keep you completely still because the surgery is so delicate.<br />It's done using a microscope that magnifies the surgery area five to 20 times, and any movements are magnified by the<br />operating microscope.<br />The surgeon will make a cut on the underside of your scrotum, expose the testicle, and release it from surrounding tissues.<br />Next, he or she will cut open the vas deferens and examine the fluid inside.<br />Fluid assessmentOnce the vas deferens has been opened, the surgeon will do a naked-eye inspection of the fluid that comes out as well as<br />examine a drop of the fluid under a microscope. This is an important part of the operation because it helps your doctor<br />determine what type of surgery you need to restore the flow of sperm.<br />If the fluid contains sperm and plenty of clear fluid, surgery to reconnect the ends of the vas deferens — a vasovasostomy —<br />is likely to work. Fluid below the vasectomy site that is thick or pasty, or that contains no sperm or partial sperm, can be a sign that there<br />is scar tissue blocking the flow of sperm. In this case, attaching the vas deferens directly to the epididymis — a<br />vasoepididymostomy — may be the best option. Freezing spermIf your doctor finds sperm during the surgery, you may choose to have some frozen in case your vasectomy reversal doesn't<br />work. If after vasectomy reversal you're not able to father a child through sexual intercourse, your frozen sperm may be<br />injected directly into an egg. This is a type of in vitro fertilization called intracytoplasmic sperm injection (ICSI).<br />After surgeryImmediately after surgery, your doctor may cover the incisions with bandages. You'll put on your jockstrap to hold any<br />bandages in place and apply some pressure to reduce swelling and movement. You'll need to rest with an ice pack placed on<br />your scrotum to reduce swelling. As the anesthetic wears off, you may have some pain and cramping that can be relieved with<br />acetaminophen. For most men, the pain isn't severe and gets better after a few days to a week.<br />After you return home, take it easy. You may be sore for several days, which you can treat with acetaminophen or, if your<br />doctor prescribes it, acetaminophen plus codeine. You may also have bruising, but the discoloration should lighten and<br />disappear after about two weeks. Any stitches should dissolve in seven to 10 days.<br />For the first two days after surgery, avoid bathing and swimming. Refrain from sports and heavy lifting for at least three weeks. If you have a desk job, you'll probably be able to return to work three days after surgery. If you perform physical labor or<br />have a job that requires much walking or driving, talk to your doctor about when it's appropriate to resume working. You shouldn't have sexual intercourse or ejaculate for about four weeks. At that point, you may resume sexual activity. You'll need to wear a jockstrap for several weeks at all times, except when showering. After several weeks, you'll need to<br />continue to wear a jockstrap during exercise. ResultsIn successful vasovasostomy, sperm usually appear in the semen after a few months. After a vasoepididymostomy, it takes<br />longer — from three to 15 months. Vasectomy reversal leads to pregnancy in about 52 percent of couples within two years.<br />While some pregnancies occur within a few months after a vasectomy reversal, the average is about a year after the procedure.<br />Sometimes problems with conception are due to female infertility. When the female partner doesn't have fertility problems,<br />couples are more likely to conceive a child after a vasectomy reversal.<br />Your surgeon will want to examine your semen after surgery to see if the operation was successful. Unless you achieve<br />pregnancy, a sperm count is the only way to tell if your vasectomy reversal was a success.<br />If vasectomy reversal doesn't workVasectomy reversals sometimes fail if there is a sperm blockage that wasn't recognized during surgery, or if a blockage<br />develops sometime after surgery. Some men have a second-attempt vasectomy reversal if the procedure doesn't work the first<br />time.<br />Experts are investigating whether anti-sperm antibodies — proteins that develop after a vasectomy — might interfere with<br />fertility after vasectomy reversal. Research shows anti-sperm antibodies can inhibit the function and movement of sperm, but<br />experts are still not sure about their effect on fertility after a vasectomy reversal.<br />RisksRisks of vasectomy reversal include:<br />Bleeding within the scrotum. This may lead to a collection of blood (hematoma) that causes painful swelling. You can reduce<br />this risk by avoiding aspirin before and after surgery and following your doctor's instructions to rest after surgery. Infection at the surgery site. This isn't common, but is a risk with any surgery. Inflammation. Sperm leakage into the scrotum can prompt your immune system to form an inflammatory mass called a sperm<br />granuloma. Granulomas usually occur sometime after surgery and can be a sign that a vasectomy reversal wasn't successful. Damage to nerves and blood vessels. In some cases, this reduces fertility after a vasectomy reversal. Call your doctor if you develop any of these signs and symptoms:<br />Fever Swelling that worsens or won't go down Difficult urination A marble-sized lump in your scrotum Bleeding from an incision that continues after you've pinched the site between two gauze pads for 10 minutes Looking aheadDifferent surgical techniques can be used to perform vasectomy reversal. Experts are evaluating the outcomes of various<br />surgical techniques to determine which ones are most successful. While surgeons can apply research about the best techniques<br />to their own practice right away, other developments are on the horizon that will take longer before they are commonly used:<br />Experts are investigating the use of new methods to replace stitches, including glue, use of lasers and biological tissue.<br />They think that once developed, methods other than stitching may decrease surgery time and provide better results.<br />Researchers are developing robotic instruments for use in vasectomy reversal and other delicate surgeries. Although the<br />technology is still in the initial stages, robots have the potential to improve surgeons' ability to perform technically<br />challenging operations. Experts are testing the use of artificial stents to reconstruct the vas deferens during vasectomy reversal surgery. So far,<br />the stents haven't been tested on humans, but initial studies with rabbits indicate that their use may lessen the possibility<br />of sperm obstruction after vasectomy reversal.