Posts Tagged ‘vasectomy reversal’

Vasectomy Reversal After A Vasectomy

December 27, 2014

I am often asked if a vasectomy can be reversed. Most often a man divorces, has a new wife and they wish to have children in their new marriage. Can the vasectomy be reversed?

Normally, sperm – the male reproductive cells that fertilize a woman’s egg – are made in the testicle. Sperm travel away from the testicle through a tube called the vas deferens. There is one vas deferens for each testicle. The vas deferens connect with a reservoir where the sperm is held, ready to be leave the reservoir during sex. The sperm also mixes with secretions from the prostate gland that keep the sperm alive. When the sperm is ejaculated, it travels through another tube, the urethra, inside the penis and is deposited in the woman’s vagina at the cervix or the “gatekeeper” to the uterus.

A vasectomy cuts or blocks the vas deferens. Once the vas deferens is blocked, sperm cannot pass from the testicle to the reservoir where semen and secretions from the prostate gland are stored.

After a vasectomy, a man continues to have normal ejaculations of semen, but the ejaculate no longer contains sperm. This can only be discerned if the ejaculate is examined under a microscope.

In a traditional vasectomy, the surgeon uses a scalpel to make small incisions in the skin of the scrotum near the base of the penis to reach both vas deferens. (The scrotum is the fleshy sac that contains the testicles.) The vas deferens are cut or blocked to prevent sperm from traveling. The incisions in the scrotum are then closed with two or three small stitches.

In my practice, I perform the no-scalpel, no-needle vasectomy, which is less painful, has less bleeding and fewer complications. The surgeon makes one or two tine openings about the size of an eraser to access the vas deferens.

The puncture is widened slightly, then the surgeon cuts or blocks each vas deferens.

The puncture site can be covered with a tiny dressing. No stitches are needed.
A vasectomy is intended to produce permanent sterilization. Special microsurgery can reverse a vasectomy and restore fertility in some cases. Vasectomy reversal is a delicate, expensive procedure. And it is only successful in about 60 to 70 percent of cases.

No Sperm, No Baby, No Problem

March 29, 2013

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Women have received a bad rap.  The assumption that most problems associated with the difficulty to conceive and have a baby is the fault of the female partner.  However, let the truth be told, 1\3 are a result of female problems, 1\3 are a male issue, and 1\3 are linked to both male and female problems. 

That’s the bad news.  The good news is that two-thirds of couples treated are ultimately able to conceive.

Part of the issue today is that many women are waiting much later in life to have children.  As women get older they’re going to see more problems trying to conceive. Men are capable of fathering children later in life, certainly into their 40s and 50s. They don’t have the same fertility issues that women have at that age.  That is, the biologic clock of men ticks longer than for women.

Common causes of men’s infertility can be hormonal problems, injuries, illness, medications, or a previous vasectomy. Lifestyle issues like smoking and alcohol use may affect sperm production, but are secondary factors.

A common cause of infertility in men is varicocele, an enlargement of the veins in the scrotum that heats the testicles, affecting the number and shape of sperm.  A varicocle is a common problem and up to 30 percent of all men have a varicocele.

Varicocele can develop in adolescence, and may be discovered by a pediatrician. Because of the long-term effects that can lead to infertility, a pediatric surgeon or urologist may recommend a procedure to correct the problem, depending on the severity. The purpose of the surgery is to seal off the affected vein and route blood flow into normal veins.

Another cause of male infertility is vasectomy.  Men are having a vasectomy, which is a reasonably permanent form of sterilization at an earlier age, and then have a change of heart when they get divorced and then marry a younger partner and want to have children and start a second family.  A vasectomy reversal is now quite successful and can be done as an outpatient in an ambulatory treatment center.

More recently, the public has been bombarded with advertisements for medications aimed at correcting low testosterone or low T. These popular medications for hormone replacement for low testosterone may affect a man’s future fertility.  Men should talk with their doctors about medications if they are trying or may be planning to achieve a pregnancy in the future.

Bottom line: Infertility is just as much a man’s problem as it is for the woman.  Help is available and the place to start is a semen examination to be sure that the man has all the ammunition he needs to father a child.