Preparing for vasectomy reversal surgery
Reasons for vasectomy reversal
Achieving a pregnancy is the most common reason to have a vasectomy reversal – but it is not the only one. Long-term pain following vasectomy, while uncommon, does occur (so called post-vasectomy syndrome). Vasectomy reversal may relieve or reduce such pain. There is also a chance there will be no improvement and a risk there will be worsening of pain after vasectomy reversal.
Age
The older you are the more likelihood that you may have some additional medical problem that may influence the safety of surgery or the chance of complications.
Medical history
It is important to be aware of your general state of health prior to any surgical procedure. There are a variety of conditions that may affect the outcome of your operation. Smoking has been shown to reduce fertility by affecting sperm function. Please ensure Dr Dezarnaulds is made fully aware of your past medical history at the time of your pre-operative consultation.
Expertise and experience matter
Pre-operative testing
The American Society of Reproductive Medicine position paper on vasectomy reversal states that provided that you are in good general health, “no specific or unique testing is required” prior to your operation.
Preoperative testing for vasectomy reversal has very low sensitivity and specificity, which essentially means that the results of such tests have a high likelihood of producing misleading results. That is they are not helpful in determining who will and will not have success with a vasectomy reversal.
Ultrasound
It is technically possible to microsurgically reanastomose both vas deferens in the overwhelming majority of cases. The only way to accurately assess those in which it is not feasible is to surgically explore the vasectomy sites. Ultrasound does not discriminate sufficiently to be useful.
Sperm antibodies
Sperm antibodies are produced after exposure of sperm to the immune system. The majority of men develop sperm antibodies in their blood following vasectomy. The presence of sperm antibodies in the blood does not accurately predict pregnancy following reversal and so the value of testing for sperm antibodies pre-operatively is both controversial and unproven. The American Society of Reproductive Medicine recommends against performing pre-operative sperm antibody testing.