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-44186590503550608212008-07-29T22:39:00.001-07:002008-07-29T22:39:31.046-07:00What are the disadvantages of vasectomy?The chief advantage of vasectomy--its permanence--is also its chief disadvantage. The procedure itself is simple, but<br />reversing it is difficult, expensive, and often unsuccessful. Researchers are studying new methods of blocking the vas that<br />may produce less tissue damage and scarring and might thus permit more successful reversal. But these methods are all<br />experimental, and their effectiveness has not yet been confirmed.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-21643875985625772212008-07-29T22:38:00.003-07:002008-07-29T22:38:57.658-07:00What are the side effects of vasectomy?A major study of vasectomy side effects occurring within 8 to 10 years after the procedure was published in the British<br />Medical Journal in 1992. Investigators questioned 10,590 vasectomized men, and an equal number of nonvasectomized men, to<br />determine if they had developed any of 99 different disorders. After a total of 182,000 person-years of follow-up, only one<br />condition, epididymitis/orchitis (defined as painful, swollen, and tender epididymis or testis)--was found to be more common<br />after vasectomy. This local inflammation most often occurs during the first year after surgery. Treated with heat, the<br />condition usually clears within a week.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-35933700173498897212008-07-29T22:38:00.001-07:002008-07-29T22:38:35.596-07:00When can a man have sex again?A man can resume sexual activity within a few days after vasectomy, but precautions should be taken against pregnancy until a<br />test shows that his semen is free of sperm. Generally, this test is performed after the patient has had 10-20 post-vasectomy<br />ejaculations. If sperm are still present in the semen, the patient is told to return later for a repeat test.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-82735647938925770262008-07-29T22:37:00.000-07:002008-07-29T22:38:09.829-07:00What happens after vasectomy?After vasectomy, the patient will probably feel sore for a few days, and he should rest for at least one day. However, he can<br />expect to recover completely in less than a week. Many men have the procedure on a Friday and return to work on Monday.<br />Although complications such as swelling, bruising, inflammation, and infection may occur, they are relatively uncommon and<br />almost never serious. Nevertheless, men who develop these symptoms at any time should inform their physician.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-26315903395190186762008-07-29T22:36:00.002-07:002008-07-29T22:37:22.303-07:00How does vasectomy compare with female sterilization?Regardless of how it is performed, vasectomy offers many advantages as a method of birth control. Like female sterilization,<br />it is a highly effective one-time procedure that provides permanent contraception. Vasectomy, however, is medically much<br />simpler than female sterilization, has a lower incidence of complications, and is much less expensive.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-65880725297817482642008-07-29T22:36:00.001-07:002008-07-29T22:36:36.837-07:00How is vasectomy done?In the conventional approach, a physician makes one or two small incisions, or cuts, in the skin of the scrotum, which has<br />been numbed with a local anesthetic. The vas is cut, and a small piece may be removed. Next, the doctor ties the cut ends and<br />sews up the scrotal incision. The entire procedure is then repeated on the other side.<br />A newer method, devised by a Chinese surgeon, has been widely used in China since 1974. This so-called nonsurgical or no-<br />scalpel vasectomy was introduced into the United States in 1988, and many doctors are now using the technique worldwide.<br />In a no-scalpel vasectomy, the doctor feels for the vas under the skin of the scrotum and holds it in place with a small<br />clamp. A special instrument is then used to make a tiny puncture in the skin and stretch the opening so the vas can be cut<br />and tied. This approach produces very little bleeding, and no stitches are needed to close the punctures, which heal quickly<br />by themselves. The newer method also causes less pain and fewer complications than conventional vasectomy<br />.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-60100037882748061242008-07-29T22:35:00.000-07:002008-07-29T22:36:02.155-07:00How common is vasectomy?Vasectomy is used as a means of contraception in many parts of the world. A total of about 50 million men have had a<br />vasectomy--a number that corresponds to roughly 5 percent of all married couples of reproductive age. In comparison, about 15<br />percent of couples rely on female sterilization for birth control.<br />Approximately half a million vasectomies are performed in the United States each year. About one out of six men over age 35<br />has been vasectomized. The prevalence of men undergoing the procedure increases with higher levels of education and income.<br />Among married couples in the United States, only female sterilization and oral contraception are relied upon more often for<br />family planning.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0tag:blogger.com,1999:blog-2801855064560274804.post-69554205278209839112008-07-29T22:33:00.000-07:002008-07-29T22:35:17.517-07:00What is vasectomy?Vasectomy is a simple operation designed to make a man sterile, or unable to biologically father a child. Vasectomy involves<br />blocking the tubes through which sperm pass into the semen. Sperm are produced in a man's testis and stored in an adjacent<br />structure known as the epididymis. During sexual climax, the sperm move from the epididymis through a tube called the vas<br />deferens and mix with other components of semen to form the fluid that is ejaculated (ejaculate). All vasectomy techniques<br />involve cutting or otherwise blocking both the left and right vas deferens, so that the man's ejaculate will no longer<br />contain sperm, and he will not be able to make a woman pregnant.griyamayahttp://www.blogger.com/profile/04523031111177355294noreply@blogger.com0