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Vasectomy reversal or vasovasostomy is an operation performed under general anaesthetic to restore fertility after a vasectomy.
The operation involves 2 incisions either side of the scrotum about 3cm in length each. The 2 ends of the vas are delicately dissected from the scar tissue which is excised. A check is made that any blockages have been removed. The 2 ends of the vas are joined with between 4 and 12 individual stitches each of which is finer than a human hair. When both sides have been joined, reinforcing stitches are placed on surrounding tissues to relive the tension on the join. The operation is completed by placing dissolvable skin stitches. The procedure takes 3 hours when performed using a microscope.
Occasionally there is an obstruction to the epididymus – the area where sperm mature before passing to the vas. If this is the case the vas has to be joined to the epididymus – a procedure which can only be performed with an operating microscope.
Success rates vary depending on the type of magnification used, and the time elapsed from the vasectomy. Those who specialise in vasectomy reversal usually use the microscopic technique which is allows more accurate and increased number of stitches which leaves a more watertight result. The longer the interval since the vasectomy, the reduced chance of a successful outcome – this is because a blockage is more likely in the epididymus (the tube which leads to the vas) which means that sperm cannot reach the vas.
Pregnancy depends on both male and female factors. Age is an important female factor and fertility declines over the age of 40. As a result overall pregnancy rate after vasectomy reversal are about 60%. There may be some delay in achieving a pregnancy after a successful vasectomy reversal – the sperm count often increases over a 12 month period after the reversal.
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