Vasectomy and Reversal Tips

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Why did my wife get pregnant after my vasectomy?

Pregnancy After Vasectomy

Though vasectomy is considered to be a permanent form of birth control for men, approximately 1 in 2000 men conceive children, following vasectomy. There are two primary reasons for this:

  1. There were still live sperm in the semen
  2. Failed procedure due to spontaneous reconnection of the vas deferens tube
There may be sperm in the semen for several months following a vasectomy. Many people believe that as soon as they are well enough to resume sexual activity that they are also unable to conceive, however it takes the body some time to clear the semen of active sperm - usually 15 to 20 ejaculations. Men will need to utilize other methods of contraception until their sperm count is zero, which can take up to 8 months.

Though it is uncommon, the vas deferens may reconnect themselves, following a vasectomy. This is called "recanalization" and is more common with procedures where a significant length of the tube was not removed. For best results, surgeons should remove a length of the vas, or cauterize the ends, to prevent recanalization and subsequent birth control failure.

What is a vasectomy and how is it done?

Different Types of Vasectomy Procedures

Many people are familiar with the term "vasectomy," however most do not realize that there is more than one to complete this procedure. There are actually two (2) different vasectomy procedures which will achieve the same results:

  1. Traditional surgical vasectomy
  2. Scalpel-free vasectomy
With the traditional surgical vasectomy, two small incisions are made in the scrotal sac, using a scalpel. The tubes are pulled through the incisions and either clipped, using metal clamps, or cut using a knife or coagulator (heated tool that cauterizes tissue), then put back inside the sac. The incision is closed with a couple of sutures. Lasers have also been used, however there has not been any significant difference noted between the use of the lasers to cut the tubes and other conventional methods.

For a scalpel-free vasectomy, there is still an opening made in the scrotal sac, however it is accomplished using a specialized device that makes a small puncture in the skin, rather than slicing the skin with a scalpel. The vas deferens are located through the wall of the scrotal sac, to determine where to make the opening in the sac wall. The benefits of this method include: 1) generally less manipulation of the tissues, which can result in less swelling and discomfort, 2) the skin puncture does not usually require sutures to close, since it is so small, and 3) there is less anxiety since the sac is not being "cut."

No matter which type of vasectomy you opt to use, both are safe and effective methods for accomplishing the goal of permanent contraception.

How much does a vasectomy and a reversal cost?

Costs of Vasectomy and Vasectomy Reversal

When considering birth control methods, cost is also a factor. Some methods of birth control are more costly than others. These include: tubal ligation or hysterectomy for women and long-term prescription birth control pills.

Generally speaking, the cost of a vasectomy is usually between $500 and $1,000, depending on where you are and what type of procedure is completed. Your health insurance may actually cover part or all of this procedure.

Conversely, a vasectomy reversal is more expensive, since it requires more time and skill. The average cost of vasectomy reversal is between $5,000 and $13,000, depending on your location and procedure. Though this is a significant sum of money, and it is considered an elective procedure (which means your insurance policy may not cover this procedure) - it is less costly than in-vitro or in utero fertilization, which would be required if a reversal is not performed, and children are desired.

Talk to your physician about vasectomy and vasectomy reversal to find out the costs in your area.

What are the risks of getting a vasectomy?

Risks and Complications Associated with Vasectomy

As with any surgical procedure, there are risks and complications. Vasectomy has its own unique risks and complications, most of which are minor and will not require any additional intervention. These can include:

  • bleeding under the skin that produces bruising
  • swelling
  • pain
Other potential risks, which are more serious but are infrequent, include:

  • infection at the incision site
  • sperm granuloma - a small lump that forms in the teste in response to sperm leakage during the procedure
  • long-term post-operative pain - this is rare
  • allergic reaction to the local anesthetic
Usually, any side effects of the procedure can be managed with simple interventions:

  • bruising and swelling can be controlled with ice
  • pain can be managed with over-the-counter analgesics such as ibuprofen or tylenol
  • infections can be treated with oral antibiotics
  • granulomas usually don't need to be treated at all, unless they are causing discomfort
  • local anesthetic reactions can usually be controlled with antihistamines,but make sure you add the anesthetic to your allergy list at your physician's office
Vasectomy will NOT cause: loss of masculinity, low testosterone levels, changes in facial or body hair, impotence or protect you against sexually transmitted diseases.

Talk to your doctor about a vasectomy to get more information about the risks and complications of the procedure.

Why would someone want to get a vasectomy?

