One of the biggest questions on a man’s mind when contemplating a vasectomy is – ‘will it affect my ...
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The Owen 3 Layer Micro-Surgical Vasectomy Reversal (the highly precise technique used at Metrocentre) is one of the few options available for men who have previously undergone a vasectomy and are now seeking to have children – IVF is generally the only other option available.
Photos supplied by proud parents after vasectomy reversal.
A typical Owen 3 Layer Micro-Surgical Vasectomy Reversal procedure conducted by Dr Lekich takes around 2-3 hours. During this procedure the vasectomy site and that best for suturing is located in response to the results of the preoperative ultrasound scan. The patency of the vas deferens is initially checked with fluid, which should exit through the penis. The fluid in the testicular end is then checked under a high magnification scientific pathology microscope to check for sperm debris and live sperm.
The finest sutures (a third of the size of a human hair) are used with a non-cutting, non-traumatic needle to join the two ends. If the vasectomy was originally conducted in the correct place, this reversal procedure should take about one hour on each side. In cases where the original procedure has been performed low down in the scrotum, an epididymo-vasotomy may have to be performed which joins much smaller epididymis to the remaining vas. These joins are made with three layers of accurately placed micro-sutures.
For comprehensive information on vasectomy reversal The Metrocentre Way, download our complimentary Vasectomy Reversal Guide.
This means that our patients can experience a rapid recovery and discharge from our facility, and avoid the risk of vomiting. Twilight sedation is especially advantageous for our fly in/fly out patients as they can return to their accommodation with their partners after this procedure. It is important to inform us of your medical history and any drug allergies you have experienced before undertaking this procedure.
Semen is produced by glands located in the pelvis called the seminal vesicles and the prostate, and this is added to the sperm to create normal ejaculate. This seminal fluid makes up about 95% of the ejaculate and so men who have undergone a vasectomy may not notice any difference in the volume of ejaculate.
The testicles will continue to produce sperm after a vasectomy, so if both vas deferens have been tied off, the stream of sperm is simply blocked in the vas tube.
This procedure re-connects the vas tube to allow the sperm to mix with the semen once more to create fertile seminal fluid. There are few viable alternatives to this procedure apart from IVF.
When selecting a clinic to perform this procedure it is highly important that you examine the success rates (not simply the pregnancies) that each clinic experiences.
We perform high volume Owen 3 Layer Micro-Surgical Vasectomy Reversals – up to 28 cases (56 sides) in a month, making us one of the largest clinics in Australia.
Metrocentre’s Dr Chris Lekich is one of the most experienced microsurgeons in the world and has been able to perform many successful re-do vasectomy reversals! See our Re-Do Vasectomy Reversal page for more information.
Ultrasound allows visualisation of the structures in detail, and from this he is then able to map and plan the surgery, reducing my need for “exploration” during the procedure. His high resolution scanning of over 2000 sides since 2008 has enabled me to see diverse pathology and details of the micro-tubules deep within the body of the testicle, epididymis and scrotum, NOT visible with the naked eye or with the microscope. This is particularly useful for past IVF extractions and past failed vasectomy reversal attempts. The ultrasound has allowed Dr Lekich to advise patients regarding the likelihood of surgical success – particularly patients who have had previous scrotal procedures and previous failed vasectomy reversals.
For example: one patient had his vasectomy 23 years ago, had two failed reversal attempts elsewhere and then had three sperm extractions through IVF. Several clinics had told him that reversal was now impossible. After careful ultrasound assessment and planning, we successfully reversed this patient – achieving a 35 million sperm per ml count nine months after our procedure, with a wound that was one (1) cm in length on both sides. His wife is currently pregnant with their baby.
