Vasectomy and Vasectomy Reversal

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Vasectomy and Vasectomy Reversal 

Vacectomy and Vacectomy reversal 

Vasectomy and Vasectomy Reversal

Vasectomy should not be confused with castration: vasectomy does not involve removal of the testicles and it affects neither the production of male sex hormones (mainly testosterone) nor their secretion into the bloodstream. 

Therefore sexual desire (libido) and the ability to have an erection and an orgasm with an ejaculation are not often affected. Because the sperm itself makes up a very small proportion of the ejaculate, vasectomy does not affect the volume, appearance, texture or flavor of the ejaculate. 

Similarly, in females, hormone production, libido, and the menstrual cycle are not affected by a tubal ligation. 

When the vasectomy is complete, sperm can no longer exit the body through the penis and it seems that they enter the bloodstream by penetrating the blood-testes barrier. 

Normally, the barrier keeps the immune system separate from the reproductive system. When the barrier is compromised by vasectomy, injury, or even a simple puncture from a biopsy, the two systems interface. 

This usually results in the development of anti-sperm antibodies. 

Safety and effectiveness of vasectomy and vasectomy reversal:- 

Early failure rates of vasectomy are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon performing the operation and the surgical technique used. 

Early complications, including hematoma, infection, sperm granulomas, epididymitis-orchitis, and congestive epididymitis, occur in 16% of men undergoing vasectomy. The incidence of chronic epididymal pain is poorly documented. Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient. 

The weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers. Although late failure (caused by recanalization of the vasa deferentia) is very rare, it has been documented.  

Vasectomy is the most effective long-term contraceptive method, and is among the safest options for family planning. 

The rate of vasectomies to tubal ligations worldwide is approximately 3/10, with large variations between countries. In Britain, for example, vasectomy is more popular than tubal ligation. 

Couples who opt for tubal ligation do so for a number of reasons, including:-

  • Convenience of coupling the procedure with delivery at a hospital. 

  • Refusal of the man to undergo vasectomy due to fear of possible side effects. 

Couples who choose vasectomy are motivated by, among other factors:- 

  • Fear of surgery in the woman.

  • Knowing men who have had the procedure and are satisfied with the results. 

  • A stronger motivation for sterilization in the man.

  • The lower cost and simplicity of vasectomy.

  • The lower mortality of vasectomy. 

Vasectomy Reversal:-

In order to allow for reproduction (via artificial insemination) after vasectomy, some men opt for cryostorage of sperm before sterilization. 

However, the long term viability of spermatozoa in cryostorage is questionable. 

Although there is a procedure to reverse vasectomies using vasovasostomy (a form of microsurgery), it is not effective in many cases, and men considering vasectomies should not think of them as reversible, but it can be more or less reversible, depending of the surgery process used. 

Various temporary male contraceptives are being researched but not yet available, such as male oral contraceptives and the intra vas device. 

There has been at least one documented case of a vasectomy being reversed on a dog, which then fathered puppies after the vasectomy reversal. 

Tubal ligation:-

In women, a tubal ligation can be done in many forms, through a vaginal approach, through laparoscopy, a minilaparotomy ("minilap"), or through a regular laparotomy. Also a distinction is made between postpartum tubal ligation and interval tubal ligation, the latter being done not after a recent delivery. 

There are a variety of tubal ligation techniques, noteworthy the Pomeroy type that was described by Ralph Pomeroy in 1930, the Falope ring that can easily be applied via laparoscopy, and tubal cauterization done usually via laparoscopy. Also a bilateral salpingectomy is, of course, effective as a tubal ligation procedure. 

A tubal ligation can be performed as a secondary procedure when a laparotomy is done, i.e. a cesarean section. Any of these procedures may be sometimes referred to as having one's "tubes tied." 

Vasectomy Reversal tubal ligation:- 

Generally tubal ligation procedures are done with the intention to be permanent. 

However, some types of procedure can be reversed with surgery, notably those that leave a sizable amount of tubal tissue in place, i.e. the Pomeroy type of tubal ligation or the Falope ring application. 

In contrast, tubal ligation with the use of cautery, or a salpingectomy are generally poor or no candidates for reversal. However, in vitro fertilization can overcome fertility problems in patients with tubal occlusion due to any type of tubal ligation.

The author of this Vasectomy and Vasectomy Reversal page is Anthony George

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