Undergoing a Delicate Surgery to Become a Father Again

When you read a headline about a "miracle" baby, it's typically about a woman overcoming infertility and giving birth. But for men, the circumstances are reversed, as approximately 40,000 men each year change their minds and decide to have their vasectomy reversed. This was the case for one of my patients, who for the purpose of this story I will call "Sam." Sam, aged 45, wanted to become a father again.

In 2002, Sam, a business owner and father of four children, felt that his family was complete and he had a vasectomy. However, like 5 percent of men in the United States who undergo a vasectomy, Sam's life circumstances changed. He fell in love, remarried and as the years passed, Sam and his wife, "Rebecca," wanted to have a baby. They began their research to explore options to restore Sam's fertility. Their Internet research gave them a basic understanding of the different procedures and the success rates, ranging from vasectomy reversal to assisted reproductive technologies like IVF (In Vitro Fertilization). "After looking at the statistics, I was concerned that my vasectomy reversal might not be successful because seven years had passed, and the odds seemed against me that I would be able to father a child again," Sam explains.

While the couple was doing their Internet research, Sam and Rebecca narrowed down the list of urologists they wanted to consult with who specialize in vasectomy reversal. In October, 2009, the couple scheduled a consultation with me.

While a vasectomy reversal seems to be a rather straightforward procedure, because it just requires suturing the ends of the vas deferens back together again, it's far more complex than that. A vasectomy reversal isn't as simple as it sounds. The procedure is a 3 to 4 hour delicate surgical procedure that uses precise microsurgical techniques with a special operating room microscope. During the operation, the urologist has to carefully stitch together the cut ends of the patient's vas deferens. An exact alignment is needed for a successful operation. This is difficult because the inside of the vas deferens is very tiny--just one-third of a millimeter in diameter. The best way to envision this is to think of putting the ends of 2 paper clips together. In that tiny area, up to 24 stitches are required on each side to obtain the most precise alignment possible.

After discussing it over, Sam and Rebecca decided they wanted to try. "We understood that there is no guarantee in life, but we very much wanted to have a baby," says Sam. In November of 2009, Sam underwent the procedure at a local community hospital. "I was discharged home the same day with minimal pain and advised to take it easy for 72 hours," continues Sam.

After six months had passed, Sam and Rebecca returned to me for a follow-up semen analysis and were thrilled to be given the good news that Sam's sperm count was good. The couple didn't have to wait long as Rebecca's subsequent pregnancy test was positive. Their miracle baby, "Angel," was born that January. "Bringing Angel home to meet her four siblings was the best New Year's gift we could ask for," says Rebecca.

The story doesn't end there. With their family now complete, Sam once again opted for a vasectomy. For Sam's next surgery, I performed a No Needle, No Scalpel vasectomy. Unlike a vasectomy reversal, the vasectomy only takes 15 minutes while the patient watches a television mounted on the ceiling and surfs through his favorite channels.No injection is used for local anesthesia (numbing). Instead, a jet spray of Novocain numbs the area instantly and no stitches are required.

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