Reasons for Getting a Vasectomy

For men, the decision to get a vasectomy is not an easy one, and usually involves their spouse or partner. There are different reasons for a man to opt for vasectomy, including:

  1. permanent birth control for men who do not want children
  2. to provide birth control for the couple, where the risks for the woman would be greater in using traditional birth control methods or surgery
  3. to prevent transmission of hereditary diseases
Some men feel very strongly about not wanting children. Some single men have stated that having the vasectomy has improved their sex lives, because the "fear factor" has been removed, in terms of unplanned or unwanted pregnancy.

For men who are part of a couple, many realize that the risks for their partner are much higher than for men, when comparing the risks associated with long term use of birth control pills or having female surgery versus having a vasectomy. They opt to take the lead in permanent birth control.

A few men have concerns about transmission of hereditary disease, which makes them not want to produce children. Some diseases which are readily transmitted include, sickle cell disease and Huntington's Chorea, both of which are serious and life-threatening.

As with any surgical treatment, one must be sure that vasectomy is the right choice, before going through with the procedure. Vasectomies, though some can be reversed, are generally considered to be permanent. Always consult with your physician for details on this procedure.

What are the risks of reversing a vasectomy?

Risks and Complication of Vasectomy Reversal

As with any surgical procedure there are both risks and benefits. In a vasectomy reversal, the desired benefit is renewed fertility, and this procedure has a greater than 80 percent success rate.

In terms of risks associated with the procedure, they include:

  1. bleeding and bruising - a common side effect of surgery due to cutting of the skin and manipulation of the tissues
  2. swelling and pain - a common side effect of surgery, which can be managed with ice and over-the-counter analgesics
  3. infection at the surgical site - treatment with antibiotics will manage this
  4. risk for failure to re-establish fertility - this occurs less than 20 percent of the time and may be related to other factors, such as low sperm count
  5. sperm granuloma - a small lump that forms in the teste in response to sperm leakage during the procedure which does not need treatment unless it causes pain
  6. allergic reaction to anesthesia - treated with anti-histamines, remember to add the anesthetic to your list of allergies
  7. decline in sperm count - may be related to scarring or interruption of blood flow
  8. long term testicular pain - this is rare and can be treated
  9. testicular atrophy - a rare complication associated with disruption of the blood flow to the testes related to the surgery
  10. sexual difficulties - these are usually emotional, rather than physical and can be related to the new stress of trying to conceive
It is important to discuss the risks and benefits with your Urologist, physician or Fertility Specialist prior to attempting a vasectomy reversal, to ensure that you are fully informed and prepared for the procedure, physically and emotionally.

Are there any alternatives to vasectomy?

Alternatives to Vasectomy

Vasectomy is one method of birth control for men not wishing to conceive children, however it is considered permanent and a reversal may not be successful. For those seeking alternatives to vasectomy, there are several options for both men and women:

Specifically for men:

  • abstinence
  • condom
  • non-vaginal intercourse sexual activity
Specifically for women:

  • abstinence
  • birth control medication: the Pill, patches or shot
  • tubal ligation
  • hysterectomy
  • diaphragm
  • IUD
  • spermicidal products: jelly, sponge
With each option, the goal and benefit is prevention of pregnancy, however there are alternative risks to consider. For men, condoms protect against sexually-transmitted diseases but have an 18 percent failure rate, and non-vaginal intercourse sexual activities lack the same intimacy and may pose a risk of infection, especially in terms of anal sex.

For the female options, birth control medications can increase risk for blood clots and breast cancer, surgeries are expensive and painful with several risks and potential complications, and barrier methods and spermicidal products (IUD, diaphragm, Sponge) have limited effectiveness in pregnancy prevention.

It requires research and education to decide upon the best contraception for a man and woman engaging in sexual activity. There are alternative to vasectomy, which demonstrate some effectiveness, however there are also risks which need to be considered. Consult your physician before seeking any alternatives to having a vasectomy.

What should I know about reversing my vasectomy?

Considering a Vasectomy Reversal

It is not uncommon for a man to get a vasectomy during a marriage or long-term relationship, only to want a vasectomy reversal, or a vasovasostomy (pronounced "vay-zo-vay-zost-oh-me), in the future.

If the goal is conceiving children, sperm retrieval rather than vasectomy reversal can be considered. Assistive reproductive technologies have come a long way, and demonstrate up to 30 percent success in achieving pregnancy. Sperm retrieval is less invasive for the man, as well, however, because this process would require the woman to undergo in vitro fertilization or in utero fertilization, she would need to take fertility drugs and the risk for multiple births is increased.

If the goal is to produce children through natural means, a vasectomy reversal is the only option, and carried an average 80 percent success rate.

Talk to your Urologist or Fertility Specialist to get all the facts before making the decision about vasectomy reversal.

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Barbara Gibson