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New vasectomy method better to reverse the snip

The “vasepididymostomy” has landed in South Africa – a method that greatly increases the success rate of reverse vasectomies.

The success rate for men who want to reverse a vasectomy is only 15% to 20%.  But a method, new to South Africa, can increase the reversal success rate to approximately 80%, according to urologist Amir Zarrabi from Stellenbosch University’s faculty of medicine and health sciences

Zarrabi was recently trained in the new method in the United States where the procedure is more common. 

“A vasectomy is a very good form of contraception for married couples. It’s reliable, it’s a minor operation without many risks, it’s a once-off expense and it doesn’t have any hormonal influence on the body,” Zarrabi says.

But he warns that men should not “have the perception that they can have vasectomies and just reverse it later when they change their minds”.

The new technique increases the possibility of having a successful reversal fourfold. 

In the standard procedure the vasa deferentia (the tube that carries sperm from the testicles to the urethra) is cut and the two ends are tied together with a metal clip or stitch. This can create pressure and can have a negative effect on the success of a reversal. 

Zarrabi is one of the only urologists in the country performing the newer technique called a “vasepididymostomy”.

With this method, the vasa deferentia is also cut, but, instead of knotting the ends,  the vasa deferentia is attached to another tube which runs just above the testicle,  the epididymis, while the other end of the vasa deferentia is sealed by burning it. 

“This circumnavigates any blockages which may have formed due to pressure in the testicles,” Zarabi says.  

A piece of tissue is then placed in between the two ends to make sure that sperm cells don’t land up in the seminal stream. 

Zarrabi says this method is not yet widely used in the country because “most South African urologists regard leaving one end of the vasa deferentia open as a risk of failure of the vasectomy”. According to Zarrabi, he usually sees men in their early to late 30s for a reversal and such requests are often  connected with divorce. 

He says divorce is one of the main reasons why men want their vasectomies reversed as they might want to start a family with their new partner: “An increase in divorce is driving the demand for vasectomy reversal – men get vasectomies when they are in stable relationships and they think they won’t have any more children, but then it doesn’t work out.”

Amy Green was a health reporter at Bhekisisa from 2013 until 2016.