Vasovasostomy
Author : Professor Mahmoud Fawzy Ghaly
• Updated at: Jun 09, 2024 •
Contraception often falls on the shoulders of women. They take hormones that prevent them from ovulating affecting their mood, libido and weight or insert an Intra Uterine Device (IUD) that prevents implantation of possibly fertilized embryos and sometimes causes excessive bleeding and pain during the menstrual cycle. Apart from using a condom, a vasectomy is a safe and permanent form of contraception for males. A vasectomy is an elective procedure where the male vasa diferentia are cut, ligated, or sealed to prevent sperm reaching the urethra and reaching the female vagina during intercourse. A vasectomy has always been promoted as a permanent irreversible form of contraception and long have men afterwards regretted undergoing it. A new microsurgical procedure called a vasovasostomy reverses the interruption of the vasa deferentia so that normal pregnancy could again occur.
Vasovasostomy
Vasovasostomy is a procedure performed on men who have done a vasectomy before to regain male fertility In some cases a vasovasostomy is not done with purpose of regaining fertility but to get rid of post-vasectomy pain. Some patients as a side effect of vasectomy experience unbearable pain. The vasa deferentia are reconnected in an attempt to stop that. Most patients at Bedaya Hospital however have a vasovasostomy to reverse infertility.
Vasovasostomy steps
Under local or general anesthesia, a small incision will be made in the scrotum to have a clear vision of the epididymis and the vasa deferentia . A testicular tissue sample will be taken for analysis of sperm and evaluation of its production. If the vasa deferentia are in good condition and not irreversibly damaged by the previous vasectomy, the surgeon will reconnect them. If, however the vasa deferentia are damaged to an extent they can’t efficiently be reconnected or will not allow a sufficient sperm flow the surgeon will choose to do a vasoepididymostomy this however requires a surgeon with higher surgical skills at Bedaya hospital all our andrology surgeons are skilled in both procedures Vasoepididymostomy is a surgery that reverses a vasectomy by connecting the severed vas deferens to the epididymis.
The procedure of a vasovasostomy takes from two to four hours, and the recovery period is days. The patient must follow the doctor’s instructions and not take any non-prescribed medications or do physical effort such as driving and lifting heavy weights.
Vasovasostomy success rate
The key factor of a successful vasovasostomy surgery is the period of time the vas deferentia have been disconnected. Some patients want to reverse their vasectomy after 3 to 5 years which is considered a short time and has higher success rates than patients who want to reverse the vasectomy after 10 years or more The factor of time affects the quality and count of sperm, and even if the vasovasostomy is successfully done, the couple could remain sterile (infertile) due to the decrease in sperm quality as an after effect of the vasectomy. The shorter the time between a vasectomy and a vasostomy the higher the chances are a normal pregnancy will take place.
Another important factor in a couple’s fertility is of course the overall situation of the female partner. A man can have a vasovasostomy and postoperatively have good sperm flow and quality yet the couple remains infertile due to female factors such as age, blocked fallopian tubes, endometriosis, PCO etc. Doctors can collect and freeze sperms after a vasovasostomy and use this sample in an IVF or ICSI trial but of course this does not mean that a normal pregnancy cannot take place if the underlying factor of infertility in the female partner can be treated.
