The Most Important Facts About Vasectomy Reversal Every Man Should Know

Every year couple of million men around the world undergo a vasectomy, one of the most effective ways of permanent birth control. Many families decide to undertake the vasectomy when they feel their families are complete, while others opt for a vasectomy because they simply do not want children. Naturally, people change their minds. Patients may decide to undergo a vasectomy reversal for a number of reasons, including change of mind in wanting kids later in life, remarriage or simply because their life circumstances change.

It’s good to know then that there is an opportunity of having a vasectomy reversal. Certainly not as common as vasectomy, men considering a vasectomy reversal are often unaware of the complexities of this special procedure and where to begin to search for a qualified surgeon.

For this reason, the vasectomy reversal surgeons and specialists at KCM Poland have compiled the most important facts that all men need to know about a vasectomy reversal.

What is a vasectomy reversal?

Vasectomy reversal is a microsurgery to undo a vasectomy, in which a surgeon uses a surgical microscope to magnify the vas deferens. During the procedure, a surgeon reconnects each tube that carries sperm from a testicle into the semen. In a vasectomy reversal, your surgeon has to re-join these tubes back together so that sperm can reach the semen when you ejaculate. Following a successful vasectomy reversal, sperm is again present in the semen, and the patient may be able to get his partner pregnant.  Vasectomy reversal is a very complexed procedure, more difficult and expensive than a vasectomy. It requires specialized skills and expertise.

Can a vasectomy be reversed after 20 years?

A vasectomy can be reversed for more than 20 years following the original procedure.

The longer you wait to reverse a vasectomy, the less likely that you’ll be able to get your partner pregnant after the procedure.

How long does a vasovasostomy take? 

The duration of a vasectomy reversal procedure, known as vasovasostomy, can vary depending on various factors, including the surgeon’s experience and the complexity of the surgery. Typically, the procedure takes approximately two to four hours, although there are cases where it may last longer. 

To ensure utmost precision, microsurgical techniques are commonly employed in vasovasostomy, with the assistance of a microscope. This approach usually takes around 2 to 3 hours to complete.

In certain instances, the procedure may require up to three or four hours, and it can be performed as an outpatient procedure under general anaesthesia. The exact duration, approximately 3.5 hours, is influenced by several factors, including the surgeon’s skill, the intricacy of the case, and the type of anaesthesia utilised.

Why is a vasectomy reversal done? 

A vasectomy, a common outpatient surgical procedure conducted to achieve permanent male sterilisation, involves the cutting and sealing of the vas deferens, preventing sperm from reaching semen. Performed under local anaesthesia, this relatively simple and safe procedure is highly effective in providing long-term contraception without affecting sexual function or libido. 

Although vasectomy is considered permanent, it is worth mentioning that fertility restoration techniques like microsurgical vasectomy reversal or sperm retrieval coupled with in-vitro fertilisation are viable options for individuals seeking to reverse their sterility.

How is a vasectomy reversed?

A vasectomy reversal, also known as vasovasostomy, is a surgical procedure that can undo the effects of a vasectomy. A vasectomy is a permanent form of male contraception that involves cutting or blocking the vas deferens, the tubes that carry sperm from the testicles to the urethra.

What happens during a vasectomy reversal?

During a vasectomy reversal, the surgeon makes a small incision in the scrotum to access the vas deferens. The surgeon then uses microsurgical techniques to reconnect the two severed ends of the vas deferens. This can be done in two ways:

Vasovasostomy: This is the most common method of vasectomy reversal. The surgeon simply reattaches the two severed ends of the vas deferens.

Vasoepididymostomy: This is a less common method of vasectomy reversal that is used when vasovasostomy is not possible. In this procedure, the surgeon connects the vas deferens to the epididymis, the organ that stores sperm. This allows sperm to bypass the blockage and reach the seminal fluid.

The surgery is typically performed under general anesthesia and takes about 1-2 hours. After the procedure, the patient may experience some pain and swelling in the scrotum. The patient will also need to avoid strenuous activity for a few weeks to allow for healing.

Are there different types of vasectomy reversals?

The surgeon will undertake the surgery in the Vasovasostomy technique as the primary one. Vasovasostomy – with this procedure the surgeon reconnects the ends of the tubes deferens after removing the blockage of each tube that carries sperm. If a vasovasostomy does not work or sperm is not present the surgeon will use another technique called vasoepididymostomy. Vasoepididymostomy – with this procedure the surgeon will attach the tubes deferens directly to the small organ at the back of each testicle that holds sperm. A vasoepididymostomy is more complicated than a vasovasostomy and is generally chosen if a vasovasostomy will not work or sperm is not present.

How successful is a vasectomy reversal?

Many factors affect whether a reversal is successful in fertility and achieving future pregnancy, including time since a vasectomy, partner’s age, surgeon’s experience and training, and whether you had fertility issues before your vasectomy.

The longer the wait, there is a decreased chance that the surgeon can successfully reconnect the tubes, known as vas deferens, that carry the sperm, the reversal though can be performed even 20 years following the original procedure.

The success of a vasectomy reversal depends on a number of factors, including the time since the original vasectomy, the surgical technique used, the skill of the surgeon, and the individual’s overall health. Generally speaking, the success rates are higher if the vasectomy was recent and if vasovasostomy is possible, rather than vasoepididymostomy.

