We have accumulated quite a few of the questions we are often asked about the vasectomy reversal procedure and provide these with their answers below. We hope you find them helpful.
Yes. There is a small chance that we find something that makes reversal unlikely to succeed or dangerous at the pre-op examination. We will gather as much information about you over the phone to give you the best advice we can as to the likely outcome. The usual deposit paid to book an operation date will cover the very unlikely chance that we don’t advise proceeding on the day.
Many, but principally Single, double and multilayer vasovasostomy. We perform the Microdot Multilayer Microsurgical vasovasostomy (MMMV). The layers referred to are the structures forming the vas. So from the inside out the layers are 1.skin lining the inner sperm tube of the vas (lumen) 2. Muscle, (involuntary), forming the thick wall of the vas and 3. Connective tissue, including blood vessels, on the outside of the vas.We use extremely fine microsutures (10-0 & 9-0) used in eye surgery. These fine sutures and the needle which are barely visible to naked eye, help to achive good approximation with minimal trauma to vas.
By approximating the cut ends of the vas in three layes, there is better chance of achieving a leak proof joining of the cut ends of the vas.
Yes. The sedation is so relaxing that you will drift off to sleep. We keep the level of sedation "topped-up" until the operation is finished at which time you will gradually wake up without any of the general anaesthetic problems (such as nausea etc.). Long acting local anaesthetic is used to completely numb the operating area. This straightforward sedation and local anaesthetic has been proven to be very much safer than GA.
We use special vasovasostomy sutures specifically manufactured for this operation by Sharpoint in the USA, size 10-0 for the inner layer and 9-0 for the outer two layers. These sutures aer very expensive and they are the best for the vsectomy reversals.
In many other places they use 6-0 nylon which has a much larger needle and thicker sutures.Larger the needle and thicker the suture, more trauma to the delicate tubes (vas)
NO! Unlike General Anaesthesia. The only effects are forgetfulness and clumsiness. Many men find the sedation very relaxing, "the best sleep i’ve had in months"!
From 2 hours to 4 hours. Fortunately for the patient this feels just like a few minutes.There is no painful effects of having a tube or laryngeal mask put in the throat required in the general anaesthetic.
Good question. For many people the answer is "within weeks". Many of our couples have become pregnant within 3 months! In general the longer the vasectomy has been done the longer it may take to return to fertility.
Yes, but fortunately only the same sort of complications that can arise during the vasectomy itself, ie swelling. Swelling can be either early (day 1-3) or later day (5-10. Early swelling is due to haematoma, ie internal bruising or bleeding ( chance2-3%), late swelling is due to infection (much less than 1%). Fortunately elective surgery centres such as ours do not attract patients prone to hospital acquired infections.
No! Our patients score the post op discomfort at around 2 out of 10. This is because we have not disturbed the tissues to any great extent, we lift the vas above the skin, repair it and return it with no trauma to the testis. Occasionally we may have to open the coverings of the testis to deal with difficult situations and challenges regarding the qulaity and length of vas.
No! We send you home with the only pain killers you will could possibly need, Paracetamol and Ibuprofen.
By law we must discharge you to the care of a responsible adult. If absolutely necessary you get accompanied by an adult since you will have sedation.Unless you have the procedure fully under the local anaesthetic without sedation, you need to have an adult with you to be dischrged home.
Not before 21 days post op. And this applies to ejaculation not just sex. The reason is that ejaculation pressurises the fluid in the vas which can force it’s way out through the unhealed join causing scarring and narrowing of the join.
We recommend semen tests at 2 monthly intervals after the op. We will give the request forms to have this arranged through the GP or through a fertility clinic. The cost of doing the test will have to be paid by you as our procedure cost does not include this cost. It would be unfair to include this cost as many of our patients come from distant places and they will not be able to avail the facility of sending the samples to our local lab..
Yes, almost always. The most common problem with reversal surgery is the formation of scar tissue at the junction. Removal of the scarred tube and microsurgically re-joining the vas is highly effective. We advise prior assessment and consultation here at the clinic.
Certainly, yes. Your chances may be reduced slightly below the average if you have undergone PESA sperm extraction.
Yes, because we will know the result of the sperm test done during the op and that the connection was successful. With a positive finding of sperms in the vas fluid your chances of returning to fertility are above 90%.
We hope so. Most men report some change for the better.
Yes, definitely. There is a chance that after some time, possibly from 6 months onwards that some narrowing of the junction may occur. We suspect that certain factors such as subtle damage inflicted on the vas by diathermy may make scarring more likely. We do not have definite statistics on this but estimate the chances of scarring being 30% over 5 years.
If you do, you risk developing blow out if you don’t you may have scarring. Scarring is treatable (by re-operation) whereas blow out is not. So on balance have it done now and have some sperm frozen. Or, change the plans, throw caution to the wind and have that family now!
Yes, that can be done.
Probably not. After vasectomy reversals, pregnancies do happen where the wife is 40 plus. The classic way of determining whether or not it is too late is to have the FSH blood test at day 0-3 of the menstrual cycle. If the level is within the normal range for your lab, then it shows that the woman may be still fertile.However there is steady decline in the pregnancy rate with increase in the age of the female partner.You may also wish to get some advice on the IVF option if your partner is older than 40 and you and your partner are considering to have only one child.
No, not too old at all. Men only very rarely slow down their sperm production.
We prefer to work on a fixed fee basis so you know exactly how much you are going to pay and that there are be NO extra charges, ever.
Our current fees are;
Full terms and conditions of the fee will be provided prior to booking a date for the procedure.
No, just the standard, routine chance unlike IVF babies over whom there are questions over their long term health.
We can arrange a consultation within a week or two, almost any day of the week. Time to surgery is from 1-3 months. But we sometimes have operation slots at short notice, so give Barbara a call.
Probably yes, but tell us all about your medical history and most importantly tell us all the medication you take. We will want to see you for consultation and discuss the matter then. Any medication that thins the blood such as Aspirin or warfarin is especially important and should be stopped 7 days before surgery.
Two possibilities. Either elect to have IVF or redo-reversal by vaso-vasostomy or vaso-epidydimostomy in selected situations
Do not even contemplate having a reversal with a surgeon who does not use microsurgery (some use "loupes" which magnify 2-3 times – it is just not good enough. The operating microscope magnifies up to 25 times and we often use all that power). If the surgeon gets the operating microscope out just once a week he is unlikely be proficient and confident as it takes repeated practice and familiarity to be competent and accurate with this little practice.
Schedule of fees
Consultation in the clinic £150. This fee will be waived from the procedure fee if you have the procedure with us.
|First time Reversal procedure (includes consultation)||£2450|
|Re-do reversal (includes consultation)||£2700|
|Initial deposit (payable on confirmation of your procedure date)||£ 450|
|Balance: First time (payable 2 weeks prior the appointment)||£2000|
|Balance: Re-do (payable 2 weeks prior the appointment)||£2250|
Booking a one day appointment
|Initial deposit (payable on confirmation of your procedure date)||£450|
|Balance: First time (payable 2 weeks prior the appointment)||£2000|
Methods of payment:
We appreciate that your circumstances may change and you may need to delay or cancel your appointment. However cancellation or deferment can seriously disrupt our operating schedule.
Our policy is therefore as follows: 4 weeks or more notification - £300 refund (£100 administration fee). Less than 4 weeks notification – refund at our discretion.
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