Fertility After 输精管结扎术
由于生活或人际关系的变化，即使你已经有了孩子，你也可能想要一个孩子 输精管结扎术. In many cases vasectomies can be reversed. 对于男性来说，和他们的伴侣进行诚实的讨论来决定输精管结扎术是否对他们来说是最好的选择是很重要的.
If your female partner is older than 40, it may be harder for you and your partner to conceive naturally. 在这些情况下, couples may be better served by having a procedure to extract sperm, 可以用来做什么 in-vitro fertilization (试管婴儿).
Sometimes doing both a 输精管结扎术 reversal and 精子提取 同时也是优化成功受孕的最佳选择.
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输精管切除术逆转 Procedures
If you've had a 输精管结扎术 in the past, 外科医生可以绕过输精管周围的疤痕组织，重新连接输精管. There are various techniques for a 输精管结扎术 reversal. Your surgeon will discuss the differences between each technique.
输精管结扎术 reversals are done using general anesthesia. You also won't need to stay in the hospital overnight to recover.
输精管吻合术
输精管吻合术 is the most common technique for 输精管结扎术 reversal. During this three-hour procedure, 你的外科医生会用高倍手术显微镜和缝合线将输精管的两端缝合在一起。. 这些针脚比人的头发还细，而且很小，肉眼看不太清楚.
We use an operating microscope that magnifies 30–40 times. We want to make sure your tissue is handled extremely carefully.
这项技术将输精管重新连接起来，这些输精管在输精管切除术中被切断. Current studies don’t show that one technique is better than the other.
To reverse your 输精管结扎术, your surgeon will perform several steps. 你的外科医生会：
- Dissect your vas deferens tube,
- Identify where your tube is blocked from the 输精管结扎术,
- Cut the vas deferens above and below this blockage, and
- Place six to ten very fine stitches to reconstruct your tube.
之前 placing any stitches, 你的外科医生会在显微镜下检查从你的输精管睾丸端流出的液体.
如果手术时输精管中仍有液体，大发娱乐才会进行输精管结扎术. If you don’t have any fluid, we will perform an epididymovasostomy.
Vasoepididymostomy
Vasoepididymostomy is a more complex version of the vasovasostomy. 这包括将输精管的一端直接连接到附睾, which is a structure that stores sperm created in the testicle.
如果你的精子阻塞在附睾，外科医生会选择这个手术. We typically use the intussusception technique, 其中包括在附睾内的小管中放置两到三个缝合线，然后在打开小管之前将它们连接到输精管上.
Epididymovasostomy
Epididymovasostomy is a more complex version of the vasovasostomy. 如果你的精子阻塞在附睾，外科医生会选择这个手术. 该手术是最复杂的显微外科手术之一. We typically use the intussusception technique.
这项技术包括在扩张的附睾小管上放置两到三个10-0的缝合线，然后在打开小管之前将它们连接到输精管上. 这使得手术更容易，因为你的外科医生可以将缝合线放在扩大的扩张小管上，而不是打开的收缩小管上.
Once your surgeon places all the sutures, 你的外科医生会用显微手术刀打开小管，然后把缝合线扎好.
之前 & During 输精管切除术逆转
大发娱乐会给你准确的指示来准备输精管结扎术. Please tell us about any medications you take, including aspirin. We may ask you to stop taking some or all of these.
手术当天，带上干净的棉质内裤或运动护具.
过程中
You’ll receive medication to keep you comfortable. 在手术过程中，你可能是清醒和放松的，或者你可能完全睡着了.
一旦药物生效，大发娱乐会在你的阴囊上做一个切口. Then we will lift out the cut ends of each vas deferens and examine them. We may need to remove a section of each cut end.
We will cut the end closer to the testicles until fluid flows freely. We may look at this fluid under a microscope to see if sperm are present. Then we stitch the two cut ends together. 如果需要，大发娱乐可以将输精管直接连接到附睾（睾丸后部的管）。.
When we have reconnected both of the vas deferens, we will suture the incisions in the scrotum closed.
输精管切除术逆转 Recovery
输精管结扎术 reversals are performed under general anesthesia. 你不需要在医院过夜来恢复，你可以当天回家. 病人 typically have minimal pain.
输精管切除术逆转 Pain
缓解疼痛, 每8小时服用800毫克布洛芬，每6小时服用650毫克泰诺，连续服用3天. Take narcotic pain medication only if needed. You can take antibiotics if we prescribe them.
为了减少肿胀的可能性，在最初的24小时内尽量不要站立. 将冰袋或冷冻豌豆袋（用薄毛巾包裹）放在阴囊上一小段时间. This helps reduce swelling.
Wear snug cotton briefs or an athletic supporter for extra support. We will also give you instructions for showering and bathing.
输精管切除术逆转 Risks
任何使用麻醉的外科手术都有一定的风险. You could also possibly have:
- 感染（症状包括发热、寒战、切口渗液或疼痛）；
- internal bleeding of the scrotum (symptoms include increasing pain, 过度肿胀, a large black and blue area, 或者一个越来越大的肿块), 和/或
- the procedure fails to restore fertility.
输精管切除术逆转 Cost
Typically, insurance doesn’t cover 输精管结扎术 reversal. The cost will depend on where you live, 但通常售价8美元,总共000美元, 包括咨询, 手术, 和麻醉.
输精管切除术逆转 Vs 试管婴儿
输精管结扎术 reversals are much less expensive than 试管婴儿. 也, 输精管结扎手术后，你和你的伴侣可能会有多胎妊娠. 使用试管婴儿，每个周期的设计结果只有一次怀孕和分娩.
输精管切除术逆转 Success Rate
输精管结扎逆转手术通常是成功的，在奖学金训练的显微外科医生谁定期执行.
有些男性没有精子或精子很少，即使他们的输精管重新连接成功. 疤痕, 慢性阻塞, 或者产生抗精子抗体会导致男性精子少或没有精子.
其他几个因素也会影响输精管结扎术是否成功. 这些包括:
- 手术技术,
- your surgeon’s skill level,
- amount of time since your 输精管结扎术,
- the quality of your vasal fluid, 和/或
- whether you have any blockage in your epididymis.
如果输精管切除术逆转成功，逆转手术后你的精液中会有精子. If your 输精管结扎术 reversal fails, you will probably need 试管婴儿 or an alternative reproductive technology.
Should I Store My Sperm in A Sperm Bank?
We also offer men the option of 储存精子 at the time of their 输精管结扎术 reversal. 大发娱乐可以在输精管结扎术中收集精子，方法是在你的睾丸上做一个小切口，切除一些输精管. This incision is then closed with very fine suture.
然后大发娱乐会把你的小管带到男科实验室提取并冷冻你的精子. 你的精子将被放置在液氮中，你想待多久就待多久.
Benefits of Banking Your Sperm
在极少数情况下，输精管切除术后精子可能不会返回到你的射精中. Your partner or spouse may also have infertility and need 试管婴儿. 如果发生上述任何一种情况，你都不需要再进行一次精子提取手术. 大发娱乐可以在你输精管结扎时提取并储存一些你的精子.
倾听病人的心声
Couple Welcomes New Baby 10 Months After 输精管切除术逆转 Surgery
Steve Tait had five grown children from a previous marriage. 当他再婚时，他和他的妻子开始讨论要一个孩子的可能性. There was just one obstacle: Tait's 输精管结扎术. After exploring their options, 他被转诊到犹他健康大学，在那里他成功地进行了输精管结扎手术. Ten months after 手术, his wife gave birth to their baby boy.
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