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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 offer both vasectomies and reconstructions of previous vasectomies. To schedule a consultation, please visit our initial consultation page.

One-day microscopic vasectomy reconstruction is performed to restore (reopen) the vas deferens after vasectomy for the purpose of childbearing due to remarriage or other reasons. The vas deferens is re-established by using a surgical microscope to re-anastomose the obstructed vas deferens. This page introduces the surgical process, costs, and frequently asked questions regarding vasectomy reconstruction.

Our Clinic’s Treatment Results

At our clinic, vasectomy reconstruction has a very high treatment performance record as follows:

  • Sperm emergence rate: 91%
    • Semen normalization rate47%

    Our doctors are experts in microsurgery and also perform super microsurgery (anastomosis of lymphatic vessels with the thinnest diameter of 0.3mm). This enables us to perform safer and more reliable surgeries for our patients.

    Image of actual connected vas deferens

    ↑Above is an image of a connected vas deferens (click the image to unblur).

ur vasectomy reconstruction procedure is also shown in the video.

 

What is a vasectomy?

Vasectomy is a male sterilization procedure performed on those who already have children and do not plan to have more children or those who do not not want to have children. Sperm produced in the testicles pass through the vas deferens to mix with the secretions of the prostate gland and seminal vesicles to form semen. Semen is ejaculated out of the body with sexual stimulation. Vasectomy is a surgical procedure in which the seminal ducts are cut (removed or closed) to block the passage of sperm and prevent them from mixing with semen. It does not affect sexual function or sexual sensation.

What is a vasectomy reversal?

Vasectomy reversal (vas deferens anastomosis) is the reconnection of the blocked vas deferens using a surgical microscope. About ten percent of the male population do not produce sperm, so Simple TESE may be performed at the same time.

Who should consider having reconstructive surgery?

Most of the patients undergo this surgery for the purpose of childbearing due to remarriage or other reasons.

Advantages of Reversal

By restoring the vasectomy, a natural pregnancy is possible. The treatment results of vasectomy reversal (vas deferens anastomosis) at our clinic are the highest with a sperm emergence rate of 91% and a semen normalization rate of 47%.

Disadvantages of Reversal

It takes 2 to 6 months for sperm to appear. On the other hand, there is a 9% chance that sperm will not emerge. In this case, intra-ovarian sperm retrieval (SimpleTESE) is necessary.
If the patient does not wish to have a baby after undergoing vasectomy reversal, contraception is necessary.

Vasectomy Reversal Process

FFrom inquiry to pre-op

First, please make an appointment for a consultation. At the consultation, the doctor will give you a detailed explanation of the surgery.

If you wish to have the surgery, you will then undergo a preoperative examination (blood test for infection).
After the explanation of the surgery, we scheduled a date for the surgery.

The next time you come back is on the day of the surgery.

Surgical Procedure

  • Hospitalization period: day trip
  • Anesthesia: local anesthesia
  • Surgery time: about 2 hours

 

On the day of surgery, please arrive at the hospital at the scheduled appointment time. The surgery is performed under local anesthesia and takes about 2 to 2.5 hours.

After the anastomosis of the vas deferens is completed, patients would have the option to view the reconnected vas deferens.

Images of the reconnected vas deferens.

Things to be aware of after surgery

  • Possible postoperative pain, symptoms, etc.
    The incision may be painful. Antibiotics will be prescribed to prevent infection. We have never experienced any serious complications.
  •  

  • Showering, bathing, drinking, smoking, masturbation, and sexual intercourse
    Showering is possible one day after the surgery. The wound should be kept dry for one week.
    No drinking
    No masturbation ejaculation: 1 month
    No sexual activity: 2 months
  •  

  • Underwear, progress of the wound, frequency of examinations, etc.
    For 2 months after the surgery, the scrotum must be lifted firmly to keep the anastomosis at rest.
    Semen analysis is recommended every 2 months starting 2 months after the surgery.

