Vasectomy Reversal Surgery
Prior to the procedure, no special tests are needed other than the standard lab tests that are required by some hospitals, ambulatory surgery facilities or anesthesiologists. For men who are more than 40 years old, an EKG is usually required. For older couples or those whose family history indicates, genetic counseling may also be helpful. Your partner should undergo a gynecological exam to ensure adequate fertility potential.
On the night before surgery, patients will need to eat nothing after midnight. Upon arriving at the Manhattan Surgery Center, Dr. Fisch will provide a full discussion and explanation of the procedure, and will obtain consent. Consent will be obtained only with Dr. Fisch. The patient will also speak with the anesthesiologist. After all of the preparation is complete, an intravenous drip will be started and you will be taken into the surgical suite.
Choices for Anesthesia
Vasectomy reversal surgery may be performed with local, regional or general anesthesia, depending on the preference of surgeon and patient. General anesthesia is commonly used because it provides maximum patient comfort considering the length and nature of the surgery. Dr. Fisch uses general anesthesia for maximum patient comfort.
The Two Possible Procedures
There are two types of procedures used in vasectomy reversal surgery: vasovasostomy and vasoepididymostomy. While a vasovasostomy is the first choice of treatment for vasectomy reversal, vasoepididymostomy (a more complex procedure) is required in approximately one-third of cases. The surgery takes an average of 2 to 2.5 hours. Microsurgical vasovasostomy takes a little less time, while vasoepididymostomy takes a little more time. The length of surgery also depends on the amount of scarring present from prior surgery, the presence of and degree of inflammation, and the ease with which sperm can be identified in the vas deferens or epididymal tubule. The decision of which procedure to conduct is made by the surgeon during the surgery.