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Micro Surgery and Vasectomy Reversal

Statistics reveal that 500,000 men in the United States have vasectomies each year and 5% of those men seek a reversal five years after their vasectomies.  Vasectomy Reversal using Micro Surgery is a multifaceted operation that calls for a high degree of expertise and experience to be effective.  When performed by an urologist who is a fellowship-trained male infertility specialist, the success of a vasectomy reversal is increased.

When a vasectomy is performed, sperm production does not stop but it blocks the entry of sperm into the urethra. Unlike women, men produce sperm their entire lives.  The body eventually breaks down the blocked sperm, it is reabsorbed and new sperm continues to be produced.  There are instances when pressure can build up in the tubes behind the vasectomy scar and in some cases, the pressure can build and cause a tiny tubule of the epididymis to rupture.  This is generally referred to as an epididymal “blow out.”   If an epididymal blow out occurs, scar tissue develops and this becomes a new level of sperm blockage.  This is neither painful nor dangerous, but it is significant in that for a vasectomy reversal to be successful, it must be performed in such a way that bypasses this new level of blockage at the epididymal blow out site.

Sperm that is found at the testis end of a vas deferens indicates that an epididymal “blow out” has not occurred in which case a vasovasostomy is planned.  If sperm is not found, a vasoepididymostomy, which is an epididymis to vas deferens connection, is needed in order for sperm to flow.

Once a surgeon performs a thorough examination and the best course to proceed is determined, A Microsurgical Vasectomy can be performed to restore male fertility.  The technique allows for very precise placement of sutures which results in a much more accurate alignment of the vas lumen, which has the advantage of increasing the success rate of a vasectomy reversal.  Using microsurgery, eight or more sutures can be placed around the inside channel of the vas.  Once the surgical procedure is completed, couples may be able to conceive a baby naturally.

Some of the reasons men decide to reverse their vasectomies include wanting to have a child with a new partner, a couple deciding that they now want children after years in a long relationship or marriage, and the unexpected death of a child.  While vasectomies are considered a permanent form of contraception, they can be reversed and barring infertility issues, the chances of conceiving a child after a reverse vasectomy is possible.

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Men’s Health – Male Infertility

Male Infertility

What Is Male Infertility?

Male infertility is the failure of a male to impregnate a fertile female and the male partner is the cause of infertility in couples 40% of the time.  A number of factors contribute to male infertility and these range from physical problems to psychological problems.  In any case, there are treatment options available to address male infertility and successfully treat males that will help couples achieve pregnancy.


Causes Of Male Infertility

Testicular damage, low sperm production and poor sperm quality are the main causes of male infertility.  Other causes of male infertility include smoking, which can significantly decrease sperm count and sperm cell mobility, recreational drug uses, alcohol abuse, steroid use, tight underwear, and stress.  Several medical conditions and other factors contribute to male infertility and each individual case is different.  There can be one cause, several causes, or there may be no particular cause.

Diagnosing Male Infertility

Male infertility is usually diagnosed by examining a patient’s medical history and then having a medical exam performed.  During the exam, a semen analysis is performed.  The patient provides a semen example, and the lab will evaluate sperm shape, movement, and measure the amount of semen and the number of sperm.  The lab will also check for infections and other problems that may be causing infertility.  To ensure accuracy, a minimum of two semen analyses are performed.  In some cases, if the problem is not found in a semen analysis, additional tests can be performed.  These include scrotal ultrasound, transrectal ultrasound, hormone testing, and genetic testing to name a few.  However, when infertility is an issue, it is recommended that the female partner be examined and tested.


Treatment Options

Once diagnosed, there are several treatments for male infertility that a patient can undergo.  These treatments include the following:

  • Surgeries ~ There are different types of surgical procedures that may restore sperm flow such as removing a varicocele, repairing a duct obstruction and performing a vasectomy reversal.
  • Treatment of Infections ~ Patients can be prescribed antibiotics to treat male infertility problems.  If treated early, permanent damage can be avoided.  If there is scarring or blockage caused by infection, surgery may be required.
  • Hormone Treatments and Medications ~ In some cases, medication may be prescribed for hormonal imbalances that may be contributing to male infertility.  Hormone replacement is recommended when there is an indication that infertility is being caused by high or low levels of particular hormones or the way the body is using the hormones.
  • Assistive Reproductive Technology (ART) is also a treatment option when the cause of male infertility is unknown or not treatable.  Sperm is gathered through ejaculation, surgery or donors and then inserted directly into the female partner or through in vitro fertilization or intracytoplasmic sperm injection.

As with any medical treatment, before deciding how to treat your male infertility you should discuss your option with your doctor and an infertility expert.  They will be able to let you know the pros and cons of treatments, the risks involved and the side effects you may experience.






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