Male Fertility Surgery

If you have had a vasectomy or are struggling with other fertility issues, you may be happy to know that there are many surgical options available to help restore your fertility. In the past, male fertility was considered difficult to solve and sometimes, not even worth treating. Luckily though, times have changed. In fact, today's microsurgical techniques have made it possible to correct many male fertility problems. If you are facing male fertility concerns, surgery may be the right step for you.

Reasons for Surgery
If you are unable to produce sperm in your ejaculate you may want to consider some form of male infertility surgery. New surgical methods developed in the past ten years have made it much easier to restore your sperm flow, thus allowing you to father a child. There are a number of reasons that your sperm flow may be compromised:

 

  • varicoceles
  • hydroceles
  • vasectomy
  • surgical trauma
  • epididymal blockage (caused by infection or inflammation)
  • vas deferens blockage
  • ejaculatory duct blockage

 

Whatever the reason for your compromised sperm production, you may consider consulting with your health care provider for more information about your options.

There are a number of different types of procedures that have been proven effective in restoring sperm flow. Depending upon the type of blockage you have, you may be more suited to a certain procedure.

 

Varicocelectomy

A varicocelectomy is a treatment for varicoceles that occur in your testes. It is a very common procedure and can be done in a relatively short period of time at your local clinic or in hospital.

Varicoceles occur when the blood flow in one or both of your testes begins to back up. This causes an enlarged vein, which is very similar to a varicose vein. A varicocele is generally painless, though varicocele symptoms can sometimes include dull aching or swelling when you have been standing for long periods of time. Varicoceles can compromise sperm production because abnormal blood flow increases the temperature in the testes. Mild cases of varicocele may be treated through non-surgical methods.

The Procedure
A varicocelectomy can be perfomed with relatively little trauma to the body. A small incision is made in the abdomen, through which your surgeon can tie of certain blood vessels in order to limit blood flow. A second incision is then made and a microscope is inserted. This allows your surgeon to accurately identify problem veins. These veins are then repaired, eliminating the varicocele and allowing blood flow to return to normal. This should help to restore sperm production.

Success Rates
Varicocelectomy success rates are very high, with about 97% of men experiencing normal bloodflow and sperm production. Some men will develop more varicoceles at some time in the future, however this is uncommon.

 

Hydrocelectomy

A hydrocelectomy is a surgical procedure performed to remove hydroceles found in your scrotum. It is not a common procedure, though it can be performed if your hydrocele is causing you pain or interfering with ejaculation.

Hydroceles are actually a collection of fluid around the testicles inside your scrotum. Hydroceles are very common in newborns, and are often associated with hernias. In older men, hydroceles can be caused by infection or trauma to the testes or epididymis, or by a blockage in lymph nodes in the testicle. Hydroceles usually go away by themselves, but if they are interefering with fertility, they should be removed.

The Procedure
The hydrocelectomy is a fairly simple procedure. Under general, local, or regional anesthesia your surgeon will make a small incision in your scrotum. The hydrocele is then drained of all of its fluid. Your testicle and hydrocele are then brought out of your scrotum, allowing your surgeon to remove the hydrocele sac. Sometimes the hydrocele sac is left behind, and folded behind the testicle. The testicle is then replaced and the scrotum is stitched back together.

Success Rates
The hydrocelectomy procedure is typically very successful. Almost 100% of hydroceles do not grow back, allowing sperm to flow easily into the ejaculatory duct.

 

Vasectomy Reversal

There are two different types of vasectomy reversal surgeries: vasovasostomy and epididymostomy. Which form of vasectomy reversal is done will depend upon how your vasectomy reversal was done and the health of your reproductive system. A vasovasostomy is the more common procedure, accounting for two-thirds of all vasectomy reversal.

The Procedure
In a vasovasostomy procedure, the surgeon will reconnect the ends of your vas deferens in order to allow for sperm to flow through. The epididymostomy procedure is bit more complex and can take up to five hours to complete but is necessary for men who have a blockage. In this procedure, your surgeon will connect your vas deferens directly to the epididymis, thereby by-passing the blockage and restoring sperm flow.

Success Rates
Vasovasostomy success rates are quite high. Almost 99% of men who undergo the procedure will produce sperm in their ejaculate. 64% will father a child. However, success rates for an epididymostomy tend to vary more, with 52% to 92% of men being able to produce sperm in their ejaculate after this procedure. On average, 41% of men who have had an epididymostomy will be able to father a child.

 

Epididymal Blockage and Vas Deferens Blockage

Sometimes, key ducts in your reproductive tract can become blocked for reasons other then a vasectomy. Due to sexually transmitted infections, like chlamydia and gonorrhea, the epididymis can become inflamed and blocked, preventing sperm from flowing out of your testes. The vas deferens can also become blocked due to these infections, or due to trauma incurred during other surgical procedures. This can prevent sperm from entering into your ejaculate, making pregnancy impossible.

The Procedure
In order to correct a blockage of the vas deferens or epididymis, the tubes must be reconnected. As with vasectomy reversal, the vasovasostomy and epididymostomy procedures are also used.

Success Rates
Success rates are similar to those found in vasectomy reversals. About 60% of men undergoing a vasovasostomy will be able to father a child while about 40% of men undergoing an epididymostomy will father a child.

 

Ejaculatory Duct Obstruction

About 10% of men who do not have sperm in their semen suffer from an ejaculatory duct blockage. Surgery is available to eliminate such obstructions and restore your ability to father a child.

Ejaculatory duct obstruction can be the result of surgical scarring during vasectomy procedures, cancerous tumors, or cysts that grow in the prostate. These scars, tumors, or cysts can press on the ejaculatory duct preventing sperm from being ejaculated. This will make it impossible for you to fertilize an egg.

The Procedure
Surgery for an ejaculatory duct obstruction can help to restore the ejaculation of semen. The procedure is simple and is usually done on an outpatient basis. Under general or local anesthesia, your surgeon will make a small cut in your testes. Using a special operating microscope, your surgeon will isolate your ejaculatory duct and locate the blockage. This blockage is then removed.

Success Rates
Success rates to restore sperm flow are generally high with this surgery, with more than 70% of men undergoing the procedure able to produce sperm in their semen once again. However, pregnancy rates following this type of surgery are not as optimistic. Between 20% and 30% of these men will go on to father children.

 

Things To Consider

Surgery is often a big step to take, so it is important to weigh all of your options first. Before booking your surgery, there are many things that you may want to consider. These include:

 

  • the cost of the procedure
  • recovery times involved
  • alternatives, such as IVF and IUI

 

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