Some considerations before undertaking a vasectomy reversal
Prior to undertaking a vasectomy reversal, it is important to discuss with your doctor all aspects of the operation and your personal situation, to pinpoint significant issues that will impact upon the ultimate result.
The extent of the period from vasectomy to reversal is an important factor, as success rates are known to diminish the longer the break has been. This is due to the increased probability of pressure injury sustained in the epididymis or even a blockage within it.
Your doctor will be interested in any history of complications that may have occurred after the the vasectomy such as scrotal hematoma or any post operative epididymis infection. Your partners reproductive potential will also be assessed and you must realise that if you were was having difficulty with conception before your vasectomy, this situation is unlikely to change after vasectomy reversal. Also, your specialist will try to procure your surgical notes relevant to your vasectomy to determine, if possible, how your vasectomy was actually carried out.
For instance, depending whether the vasectomy was performed high up on the tube or quite low down near the epididymis, could have an effect on the difficulty of the reversal surgery. Your physician will also analyse your physical make up to get a superior understanding of what he will encounter during the reconstruction.
Small spongy testes can suggest impaired sperm manufacture and project a poor result.
An enlarged or uneven epididymis can mean secondary epididymal impediment that may require a vasoepididymostomy. On the other hand, an incidence of a sperm granuloma is a satisfactory diagnosis as these sperm granulomas allow for the venting of high pressure away from the epididymis, and subsequently allowing protection from pressure induced harm.
If you have a sperm granuloma your prognosis is good irrespective of the period since the vasectomy took place.
When a very harmful vasectomy has been undertaken, it is conceivable that large portions of the vas have been excised or cut out. This may mean that extensions of the incisions may be required to establish a tension free reconnection leading to more complicated surgery. Naturally, if a satisfactory outcome is obtained by re establishing sperm flow in the man, a successful pregnancy can only be obtained providing the female is also capable of giving birth.
The woman should organize for a gynecological examination to guarantee that she is able to conceive. How near she is to menopause can be also be an issue because of the time that it may take for sperm flow to be re established in the man following a successful vasectomy reversal.
These are just some of the considerations that need to be taken into account before undertaking a vasectomy reversal.
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