The use of the ultrasound in has facilitated the delivery of safe and minimally invasive Owen Three Layer Micro-surgical Vasectomy Reversals, difficult vasectomies and the management of post vasectomy congestion syndrome. Coupled with Dr Lekich’s micro-surgical training, the ultrasound has helped our team assess and plan what often becomes relatively straightforward surgery once there is a clear map. This is particularly important in the following challenging cases;
There has been open criticism with regards to the use of ultrasound by competing surgeons, with suggestions that this is a waste of time. At Metrocentre we respect these opinions as all surgeons try their best – open exploration has been common place during vasectomy reversal procedures for many years. With the benefit of ultrasound, Dr Lekich has almost completely eliminated the need to explore the scrotum during the procedure, which preserves the precious vas deferens. This subsequently reduces the risk of bleeding. To date we have never had a patient experience a scrotal haematoma after surgery. We do not routinely use drains which are often used in other practices.
Some of the primary factors that can influence the success of a vasectomy reversal include:
By making use of the highest resolution ultrasound available, Dr Lekich can plan and predict the most beneficial Owen 3 Layer Micro-Surgical Vasectomy Reversal procedure and efficiently establish the position of the vasectomy and the vas deferens ends. The images are viewed in real time and are discussed with each patient and his partner.
Ultrasound is a painless examination that takes approximately 15-20 minutes and is done on site as part of the consultation process. The ultrasound is not an X-ray, does not use radiation and is particularly safe.
If you do experience some mild discomfort in the first few days after this procedure, paracetamol can be used to offer relief. A comprehensive summary of the postoperative instructions will be provided well before your procedure.
At Metrocentre we recommend the following for the first four weeks after surgery:
With good care you should experience a swift and successful recovery from your Owen 3 Layer Micro-Surgical Vasectomy Reversal procedure.
Every man who has had a vasectomy is virtually guaranteed to have sperm antibodies develop as a natural response to the presence of a new protein within the body.
When the sperm protein is detected in the body after a vasectomy procedure, this triggers the immune system to produce antibodies (or white blood cells) which attack the sperm cells present outside of the reproductive tract.
This process is not a cause for concern for men who have developed sperm antibodies in response to a vasectomy procedure as these antibodies only attack sperm cells in the blood stream. With more than 18,000 immature sperm cells developed every minute by mature males, these lost sperm cells are easily replaced. Contrary to myths, these sperm antibodies do not cause any health related problems or prevent a vasectomy reversal from working.
It has long been shown that sperm antibodies are not significant after a vasectomy reversal. This has been disproved over 40 years in the practices of the pioneers of microsurgical vasectomy reversals Professor Earl Owen (Australia) and Dr Sherman Siber (USA). This has been confirmed scientifically and has also been noted not to be significant in the practice of Dr Lekich. This issue is made interesting by numerous patients in Dr Lekich’s practice testing up to almost 100% positive for sperm antibodies by IVF labs yet they still fathered children naturally after their reversals with us.
Some of our patients who have had a reversal with us (and then had a baby) have chosen to have a sperm antibody test for their own information. Two of these patients, both having had multiple rounds of IVF without success before they had the reversal (and subsequent baby) with us, were happy to share their results with us. These two results came back with 100% agglutination and comments by the pathology company that this indicated that they were infertile and that IVF was the only option to achieve a pregnancy. Yet, they had both just fathered children after our reversal.
It is generally stated in IVF circles that sperm antibodies will render a vasectomy reversal a failure. This very controversial issue of sperm antibodies has been long criticised by Professor Owen and is explored in further detail by Dr Sherman Silber both a pioneer in IVF and Vasectomy Reversal in USA at (www.infertile.com). A failure of vasectomy reversal would rarely be from sperm antibodies.
Some women may develop sperm antibodies which can result in permanent infertility, but this unfortunate and rare condition is not connected with a vasectomy procedure whatsoever.
Dr Lekich uses the advanced Owen Three-Layer Close technique, pioneered and perfected by Professor Owen since 1971, in his specially designed facility located on the Gold Coast. This technique has been used in over 6000 procedures, and draws on over 40 years of microsurgical research and experience. Our procedure has been optimised to reach the very highest success rates.
The success rate of the Owen Three-Layer closure technique has enabled the following success rates:
Years since vasectomy:
Several factors can influence the success of this reversal procedure, and these include:
At Metrocentre, we currently perform around 25 Owen 3 Layer Micro-Surgical Vasectomy Reversal each month, making us one of the largest and most experienced clinics in Australia.