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Registriert:Fr 12. Sep 2014, 05:08

Beitrag von bcc »

I have had two vasectomy reversals. The first one was not micro surgical and unsuccessful. The second procedure was successful, but it was discovered that there was a partial obstruction on both sides upstream of the vasectomy reversal (possibly due to scaring from the first reversal). My latest sperm test showed good quality, but an extremely reduced quantity - 4 mil/ml. It has been almost 1 year since the last reversal. I am interested in hearing what can be done to correct this problem.
Dr. Petsch
Registriert:Di 29. Jul 2014, 07:09

Re: obstruction

Beitrag von Dr. Petsch »

Dear BCC
Thank you for your email.
The spermcount after vasectomy reversal needs serveral month (up to a year) to recover. The 'old sperm material' needs to be cleaned out and the dilated tubules of the epididymis need time to recover their ability to transport the sperm cells by a pumping (peristalsis).
If the vasectomy reversal is done well the patient should be fertile within a year. If your sperm count is very low it is likely that the reason is continous obstruction that can normally corrected by a re-operation.
Most often the obstuction is eighter at the reconnection of the vas or at the epididymis ('blow-out').
As most surgeons are not very experienced in microsurgery they are only comfortable doing a vas-vas connection. They will not do a vas-epididymis connection (much more difficult) although there may be 'blow-outs' at the epididymis - but in many cases (up to 80%) the 'simple' reconnection will not result in sucess.
A proper microsurgical vasoepididymostomy should relieve all obstructions and result in normal sperm counts in most of the patients.
As the most frequented specialist for microsurgical vasectomy rerversal in Europe I frequently help patients who have had previous surgeries - in most of the cases we can help you.
To decide if a revision surgery is possible for you (you already had two reversals....) I would ask you to please send me the OR reports from the previous procedures and than we should discuss your case via phone.
With my best regards
Martin Petsch
Dr.med. Martin Petsch
Spezialist für
Andrologie - Mikrochirurgie - Urologie
Louise Dumont Strasse 1
40211 Düsseldorf
Tel. 0211-4379115
Fax 03212-1464381
Mobil 01520-1859607