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Question: Persistent sperm after a vasectomy?

From Vasectomy.com

My husband had a vasectomy 8 months ago he has had more then 40 ejaculation since his surgery, or maybe even more. The semen analysis came back with more then 20 hpf. Motile and non motile sperm were seen. Could his vasectomy have failed, or can it take a long time to become sterile? Thank you.

Dr. McHugh’s answer:

There two scenarios here. It is possible that the vasectomy has successfully divided the vas and that the sperm are, for whatever reason, slow to completely clear. If this is the thinking you would re check after another twenty or so ejaculations. On the other hand this may represent a recanalization of the vas tubes, a small channel, that has reconnected the vas tubes. In this case another vasectomy would be performed. A couple of things: You could have a formal semen analysis performed to actually get a count, it is possible that 20 per highpower field correlates with a very low total count. Some feel that after a vasectomy less than 100,000 on a semen analysis is acceptable. I have experienced your particular situation about five times in my career and I have repeated the vasectomy. Interestingly each time it corrected the small numbers of sperm that persistently showed up on microscopic exam.

How long out of work if you have a vasectomy reversal? Ga Vasectomy Reversal.

Patients often ask if the post procedure course of a reversal is similar to that of a vasectomy. Usually not. The reversal is a much longer and involved procedure.

Georgia Vasectomy Reversal-John McHugh M.D.

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Medical aphorism: “The art of getting away with it.”

Patients who are considering a vasectomy reversal usually have a busy life. They to a person don’t like being out of work and even if they did their employer probably won’t view a reversal as medically necessary. So a common question is how soon can I go back to work and how soon to resume working out? Well…this is where “getting away with it” comes in.

Since a reversal is a procedure which usually takes a bit over two hours, the incision on each side is open for about an hour each and this lends itself to bruising and scrotal swelling. A patient can physically go back to work in three to four days but because of the nature of the procedure and the fact that the scrotum is a dependent structure (hangs down) and is potential space (not tight like…

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What to expect after a vasectomy reversal…is it like having a vasectomy?

Georgia Vasectomy Reversal-John McHugh M.D.

From Vasectomy.com

What You Can Expect After a Vasectomy Reversal

Vasectomy reversals are longer and more complicated than the original vasectomy procedure. Because of that, recovery takes more time, although it is still fairly quick. In general, side effects after a reversal tend to be mild and disappear within a short period of time.

The First Few Days

During the first couple of days after surgery, you may experience slight swelling or bruising in the scrotum. In addition, the surgery and anesthesia could cause a headache, general pain, and nausea, among other short-lived side effects.

To soothe the scrotal area and help minimize swelling during the first few days, you’ll need to elevate your legs, stay off your feet, and use ice packs. You’ll need to avoid submerging the incision in water fort he first 48 hours after the procedure–showers after a day or so are just fine but…

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Convincing your partner to have a vasectomy.

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From Womenforvasectomy.com

Convincing Your Partner / Myths About Vasectomy

 

Convincing your partner that vasectomy is the right choice for birth control is a simple task. That is because vasectomy truly is the safest, cheapest, and most effective form of birth control. To convince your partner, just present the following facts:

  1. Vasectomy does not cause any hormonal changes, nor will it change his sexual function or desire.
  2. Vasectomy will not significantly change the character or quantity of his ejaculation. It simply blocks the sperm cells from being in the seminal fluid.
  3. The local anesthetic used is injected into the skin of the scrotum, not into the testicle.
  4. The no scalpel vasectomy is an innovative method of performing a vasectomy. It is done through a single small puncture through the scrotal skin, not an incision. It does not even require a stitch or a suture to close the skin.
  5. MAN UP! The burden of birth control and child bearing needs to be shared. Tell him that stepping up for a vasectomy is an important way for him to do his share.
  6. A Board Certified Urologist is a fully trained surgeon, and the no scalpel vasectomy is commonplace and easy for him. The procedure is safe and easy to perform.
  7. Show him the less than perfect options in our COMPARING OPTIONS section.
  8. Again: Vasectomy is the safest, cheapest, and most effective form of birth control.

What does the vasectomy site look like at the time of a reversal?

Georgia Vasectomy Reversal-John McHugh M.D.

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There are several things about the picture above. First of all, the vas deferens has been isolated and is ready to begin the vasectomy reversal procedure proper. There are basically three parts to a vasectomy reversal.

  1. First you have to dissect out the  vas deferens and identify the vasectomy site. In the case above this was easy. You see in the middle of the picture a conglomeration of clips which were used to do the vasectomy. I like it when clips have been used. The area is much easier to find and there is less damage to the vas deferens.
  2. Secondly, the vasectomy site is excised and fresh vascularized vas deferens are delineated and prepared to reconnect.
  3. Finally the actual reversal. The microscope is brought into the operative field and after having approximated the two ends…the reversal is performed under the microscope using microscopic suture, usually 12-14 on each side.

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