Vasectomy Reversal

About the Procedure

A Vasectomy Reversal procedure is performed to reconnect the vasa deferentia, previously cut during a vasectomy, with the goal of restoring fertility. The two techniques used are as follows: if sperm is found in the vas deferens fluid when the surgeon begins the procedure, a vasovasostomy is performed; if sperm is not found, a blockage is presumed and a vasoepididymostomy may be required to by-pass the blockage. The potency of the sperm is a major factor in the patient's eventual fertility as the physiological changes following a vasectomy may influence the shape and motility of sperm. The type of vasectomy and damage to tissues during the original procedure can make a reconnection of the ducts difficult, particularly if the ends of the vas deferens were cauterized.

Since this procedure is complicated and many surgeons prefer using general anesthesia to avoid patient movement (although local or regional anesthetic are options), it is done in a hospital or out-patient clinic. A mild sedative is given, followed by anesthesia. The surgeon begins reconnecting two tiny ducts, each the diameter of pencil lead, sewing them together with thread thinner than a human hair. The surgery takes two to five hours for the less complicated technique, additional time for the other. After two to three hours in recovery, the doctor may agree to discharge.

What to Know Before the Procedure

The vasectomy reversal recovery has a longer period of discomfort than the vasectomy. Returning to normal activities is not recommended until about five days after surgery and heavy lifting or physical exertion should be postponed for three to four weeks. Men who have desk jobs may return to work in a week, sometimes sooner; and those with more strenuous jobs require a two to three week wait. The patient will have to refrain from ejaculation for three to four weeks in order to avoid rupturing the newly connected ducts.

Preparation for this operation includes a health assessment, blood work, and x-rays during the week prior to the procedure. The doctor will review the patient's medications to avoid anticoagulants causing excess blood loss during the operation and give pre-operative instructions on food and water restrictions. Patients are asked to bring a jockstrap or a pair of snug underwear to help relieve discomfort and to protect the area after surgery. Advanced planning for a ride at discharge and assistance for the first day is recommended because pain and tiredness are the chief complaints at that time.

What to Know After the Procedure

The first day or two after the procedure the patient's legs will need to be elevated. Ice packs should be applied to the scrotum area to reduce swelling and pain, and standing, which puts pressure on the groin, should be avoided. Patients who have had general anesthesia may experience a headache, body ache, and/or nausea which will go away in a few days. Showers can be resumed in one or two days, but no baths should be taken until the physician advises. At the end of the surgical procedure, the snug fitting scrotal supporter lined with sterile fluffs to keep the scrotum protected and still, will continue to be worn whenever the patient is standing. When sexual activity is permitted the patient may not yet be 100% fertile but impregnation is still possible. Schedule an appointment with your physician to assess when a return to fertility has been achieved.

If you Need to Travel Outside of your Local Hospital

A surgeon with excellent microsurgery skills and extensive experience performing successful reversals is critically important and may significantly limit potential locations. The initial period of recovery requires rest and leg elevation with standing being strongly discouraged. If the patient can remain at the location where the surgery was performed for a few days, travelling to have the surgery is an option. Research multiple doctors to find one of the highest skill level; and seek their advice regarding post-surgical care, as well as travel restrictions and recommendations. This may influence your decision on whether to have this procedure performed domestically or internationally.