Cape Town - Men who undergo vasectomies have slim chances of fathering children again.
The procedure is seen as permanent sterilisation and is tricky to reverse.
There is just a 15 to 20 percent chance of a successful vasovasostomy – or reconnection of the vas deferens. However, a microsurgical technique being used by Stellenbosch University could change all that in South Africa.
Urologists are able to increase the success rate to 80 percent, using a vasectomy reversal technique called vaso-epididymostomy – the reconnection of the vas deferens to the epididymis of the testicle. Even though vaso-epididymostomy is widely practiced in countries such as the US and Europe, it is still new to South Africa.
Dr Amir Zarrabi is a Stellenbosch University urologist who perfected his ability to carry out the procedure in the US.
He explained that in the regular vasectomy reversal, the ends of the severed “sperm transporting tube” – the vas deferens – are merely re-attached.
With the microsurgical procedure, urologists bypass the initial incision and attach the undamaged part of the tube directly to the epididymis – the tube that sits above the testicle which stores sperm and ejaculant.
During a vasectomy, the vas deferens from each testicle is cut and tied with a stitch or metal clip. This prevents any future transport of sperm away from the testicle. This means that while sperm is still being produced, they have no way of getting from the testicle into the urethra.
This causes blockages in the vas deferens, sometimes as far back as the epididymis.
The closer the blockage is to the epididymis, the lower the chance of a successful vasectomy reversal as it was difficult to connect the vas deferens directly to the epididymis. However, the less invasive keyhole surgery technique of vaso-epididymostomy allows surgeons to bypass any potential blockages that may have occurred.
Zarrabi said he is the only urologist to have performed the procedure in the country.
He added that while regular vasectomy reversal was done quite simply as it involved the reconnection of vasa deferentia, the vaso-epididymostomy was a specialised technique that had to be done under the microscope due to the thinness of epididymis tubes.
“The epididymis tube is as thin as human hair and therefore has to be attached with microsurgical techniques and specialised microsurgical instruments. It’s a very specialised technique and it requires surgeons to have excellent microsurgical skills and extensive experience to be able to perform this procedure between the vas deferens and epididymis.”
Zarrabi said while vasectomy was a form of permanent contraception mostly chosen by married men, the increase in the divorce rate meant there was a growing demand for reversals of the procedure.
Cape Argus