Everyone has some experience with a change of mind. Typically this occurs around events that are easily reversed. Yet, some situations seem more permanent that others. Since a vasectomy is considered permanent sterilization, who is a candidate for vasectomy reversal?
Many couples elect for the man to have a vasectomy as a means of birth control when their family is complete. If a child dies, the couple divorces, or their financial situation changes and the couple feels they can afford to raise another child, a vasectomy reversal procedure maybe contemplated as a way to have more children. Usually these men, having already fathered children, are excellent candidates for vasectomy reversal.
Especially if the procedure was performed easily and without complications, the likelihood of viable sperm being present is good. Also, a shorter time period from vasectomy to reversal bodes well for success. Again, with no complications the two segments of the vas deferens, the tubes cut during a vasectomy, can be reapproxiamated with normal sperm flow about nine out of ten times. It is important to know exactly how the vasectomy was performed in order to more accurately determine the chances of a successful reversal.
All vasectomies involve the interruption of the vas deferens but this is done in different ways. In some cases the vas deferens is simply lifted through a small incision in the scrotum, cut in two, and the ends clipped or tied. In other cases, a segment of the vas deferens is removed after tying off the ends, and in a third method, the ends are cut, tied, and burned with an electrocautery device. If a larger, greater than 16 mm, segment of the vas deferens is removed, and if electrocautery is used, the chance of successful vasectomy reversal will be less. The operative record from the procedure will record these events and give a better idea of the likelihood of reversal.
When several years have passed from the vasectomy to the reversal, the chance of sperm granulomas increases. This decreases the success of a simple vasovasotomy or sewing the two ends of the vas deferens together. Usually this cannot be determined until the surgery is being preformed. The surgeon must check for motile sperm in the part of the vas deferens closest to the testicle. If this is not present then a more complicated procedure, with a lower success rate, a vasoepididymostomy, must be performed.