Revasectomy

• The most important moment is to make a thoughtful decision
• Search for all the information on revasectomy in the scientific literature
• Check which Centres and where provide this type of surgery.
• In case of a Family Planning Centre, it would be a good idea to schedule an appointment (only at CPR headquarters - Kazachska 5/U1).
• Perform additional laboratory tests: complete blood count, HBs antigen, liver tests, coagulation system
• The day before and after, you can stay at the Portos Hotel - we will cover the cost of the hotel.
• On the day of surgery, stay 5-6 hours without food and drink
• Come with Assistance.
• An hour after the procedure, you can return home, or go to our friendly Portos Hotel.
• We will be waiting for an e-mailed scan of the first semen test result, checking for the presence of spermatozoa: badania@wazektomia.com
• We look forward to seeing a photo of the Newborn and the entire Happy Family.

The cost of the procedure in our clinic is 19900PLN

I have already spoken with many Patients about the cost of the planned revasectomy. Since Patients have good information from country where revasectomy is most often performed - the USA - therefore, as a principle, we compare the costs in the USA and in our country. Such fees average between 7,000 and 20,000 USD, with slightly less at 5,000-6,000 USD in Canada. Before deciding on a revasectomy, it is a good idea to consider the IVF method, but then the higher cost as well as the effectiveness must be carefully considered. Why are there such big differences? It depends on several factors:

• Reputation of the respective Centre
• What kind of Doctor performs revasectomy procedure
• Is there an anaesthesiologist during the procedure? (Anaesthesiologist's fee: 4000-5000 USD)
• Type of anaesthesia (there will be another text on this topic).
• Is there a second operator present?
• Treatment duration: from 2 to 4 hours
• The scope of the procedure carried out, it may be decided to perform a connection between the epididymis and the vas deferens, and then this will probably mean be the amount of 20,000 USD.

• After 11 years of performing vasectomies, we have started a new venture in the form of revasectomy
• We use local anaesthesia (the procedure is completely painless) with the assistance of a Specialist Anaesthesiologist.
• At the Patient's request, or the suggestion of the Anasthesiologist, the Patient may sleep throughout the procedure.
• Clinical costs in the form of an operating room are several times greater than a treatment room
• Using a state-of-the-art system to unclog the vas deferens, we have reduced the procedure to one hour and 15 minutes.
• Our fees are not as high as in other countries
• The cost of the hotel the day before the procedure and the day after, are included in the 19900 PLN.
• Can this fee be increased after the holiday season? Yes, by about 10%.
• Consultations before or after do not require additional fees.
• In justified cases, as with vasectomy, we apply student discounts.

Numerous authors from different Centres around the world report different statistics. On average, 50-80% is reported. This means that the new partner or the previous one should give birth to a newborn within 2 years. Please keep in mind that no statistic refers to a single person, namely you. Your thoughts, dreams, musings, and thought-forms encode only one consciousness, namely: "in the next 12 months, we will be happy Parents".

• Why? Well, the so-called Patient Assessment is carried out, even though it doesn't sound quite appealing.
• In the aforementioned evaluation, a thorough health history of the man and his previous or new partner, prior to the procedure, is taken into account, and a targeted physical examination is performed
• Many authors emphasize an important revasectomy success predictor here, i.e. the duration of the vas deferens obstruction period after the vasectomy.
• A thorough history of the Patient, taking into account such data as postoperative hematoma, inflammation, allows prognosis for more difficult preparation or reanastomosis (restored patency).
• Other health factors, such as previous surgery on the inguinal area (especially hernia surgery using a reinforcing mesh), may also affect the effectiveness prediction
• A man's previously proven fertility, and his overall health status
• On physical examination, further prognostic factors include the presence of a seminal granuloma, and the length of the testicular segment of the vas deferens – both of which can affect the decompression of the epididymis and prevent concomitant obstruction.
• Significant loss of vas deferens fragments, nuclear anomalies, and significant hardening of the vas deferens, or epididymides, should still be noted.
• Laboratory testing of folliculotropic hormone (FSH), or serum testosterone, is not necessary before most reconstructive procedures, unless small testicles are noted during a follow-up visit and damage is suspected.
• In addition, the reproductive potential of the partner should be estimated and discussed impartially with the couple. This is specifically important if your partner is non-parous or over 35 years of age.
• It is good to have a conversation on any prerequisites (health condition, indications for revasectomy - actually, there is only one indication, namely: your own decision). After this visit, we decide together on the possibility of a revasectomy. Sometimes, we may advise the in vitro method. The obstetric history of the Partner, as mentioned above, is also extremely important.

