vasectomy reversed.

Posted by keith smith on May 08, 1999 at 02:32:23
hi
i recently had a vasectomy reversed. i am 40 years old and went 20 years before trying to have it done. its been 6 mouths and when tested for sperm there was none not even dead sperm .
   after a nother couple mouths i started having pain in my left testical. went to the doc and had altra sounds and was found to have fluid around my testicals. could this be sperm leaking from a failed  vasectomy reversail.
thanks

Posted by HFHS M.D.-AK on May 10, 1999 at 18:40:53
Dear Keith,
The procedure of vasectomy reversal can be accomplished several ways.  The most common method is a vasovasostomy.  This means that the two cut ends of the Vas deferens are sewn together after sperm has been identified from the testicular end of the Vas.  Most likely, this is the surgery which was performed for you.  If this is the case, your doctor would have confirmed the presence of sperm microscopically before proceeding.  If sperm could not be found, a Vasoepididymostomy would have been performed.  This involves a similar procedure, but the hook-up is directly into the epididymis rather than the Vas.
Yes it is possible to have a sperm granuloma formed after surgery.  This means that the sperm leaks out into the surrounding tissues.  But more likely, the hydrocele (fluid around the testis) is secondary to the surgery itself.  This fluid should be reabsorbed by the body over time.  If it continues to get larger and cause you pain, I would have your urologist re-examine you.
Other post operative complications include, hematoma, wound infection, and late stricture not allowing the sperm to pass.  The information that I gathered to respond to your question stated that the last 99 out of 100 patients who were found to have sperm during surgery, eventually had sperm in their ejaculate.  Late obstruction occurred in 13% and these stricture needed another operation.  Overall success of the procedure is about 70%-90% in experienced hands with about a 40%-60% pregnancy rate.
Just one other general concept to understand is the length of time between vasectomy and reversal.  Patients that have had their reversal operations less than ten year after vasectomy generally do better than those over ten years.  Since you are in this later category, your ability to produce functional sperm may be less than someone who had their vasectomy reversed at an earlier time.  You can ask your urologists these specific questions as well as success rate.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Infertility