Cost of Vasectomy Reconstruction

  • Initial medical examination: 5,500 yen
  • Echographic examination*: 5,500 yen
  • Preoperative examination: 22,000 yen
  • Surgery cost: 880,000 yen (3.0 hour frame)
  • Local anesthesia 22,000 yen
  • Surcharge (weekends and holidays): 22,000 yen every 1.5 hours

 

*When deemed necessary by the doctor or requested by the patient
For surgical fees, please deposit the amount to the designated account after the appointment is scheduled and before the surgery. For other fees (initial consultation fee, preoperative examination fee, etc.), cash and credit cards are accepted.

FAQ

  • Is the surgery painful?

    The initial anesthesia can cause a little pain, but most of our patients say that it was not painful at all compared to when they had vasectomies at other hospitals. The reason for this is that our surgical procedure involves the use of a microscope from the beginning to carefully perform the surgery.

  • How long does it take for sperm to appear after the surgery and does this increase the chance of pregnancy?

    It takes from 2 to 6 months for sperm to appear. For more information on the surgical procedure, please click here.

  • What are the sperm emergence and pregnancy success rates?

    Our vasectomy reversal has the highest sperm appearance rate of 91% and semen normalization rate of 47%.

  • Are there alternative fertility treatments available if a patient is unable to conceive after surgery?

    There is a 9% chance that no sperm will emerge. Even if sperm do not emerge, it is possible to treat it with intra-ovarian sperm retrieval (SimpleTESE) or other methods.

  • Are there alternative fertility treatments available if a patient is unable to conceive after surgery?

    There is a 9% chance that no sperm will emerge. Even if sperm do not emerge, it is possible to treat it with intra-ovarian sperm retrieval (SimpleTESE) or other methods.

  • Are there any postoperative complications to be aware of?

    For the first 2 months after the surgery, the scrotum should be lifted firmly.

  • How long is the surgery?

    The surgery takes about 2 to 2.5 hours. Ginza Repro Surgery performs day-of surgeries and does not require hospitalization. You can walk home immediately.

  • When do sperm appear after surgery?

    Sperm will appear in 2 to 6 months.

  • How much hope is there for pregnancy with vasectomy reversal surgery?

    Ginza Repro Surgery has the highest rate of sperm emergence (91%) and semen normalization (47%). In cases where sperm do not appear (10% rate), Intracytoplasmic Sperm Eruption Surgery (Simple TESE) and Intracytoplasmic Sperm Injection are required at a later date.

  • If I am unable to conceive after surgery, are there other fertility treatments available?

    Even if sperm do not appear, it is possible to treat with Simple TESE and ICSI.

 

Post-vasectomy infertility treatment other than vasectomy reversal

  • Microsurgical epididymal sperm aspiration (MESA) / Testicular sperm extraction (TESE)
    Normally, MESA and TESE are used to extract sperm directly from the epididymis or testis for the purpose of intracytoplasmic sperm injection (ICSI) when there is no sperm in the semen.

    If you have had a vasectomy and wish to conceive, a vasectomy reversal is commonly performed, but MESA and TESE may be performed if the desired results are not achieved.
    If you wish, we will refer you to the Reproductive Center (Department of Urology) of Toho University Omori Hospital, which is affiliated with our clinic.
    For more information, please visit the following link, Toho University Omori Hospital Reproductive Center (Department of Urology) website.
    https://www.lab.toho-u.ac.jp/med/omori/repro/patient/man_sterility/tese.html

  •  

  • Testicular sperm extraction (TESE)
    TESE is usually performed in cases such as obstructive azoospermia or ejaculation disorders, where there are no sperm in the ejaculated semen, no spermatogenesis problem, and a high probability of sperm retrieval is expected.
    Sperm can be retrieved by removing only a small portion of the testicular tissue, and the size of the wound is small.

この記事の執筆医師

永尾光一(東邦大学泌尿器科教授 リプロダクションセンター長)

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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