This is not necessary in every case. You can always go to your specialist at your place of residence and discuss the resulting concerns after the revasectomy. You also have to take the distance to Warsaw into account. The last two of our Patients probably won't come from London for a follow-up visit, but we would definitely expect those from Piotrków Trybunalski, Cieszyn, or Wrocław to decide on a trip to Wilanów. Then again, a visit with a Newly Born Resident of Planet Earth, after a revasectomy is performed, would be much appreciated.

Jeżeli rewazektomia wykonywana jest obustronnie, skuteczność zabiegu może sięgać nawet 90%.

Jeżeli natomiast w trakcie badania śródoperacyjnego, w ocenie mikroskopowej, nie stwierdza się obecności plemników, wówczas wykonanie połączenia nasieniowodu z najądrzem (vasoepididymostomia) daje około 60% szans na przywrócenie płodności.

Niektórzy autorzy biorą pod uwagę okres, jaki upłynął od wykonania wazektomii — zwłaszcza gdy wynosi on 14 lat lub więcej. W takich przypadkach skuteczność zabiegu notowana jest na poziomie 40–60%.

Complications after revasectomy occur extremely rarely. A scrotal hematoma, if any, is prevented by constant and meticulous attention to hemostasis throughout the dissection area. In case of minimal bleeding, a seton can be inserted to drain the secretion. Soreness, especially for the first three days, can be alleviated by taking oral analgesics, or non-steroidal anti-inflammatory drugs (NSAIDs). In case of slight swelling for the first two days, it is good to apply ice packs.

Greater attentiveness to physical activities is recommended with a revasectomy compared to a vasectomy. Heavy physical work, strenuous exercise, cycling, running - moderate break and attentiveness for up to 5 weeks. I would like to compare this behaviour to that presented by the Queen of England, namely: move carefully, with grandiosity and dignity, because the very purpose of such behaviour is great. Walking is not contraindicated during any postoperative period.

• After the procedure is completed, a gentle pressure dressing is applied
• For two consecutive days, you can apply an ice bag for a while
• For two weeks: wear tighter scrotal protectors, or special briefs.
• 3 weeks after the procedure: light physical exercise (preferably walking) is indicated.
• Two weeks – no sex
• After three weeks, there are no contraindications to sex.
• Soreness – anaesthetics, NSAIDs – non-steroidal anti-inflammatory drugs, are sometimes used for up to three weeks.
• Semen test for spermatozoa presence is performed after 8 weeks
• Subsequent semen tests should be performed every three months for a year. If the Partner has become pregnant in the meantime, then no further testing is necessary.
• After revasectomy, it can take up to 6 months to restore full sperm viability and presence

After revasectomy, couples can resume sexual relations after three weeks (3 weeks). Pregnancy can happen at any time after the revasectomy has been performed. At this point, it is important to remember to carefully examine your partner beforehand. In case of finding, for example: obstruction of the fallopian tubes, performing a revasectomy misses the point. Likewise, hormonal testing to determine ovulation can be helpful in deciding whether to perform a revasectomy. This is extremely important because the new life situation takes new health, emotional and financial obligations related to the process of restoring patency of the vasa deferentia, and thus secondary fertility, into account.