Vasectomy and Reverse Vasectomy

Vasectomy

There are many types of contraceptives available for both men and women. However, many are only temporary measures that require preparation each time before intercourse.

A more permanent solution to preventing unwanted pregnancies is the vasectomy (surgical removal of the ductus deferens or ligature of right and left ductus deferens) for men and the salpingectomy (removal of the uterine tube) for women.


The principle behind a vasectomy is to block the passage of sperm from the testicles, where it is produced, through the vas deferens and the urethra, by tying up or removing the vas deferens. Nowadays ligature, or crossover vasectomy, is preferred, as surgical reconstruction may restore the use of the canals in men who change their minds and decide to father more offspring (see Reverse Vasectomy below).

Occasionally, after surgery, there may be pain in the area, bleeding, inflammation of the epididymis, leakage of sperm, and even a return to fertility. Thus, as a precautionary measure, other contraceptive measures should be used until the semen is verified to be without sperm.

There are concerns that a vasectomy might reduce sexual energy or the amount of semen produced; however, these concerns are unfounded. The male erection is mainly influenced by the corpus cavernosum, and the vas deferens has no role in an erection. The male hormone, which is produced in the testicles, is continuously secreted and absorbed by the body, leaving sexual function unaffected. The seminal fluid is mostly a secretion of the prostate gland and the seminal vesicle, and is composed of only 1% sperm, so a reduction in the amount of semen should be of very little concern.


Reverse Vasectomy

A reverse vasectomy is a surgical procedure to reconnect or unblock the vas deferens to restore reproductive capability for patients who have had a vasectomy or are sterile for other reasons. Reversing a vasectomy will not necessarily bring back reproductive capability. Therefore, it is very important to carefully consider the consequences before deciding on a vasectomy.

Due to the increase in divorce and remarriage rates, the number of men wishing to reverse a vasectomy is on the rise. Since the surgical procedure is microscopic in nature, and uses threads thinner than human hair, a reverse vasectomy is a very delicate operation and is only successful 90% of the time for men who have had a vasectomy within the last 10 years. However, the pregnancy rate for these people may be much lower -- 60-70% -- depending on such factors as the fertility of the spouse and the receptivity of the sperm in the women's reproductive tract.

When recovering from a reverse vasectomy, extreme exercise should be avoided, and for the first 2-3 days it is advisable to fix or secure the testicles to keep them from being disturbed. A bath should not be taken until after 5 days, and the man should abstain from sexual relations for 1 month, at which point the semen is tested for the absence of sperm. The success rate of the reverse operation is highest during the first 5-7 years after a vasectomy and drops off after 7 years, so an early decision can be the difference between success and failure.