Dr. Yaniv Larish specializes in micro-surgery to reverse vasectomies.
Dr. Larish performs vasectomy reversal micro-surgery at Gramercy Surgery Center. This state of the art facility utilizes the most modern and advanced high quality surgical microscope, micro-instruments and the most highly trained nurses and support staff.
Dr. Larish has helped many men successfully reverse their vasectomies.
Do you need a Vasectomy or Vasectomy Reversal Procedure? Vasectomy is a small surgery procedure to prevent the sperm from reaching the semen. The semen will still exist but carries no sperm content. On the other hand, a vasectomy reversal surgery is a process that reverses the vasectomy.
Keep reading to learn more about Vasectomy and Vasectomy Reversal Procedures:
Men undergo vasectomy surgeries in hospitals or at surgery centers. You can discuss with your urologist whether you need complete sedation for the surgical procedure.
You will have to sign a form that gives permission to your urologist permission to carry out the procedure.
In the surgical room, your urologist will first shave and then wash your scrotal region thoroughly with an antiseptic solution. The doctor numbs the area by injecting it with local anesthesia. However, you will be aware of the feelings of movement, tension, and touch. This anesthetic will serve to block any acute pain that you might experience otherwise. If, by any chance you do experience pain during the surgical procedure, you can inform your urologist so that he/she can inject you with more anesthesia.
There are two vasectomy procedure types:
In the no-scalpel vasectomy procedure , your urologist feels for the vas under your scrotum skin and uses a small clamp to hold it in place. He/she then makes a small hole in the skin and stretches the hole open for lifting the vas deferens in a gentle manner. Your surgeon then ties and puts it back in its original place.
In this vasectomy procedure, the urologist makes one or two tiny cuts in your scrotum skin. The purpose of this is to be able to reach the vas deferens. The vas is then cut and a minuscule piece can be taken out which leaves a short gap between the vas deferens ends. After this, your urologist may sear the vas ends and then tie up the ends that have been cut with a suture. The doctor then performs the same steps on the other vas. Dissolvable stitches are useful for closing off the scrotal cuts. Alternately, the cuts can seal off on their own.
To put in simple terms, vasectomy reversal surgery undoes the effects of a vasectomy. This procedure reconnects the passage for the sperm to get inside the semen. Read on to know about the Vasectomy Reversal procedures.
Vasectomy Reversal Procedures
It is a urologist who usually performs vasectomy reversal surgeries at a surgery center. If using a surgical microscope, the surgery is completed while you (the patient) are sound asleep under the influence anesthesia.
Microsurgery is the ideal way to perform this vasectomy reversal surgery. A powerful microscope enlarges the small tubes around five to forty times their original size. Your urologist can then join the vas deferens ends by using exceedingly thin stitches.
The urologist will make a minuscule cut on either side of your scrotum after you have fallen asleep. He/she will then clip the vas scarred ends where they were earlier sealed off by the vasectomy. The surgeon will extract the fluid from the vasal end that is closest to the testis. The doctor will next check whether the fluid has any sperm in it.
At this stage, you can go with either of the two following reversal procedure types:
If no sperm is found in the vasal fluid, this indicates that the back pressure created by the vasectomy lead to a block in the epididymal tube. The urologist has to circumvent this block and join the upper vas end to the epididymis. This is referred to as “vasoepididymostomy”.
Although Vasoepididymostomy fulfils the same purpose as the vasovasostomy procedure( more on this later) , the former is more complex than the latter. However the results achieved at the end are equally good for both the reversal procedure types
This is the second type of reversal procedure. If it turns out that there is in fact sperm in the vasal fluid, that shows that the passage is clear between the place where the vas was cut and your testis. What this means is that the urologist can then join the ends of the vas. The term “Vasovasostomy” is used to reconnect the vas ends.
For men, the vasovasostomy success rate is about 85 percent when microsurgery is used .The likelihood of pregnancy occurring stands at 55 percent. ( In other words, 55 out of 100 women get pregnant).
Should you go for a Vasoepididymostomy or a Vasovasostomy ?
Unfortunately, you cannot know which procedure works best for you prior to the reversal vasectomy surgery. The urologist is only able to find this out during the surgery procedure itself. A vasovasostomy is performed if there is presence of sperm inside the vasal fluid. On the other hand, if there is no sperm in the vasal fluid, your urologist will decide what next to do bearing in mind other factors. If there is an occurrence of a block in the epididymal tube, the vasoepididymostomy procedure will be required.
If there is no block, then the look of the vasal fluid might assist the urologist in deciding which surgical procedure is best. Usually, if the fluid has a watery look, your urologist will perform a vasovasostomy even if there is no presence in the vasal fluid. Creamy looking fluid in the absence of sperm suggests that vasoepididymostomy is required.
If you want to reverse your vasectomy, be sure to reach out to us at Vasectomy Reversal NYC. Feel free to call us at (646) 862-5500 for a consultation with Dr Yaniv Larish, who specializes in vasectomy reversal surgeries.
Yaniv Larish, MD
4 East 76th Street
New York, NY 10021
What is Vasectomy Reversal?
Vasectomy surgery entails cutting the vas deferens to prevent sperm from entering the ejaculate in order to produce long term sterility. (click to enlarge)
Vasectomy reversal micro-surgery entails reconnecting the two ends of the vas deferens utilizing a surgical microscope, micro-instruments and micro-sutures in order to allow the sperm to enter the ejaculate and regain fertility after vasectomy surgery.