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パイプカット再建 / 元に戻す(日帰り顕微鏡下パイプカット再建術)
 

At our clinic, we perform both vasectomy and reconstruction (restore) of vasectomy that you had in the past. We are waiting for consultation on the surgery from the appointment page for your first visit.
 

After undergoing vasectomy , surgery to restore (recanalize) for the purpose of vocational training for reasons such as remarriage is “One-Day Microsurgical Vasectomy”. The vas deferens are recanalized by re-anastomizing the vas deferens obstruction using a surgical microscope. This page introduces the flow and cost of surgery related to vasectomy, and frequently asked questions.

 
Treatment results of our clinic

At our clinic, vasectomy has a very high results as follows.

  • Sperm appearance rate91%
  • Semen normalization rate47%

 

What is Vasectomy

Vasectomy (vas deferens ligation) is also called pipe cut. This is a male contraceptive surgery performed when a person who already has children does not wish to have any more children. Sperm produced in the testes pass through the vas deferens and mix with the secretions of the prostate and seminal vesicles to become semen, which is ejaculated outside the body with sexual stimulation. Vasectomy (vas deferens ligation) is an operation in which the vas deferens is cut (excised or closed) in the middle to block the passage of sperm and prevent sperm from being mixed with semen. It also has no effect on sexual function or sexual sensation.
 

What is Vasectomy Reversal?

Vasectomy reversal (vas deferens anastomosis) re-anastomizes the vas deferens obstruction using a surgical microscope to recanalize the vas deferens. Since sperm may not be produced at 10%, Simple TESE may be performed at the same time.

Who wants to undergo reconstruction

Most people undergo this surgery to get it back for the purpose of giving birth because of remarriage.

Benefits of reconstruction

By restoring it, you will be able to expect a natural pregnancy. In addition, the treatment results of pipe cut reconstruction (vas deferens anastomosis) at our clinic are the highest with a sperm appearance rate of 91% and a semen normalization rate of 47%.

Disadvantages of reconstruction

It takes 2 to 6 months for sperm to appear. On the other hand, there is a 9% chance that sperm will not appear. In this case, intratesticular sperm recovery (SimpleTESE) is required.
If you do not wish for pregnancy, you will need contraception

 

Flow of vasectomy reversal

From signing up to preoperative

First, please make an appointment for a medical examination and have an examination. After the examination, the doctor will explain the surgery in detail.
 
If you wish to have surgery after that, you will be asked to undergo a preoperative examination (a blood test for infectious diseases).
After explaining the surgery, we will make an appointment for the surgery.
 
Your next visit to the clinic will be on the day of surgery.
 

Flow of Surgery

  • Hospitalization period: day trip
  • Presence or absence of anesthesia: Local anesthesia
  • Surgery time: about 2 hours

 
On the day of surgery, you will be required to come to the clinic at the time of the appointment. The operation is performed by local anesthesia and takes about 2 hours to 2 hours and 30 minutes.
 
When the vas deferens have been anastomosed, we will speak to you so that you can see the actually connected vas deferens.

The image of the actually connected vas deferens.
* This is an image of the affected area after surgery, so please view it with caution.

Things to be careful of after surgery

  • Postoperative pain, symptoms (side effects), etc.
    The wound in the incision may hurt. Antibiotics are prescribed to prevent infectious diseases. In addition, we have no experience of serious complications so far.
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  • Shower / bath, drinking, smoking, masturbation, period until sexual activity becomes possible
    Shower is possible from the next day.
    Do not get your wounds wet for a week Drinking prohibited
    Ejaculation by masturbation is prohibited for 1 month
    No sexual activity for 2 months
  •  

  • Underwear, progress of wound, inspection frequency, etc.
    For 2 months after the operation, you will be required to lift the scrotum firmly to rest the anastomotic site.
    We recommend that you perform a semen test every 2 months from 2 months after surgery.

 

Cost of vasectomy reversal

  • Examination 5,500 yen
  • Ultrasound * 5,500 yen
  • Preoperative examination 22,000 yen
  • Surgical cost 880,000 yen (3.0 hour frame)
  • Local anesthesia 22,000 yen
  • Extra (Saturdays, Sundays, and holidays) 22,000 yen (every 1.5 hour frame)

 
* When the doctor deems it necessary, or when the patient wishes, please depositthe cost of surgery to the designated account after the apointment has been placed and before the surgery. For other expenses (examination fee, preoperative examination fee, etc.), cash or credit card can be used.


FAQ

  • How long does it take to the sperm to appear after surgery, and increasing the chances of pregnancy?

    It takes 2 to 6 months for the sperm to appear. Please refer tohere for the method of surgery.

  • What is the sperm appearance rate and pregnancy success rate?

    Our vasectomy reverse has the highest treatment results with a sperm appearance rate of 91% and a semen normalization rate of 47%.

  • If there is no pregnancy after surgery, are there alternative fertility treatments?

    There is a 9% chance that sperm will not appear. Even if sperm do not appear, it can be treated with intratesticular sperm recovery (SimpleTESE).

  • Are there any complications to watch out for after surgery?

    For 2 months after the surgery, you will be required to lift the scrotum firmly to rest the anastomotic site.

Infertility treatment after vasectomy other than vasectomy reverse

  • Epididymal sperm extraction (MESA) / Intratesticular sperm extraction (TESE)
    Usually, epididymal sperm extraction (MESA) or intratesticular sperm extraction (TESE) collects sperm directly from the epididymis or testis for the purpose of microinsemination when sperm are not present in the semen.

    If you had a vasectomy and wish for pregnancy, you usually have a vasectomy reverse, but if you don’t get the results you want, these surgeries may be done.
    If you wish, we will introduce you to the Toho University Omori Hospital Reproduction Center (Urology Department), which is affiliated with this clinic.
    For details, please see the link below and the site of the Toho University Omori Hospital Reproduction Center (Urology).
    https://www.lab.toho-u.ac.jp/med/omori/repro/patient/man_sterility/tese.html

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  • TESE testicular sperm extraction
    Normally, Simple TESE is expected to have a high probability of recovering sperm without any problem in sperm formation function by simply not recognizing sperm in the ejaculated semen, such as obstructive azoospermia and ejaculatory disorder. It is done in cases, but it may also be done if you wish for pregnancy.
    Sperm can be collected by collecting only a small part of the tissue of the testis, and the size of the wound can be reduced.

この記事の執筆医師

永尾 光一 先生

東邦大学 医学部教授(泌尿器科学講座)
東邦大学医療センター大森病院 リプロダクションセンター長
東邦大学医療センター大森病院 尿路再建(泌尿器科・形成外科)センター長

昭和大学にて形成外科学を8年間専攻。その後、東邦大学で泌尿器科学を専攻し、形成外科・泌尿器科両方の診療科部長を経験する(2つの基本領域専門医を取得)。得意分野はマイクロサージャリーをはじめとする生殖医学領域の形成外科的手術。泌尿器科医の枠を超えた細やかな手術手技と丁寧な診察で、様々な悩みを抱える患者さんから高い信頼と評価を得ている。

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