Vasectomy Reversal
Vasectomy reversal is a surgical procedure to undo a vasectomy by reconnecting the male reproductive tract. It reconnects the tubes that carry sperm (vas deferens). Once this procedure is successful, sperms are again present in the semen and you can get your partner pregnant.
Depending on the type of procedure that is performed, pregnancy rates after vasectomy can range from 30 percent to over 90 percent. Several factors can affect how successful a reversal is, in achieving pregnancy. This can include time since the vasectomy, age of the partner, the experience of the surgeon and whether or not the person has had any fertility issues before the vasectomy.
Purpose
Men can choose to go for a vasectomy reversal for multiple reasons which sometimes includes loss of a child, a change of heart or remarriage. Sometimes few men also go for a vasectomy reversal for treating testicular pain which can be linked to a vasectomy.
Preparation
Doctors can perform vasectomy reversals at a surgery center or at a hospital. It is generally an outpatient procedure with no need for an overnight hospital stay. Before the reversal, your doctor will:
- Take a medical history and do a physical exam – It is quite important to ensure that there are no other health problems which may lead to any complications during or after the surgery.
- Confirm that healthy sperm can be produced – Generally, evidence of having fathered a child before can be sufficient, but if there is any uncertainty, sometimes additional testing can be required.
- Review the surgical history – It is also important for your surgeon to know if you had any previous surgeries other than vasectomy or any previous injuries which can interfere with this procedure.
- Consider blood tests – Though this is not always necessary, it can be recommended for any man who has issues of sexual function or an abnormal sexual function.
During the procedure, generally, general anesthesia is used. It is best if you can arrange for someone to drive you home after the surgery. The surgery should generally take around two to four hours. If general anesthesia is used, you might need some additional time for your recovery. Ask your doctor when you will be able to go home after the surgery.
Procedure
During the procedure, your doctor will first make an incision on your scrotum. This will be exposing the vas deferens i.e. the tube that carries the sperm and releases it from the surrounding tissues.
Next, the doctor will be cutting out the vas deferens in order to examining the fluid inside. When sperms are present in the fluid, the end of the vas deferens is connected so that the passageway for the sperm can be re-established.
However, if the fluid doesn’t contain sperm, then the sperm flow may be blocked by scar tissue. In this case, your doctor has to attach the vas deferens directly to the small organ at the back of each testicle holding sperm.
Robot-assisted surgery has also been used for vasectomy reversal, though it is usually required only in a few selected cases.
After the procedure
Immediately after the procedure, your doctor will cover your incisions with bandages. You’ll put on tightfitting undergarments such as an athletic supporter and also need to apply ice for 24 to 48 hours for reducing the swelling.
You might feel sore for several days. If bandages are placed over the incisions after the surgery, you should ask your doctor, when you will be able to take them off.
After you return home, try to limit activities that might cause the testicles to move around too much. You will be experiencing some pain and swelling once the anesthetic wears off. For most men, the pain is not severe and it should get better after some weeks.
Your doctor might give you the following instructions as well:
- Wear an athletic supporter at all times for some weeks after the procedure, except when you are showering. After that you need to continue to wear one while exercising.
- For the first two days after your surgery, avoid any activities that can get the surgery site wet, such as showering, bathing or swimming.
- If you work a desk job, you should be able to return to work just a few days after surgery. However, if your job involves physical labor or your job requires much walking or driving, discuss with your doctor about when you should go back to work.
- Limit any kind of activity such as jogging, sports or biking that may pull on the testicles or scrotum for a minimum of six to eight weeks after surgery.
- Refrain from having sexual intercourse or ejaculating until your doctor says that it is okay to do so. Generally, men need to refrain from ejaculating for two to three weeks after the surgery.
Results
Some time after the procedure, your doctor will examine your semen with the help of a microscope to see if the operation was a success. He/she may want to check your semen periodically. Unless you get your partner pregnant, the only other way to determine if the vasectomy reversal process was a success is to keep checking.
When a vasectomy reversal is a success, the sperm should reappear in the semen within a few weeks. However, in some cases, it may take more than a year. The likelihood of pregnancy can depend on multiple factors, such as the number of quality of sperm present as well as the age of the female pregnancy.
If there is an underlying issue with the testicle which the doctor cannot recognize during the surgery, then there is a chance that the vasectomy reversal might fail. Some men also attempt a second vasectomy reversal surgery if the first one fails to work.
If the reversal fails, it is also possible to father a child through in vitro fertilization with the use of frozen sperm.
Risks
Though it is safe, there are few risks to vasectomy reversal surgery. Sometimes full fertility may not resume. Other risks include chronic pain as well as infection. Few other risks include:
- hematoma
- inadequate sperm count
- bruising and swelling
- bleeding
- testicular atrophy, although very rare