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Vasectomy-Reversal : What are the factors affect the success rate?

Vasectomy
FB Dr Soarawee
Soarawee Weerasopone, MD

Andrologist
Royal Phnom Penh hospital, Kingdom of Cambodia

Due to in nowsdays the rate of divorced couples become higher, men whom ever underwent Vasectomy will change their mind and seek for the reversal procedure. There are a survey in US that 2% to 6% of Vasectomized men have to do reversal procedure.

Vasectomy procodure
Vasectomy procodure

Day-care Vasectomy operation

Let’s get start with Vasectomy first, the day-care operation for male permanent contraception. This kind of procedure start with infusion of pain killer at scrotal skin, after that the surgeon will make 1-cm incision and then catch both Vas deferens then cut, ties and cauterizes them as picture. Some surgeon perform “No-scalpel technique” which no incision is required, this special technique has pros on less pain and less operative times but we still question about its effectiveness because when I discuss with patients about “Contraception procedure”, they always expect 100% success rate (I have reviewed latest literature on this question which had launched on 2014 – still questionable).

Vasectomy-revesal operation

Back to the reversal procedure. It is not a minor operation like Vasectomy one, patient need to be done under General anesthesia with several hours of operative times, patient need to stay overnight at the hospital.

After the operation, patient must strictly follow the doctor’s advices as shown below

  • Shower 48 hours after surgery
  • All-time wear scrotal support (Except in shower) for 6 weeks
  • Scrotal support still needed during heavy activity until pregnancy
  • Desk work can be resumed in 3 days
  • Avoid sport for 3 weeks
  • No ejaculation for 3 weeks
  • Semen analysis at 1, 3 and 6 months postoperatively

With Microscopic surgery was reported on superior outcome so it needs well-trained urologist or andrologist to perform this operation. After Reversal procedure has done, 70% to 95% of patients have sperm with their ejaculation fluid and get pregnancy by natural in 30% to 75% of couples.

Anyway, there is a magic number on this operation. If you decide to undergo reversal within 5 years after Vasectomy and get young wife, you will get good chance of becoming fertile so? Better make decision divorce early and find young wife will make better outcome? Just little joke. If you need more information on this, come and see me at the office.

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