Considering a vasectomy reversal? Here’s some information you might find useful, from the Surgeon himself who performed the first successful micro-reversal of a vasectomy for an Australian in 1971, Professor Earl Owen.
What Happened After My Vasectomy?
With each passing year since your vasectomy years ago, millions of cells are put out by the testicles on a daily basis. Normally they go on through the system of maturation (mainly in the epididymis, the maturation coil to the testicle) for six or more weeks and then progress as ‘spermatids’ (a cell with some small body and a little tail) into the vas deferens which has a muscle to push the flow along some 22 centimetres to the prostate gland (takes another few weeks). They arrive as mature sperms able to be ejaculated and swim well. They are then 10 weeks old, and only then are “ready to go!”
Your system was tied off in the vas a long time ago. The sperm production continued, slowing down as the pressure increased because the immature sperms had nowhere to go once they reached the tied off vas. But sperm production does go on, the epididymis does stretch, and the tubules in the testicle do swell, and a certain laxity in the system contains the increased pressure.
Being mainly water (80%+) the cells disintegrate, and some are absorbed by the body too, but the mess in the system does get thicker over time.
Some Facts About Vasectomy Reversal
Over 22,000 Australian men have a vasectomy each year. That’s because it’s the easiest, most efficient and least troublesome form of contraception and a vasectomy is also reversible.
The vasectomy reversal was pioneered, perfected and successfully performed since by Professor Owen 1971. With his team unchanged for the past 24 years, they do more reversals each year than any other unit in Australia. Men aged 22 to 70; from one to 3 years after their vasectomies have had it successfully reversed. Professor Owen publishes the team’s outstanding baby birth rates – not just their technical successes – and are the only surgeons to do so.
The Sooner The Reversal, The Better The Result
It is well known because sperm production continues, sperm debris accumulates in the system after a routine (not an “open ended”) vasectomy, even though most debris is absorbed. The fluid left in the system thus inevitably thickens making it less likely to flow the longer the interval between vasectomy and reversal. Other factors include microsurgical precision and experience, delicateness and familiarity with this tiny 3-layered tube whose bore is only 2-3 hairs thick and the equipment and skill of a practiced expert team.
How Long Does A Reversal Take?
The Owen reversal operation takes up to one careful hour each side and is not painful when you awaken from a light general anaesthetic. They advise against sexual intercourse for the first month post operation to allow for healing at the operation site. They then recommend more sexual activity than you are used to, as that activity causes peristaltic muscle movement to help empty the accumulated old sperms along the system and out by ten weeks post operation.
How Do We Know If It Has Been Successful?
Ten weeks after the operation we request you take our referral form to the nearest pathologist’s laboratory where the first sperm count is taken – after that is done it’s safe to commence intercourse to achieve pregnancy, as accumulated sperms made under pressure will have been passaged. We check the count, advise you and keep in touch as we also like to collect baby photos.
What Are The Success Rates?
Our consistent success rates are the best ever recorded. From 4,300 consecutive unselected cases, we have an 85% baby rate (that’s from all comers irrespective of age of the man or his vasectomy).
Our results in first babies (from time of vasectomy):
- First 5 years – 95%
- Years 6-10 – 90%
- Years 11-15 – 80%
- Years 16-20 – 57%
- Years 21-35 – 45%
Can A Reversal Not Be Possible In Some Cases?
Our percent baby rate as the result of our micro-operation of reversal falls slightly each year after the vasectomy. We have less than 300 men reversed between 20 and 35 years after vasectomy and they have differing ages and fitness. Overall it’s hard to compare them but about 50% in this over 20 year group go on to have a baby, but there are more significant pointers to success than age and age of the vasectomy. Those are the consistency of the flow and the position where the “vasectomy” (which might have tied off the epididymis low down in the scrotum) was done.
If in the vas itself and with reasonable flow then the results are good, if not they are not as good. We can’t tell until we operate what we will find inside the tiny tubes, but explain all this before the operation and we ask patients if they want to continue if we find things in a too damaged state. If they do not want to continue there is a closing up of the small incisions and a refund of most of the fees.
Recovery From Vasectomy Reversal
The most frequently asked question Professor Owen’s team gets asked is, “If the operation is painless and you feel okay afterwards, why do you have to stay for hours in hospital?”
Professor Owen says:
“The answer concerns how we humans heal. In the first 40 hours you will get almost perfect healing if you allow the tiny blood capillaries to join up across the surgical join. That takes that amount of time in a wound with freshened ends brought together just “right”. Not too tight, and not too loose, in a technique allowing the exact juxtaposition of the two shaped ends – and not too many stitches either. I won’t bore you with surgical details but we worked all this out in the surgical laboratory years ago and have taught in over 50 countries, but not all Surgeons are as dedicated (or maybe as obsessive) as others. We pride ourselves as not only being the World’s first ever clinical Microsurgeons here Sydney, but also keeping the highest standards of patient care possible, while enjoying our procedures which we developed and perfected.”
Getting The Best Results
Professor Owen says:
“This is difficult because you will think I am criticising your local Surgeons, but I will answer honestly and you decide where you will get the best chance of achieving your goals. There is a big difference between the results achieved by different Surgeons using different methods. Our present team has been together 24 years, does an average of 3 to 4 cases each week, publishes our baby birth results (everyone else publishes pregnancy results or return of sperm to the ejaculate results) which remain the gold standard, and our results include operating after other surgeons have already failed to achieve a result, as we accept all comers who are healthy enough to make it here.”
“We use a general anaesthetic as our operation lasts between 1.4 to 2 hours including both sides. The field of view under the Zeiss operating Microscope ranges between 1.1 mms and 1.4cms. We do all operations in a specialised Microsurgical Operating Theatre because it is the only way to get proper sterile conditions and equanimity for all concerned. We use very specialised microsurgical equipment that is not available in any other clinic, designed specifically for this operation. This is concentrated, meticulous finest microsurgery of an obsessive nature on the vas which has a bore internally the size of two hairs (0.2mms) and an outside diameter of less than 1 mm. It has an internal pressure of 100 to 200 mms mercury (can be higher than blood pressure) when the muscle is pushing the sperms along by peristaltic contractions as soon as the anaesthetic wears off, and unless the joins are made with our unique overlapping three layer technique your tiny (one micron sized) sperms could be squeezed out straight away, rather like water out of a watering can, and as your then leaking sperms are toxic to your own tissues they form dense scar tissue and block the vas again as it heals. Thus another vasectomy or vas block has occurred, and wasted that operation, due to leakage at the site of the joins. This is only one point in our well researched, universally acknowledged most successful technique.”