Second vasectomy scheduled – got some questions.
Sep 22nd 2009adminGeneral questions & Vasectomy failure
From Bill:-
Dr. Karpman. Would love to have a few of these unanswered questions dealt with before my second vasectomy that is scheduled in less than two weeks. Long story short, had a Vasectomy in March this year. Found out about 1 month ago that I still have live sperm. It did not work as you can tell, and I have a second one right around the corner. Hopefully you can get back to me before that. Great Urologist did the first and it was very easy. He has done them for over 20 years and I am his first that did not work. He wanted to do the second one under general in the hospital to make sure this one works. Keep in mind that he sent in to pathology and got confirmation that he did cut the left and right vas…..so he did not make a mistake. Instead of a “free” in office procedure which I was looking for, the hospital has to be paid and would be pretty expensive. He recommended another Urologist at his practice that said he would do it and he feels very sure that a second would work just fine. So, do you have any data that shows how successful second procedures are? If so, are they done with general so that the Dr. can take a bigger piece of the vas to insure it will work. Or is the same 10 minute office procedure also as successful? With that answered, what does the new Dr. expect to find when he goes in? Will he know at that point if either or both vas had re-joined? Also, first procedure was 2 small incisions and this Dr. does it the other non scalp way? Any reason this is or should be a concern. I just really want to know going in for the second that I can expect it to work. Also worried that a second will be worse in some way regarding pain, recovery, added or more risks that I did not have from the first. It has been difficult to get these questions answered as for me to have an office visit first, I would have to pass on Sept. 8th. because he is so booked and I would be pushed back till Oct. My wife is due last month to have her 5 year IUD taken out and she is 42 and I do not want her to have to do that again. Looking forward to your response to these questions. Thanks so much for taking the time to read and answer this e-mail.
Regards,
The chances that a vasectomy will recanalize is extremely low and the chances of the same occurring with a second vasectomy is no different. The reasons why the first vasectomy did not work can be numerous and we can only guess at what is the reason. There is no reason why a repeat vasectomy after a failed vasectomy should be performed under a general anesthetic. Physician preference usually dictates the approach (scalpel vs no scalpel, one vs two incisions) and where the vasectomy will be performed (office or operating room). The findings at the time of repeat vasectomy are usually that of a joined vas deferens at the previous vasectomy site. Histologic evaluation can confirm which side recanalized.