Success rates are often measured in terms of the return of sperm to the semen and the ability to conceive a child after the reversal. On average, success rates range from 40% to 90%. If sperm return is observed, pregnancy may occur within a year or two after the procedure. However, it is important to keep in mind that a successful vasectomy reversal does not guarantee pregnancy. There may be other fertility factors at play for both partners.

The best chances occur when the reversal is less than three years from the time you had the vasectomy, although it is still possible in many cases.

How do you prepare for vasectomy reversal?:

If you’re considering a vasectomy reversal in order to try to conceive, it’s important for both partners to undergo fertility testing before the surgery in order to account for all possible outcomes.

You should review your current medication list with your doctor. It is advisable to eliminate the use of blood thinners, including aspirin, and anti-inflammatory medications for several days before the surgery. You will also be asked to bring loose fitting clothing and an athletic supporter when you come to the clinic.

Make sure that the lines of communication are opened and try to support your partner in the process. Joining a support group or counselling might help as well.

Many questions will be answered by reviewing the pre-operative instructions given to each patient during the pre op consultation. Following these instructions will benefit the patient both during and following their procedure.

It is important to be aware of your general state of health prior to any surgical procedure. There are a variety of conditions that may affect the outcome of your operation. Please ensure to inform your doctor of your past medical history at the time of your pre-operative consultation. Some patients are asked to obtain cardiology clearance before proceeding with the operation.

What is the recovery after the vasectomy reversal?:

After the surgery, your doctor will cover the incision with bandages. You’ll put on tightfitting undergarments, such as an athletic supporter. Remove dressings from inside the athletic supporter in 48 hours. Any stitches should dissolve in seven to 10 days.

Apply frequent ice packs (or frozen peas, any brand) to the scrotum the evening after the vasectomy reversal and the day after that for 24 hours to reduce swelling.

You should not drive directly after the surgery and have a driver arranged to take you back to your place.

Wear athletic supporter at all times for the first 4 weeks. After that, you’ll need to continue to wear one when you exercise.

Shower once the dressings are removed. For the first couple of days after surgery, avoid anything that might get the surgery site wet, such as bathing or swimming. Patients should take showers, rather than baths, for the first few days after surgery.

Take prescribed pain medication as directed. You may feel sore for several days. Pain after surgery is most often relieved with pills. Pain usually lasts a few days to a week. For most men, the pain isn’t severe and gets better after a few days to a week.

Resume a normal, well-balanced diet upon returning home or to the hotel. Drink a lot of fluids.

Normal, non-vigorous activity can be restarted after 48 hours or when feeling better. At home, you should relax and try to limit any activities that might cause the testicles to move around excessively.

Heavy activities such as jogging and weight lifting can be resumed in 2 to 4 weeks depending on the particular procedure.

If you have an office work, you’ll probably be able to return to work a few days after the surgery. If you work physically, talk to your doctor first about when it’s safe to go back to work.

Refrain from sexual intercourse for 4 weeks and the surgeon’s recommendations. Patients may resume sexual activity when they are comfortable, usually after 4 weeks. It is best to ask the urologist for their recommendation. Men may notice blood in their semen, which is normal.

The semen is checked for sperm at between 6 and 12 weeks post-operatively and then depending on the results may be requested monthly semen analyses are then obtained for about 6 months or until the semen quality stabilizes.

You may experience discomfort after the vasectomy reversal. Symptoms that may not require a doctor’s attention are: (a) light bruising and discoloration of the scrotal skin and base of penis. This will take one week to go away. b) limited scrotal swelling (a grapefruit is too large); (c) small amounts of thin, clear, pinkish fluid may drain from the incision for a few days after reversal surgery. Keep the area clean and dry and it will stop.

As a result of general anesthesia, a sore throat, nausea, constipation, and general “body ache” may occur. These problems should resolve within 48 hours.

Recovery takes about 2 – 4 weeks.

Can there be anything worrying about the procedure?:

In general, vasectomy reversal is a safe procedure and complication rates are low. There are small chances of infection or bleeding, the latter of which can result in a hematoma or blood clot in the scrotum that needs surgical drainage. It is possible, though unusual, to experience a bleeding episode during or after surgery. Should post-operative bleeding occur, it might require emergency treatment to drain accumulated blood or blood transfusion.

Infection is unusual after this type of surgery. Should an infection occur, treatment including antibiotics or additional surgery may be necessary.

If there is significant scar tissue encountered during the vasectomy reversal, fluid other than blood seroma can also accumulate in a small number of cases. The degree of scar tissue is unpredictable. Sometimes, depending on the location of the scar tissue, the scar tissue must be cut (called “lysis of adhesions”) in order to perform the operation.

Painful  granulomas, caused by leaking sperm, can develop near the surgical site in some cases. Very rare complications include compartment syndrome or deep venous thrombosis from prolonged positioning, testis atrophy due to damaged blood supply, and reactions to anesthesia.

In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reaction which are more serious may occur to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

As with any surgery and general anaesthesia involve risk. unforeseen complications may result in a prolonged hospital stay.