Vasectomy Reversal

What is vasectomy reversal?

A vasectomy is a surgical procedure performed in men as a means of permanent birth control to prevent reproduction. Vasectomy reversal is a surgical procedure where the ends of the sperm carrying tubes, the vas deferens that were cut and sealed during vasectomy are joined back together to enable reproduction.

What are the different approaches to vasectomy reversal?

Vasectomy reversal is a sophisticated procedure that can be attempted by two different surgical approaches depending on to location of the original vasectomy:

  • Vasovasostomy: In this procedure, the cut ends of the vas deferens (the sperm carrying tubes) are reconnected.
  • Vasoepididymostomy: This approach involves the connection of the detached vas deferens to the epididymis (a tube that lies at the back of each testicle).

How is vasectomy reversal performed?

Vasectomy reversal is generally carried out as a day procedure under general anaesthesia. Your surgeon makes a small incision in the skin of the scrotum, the sac that contains the testes. The surrounding structures are retracted to expose the testicle. The vas deferens is carefully cut and inspected for fluid and the presence of sperm. When your surgeon confirms the presence of sperm with motility, the tubes are reconnected to enable the transit of sperm.

In cases where there is no seminal fluid or fluid is present but has no sperm, a vasoepididymostomy would be performed in a similar manner to connect the detached vas deferens to the epididymis.

The operation is performed under an operation microscope to allow precise approximation and suturing of the vas deferens

What does your post-operative care include?

Following are the post-surgical guidelines to be followed after surgery:

  • Apply ice packs over the scrotum to reduce post-operative swelling.
  • Your doctor may prescribe medications to help alleviate pain and make you feel comfortable.
  • Wearing an athletic supporter at all times for the first four weeks helps support the testicles, and reduce swelling and movements.
  • Keep the surgical area clean and dry.
  • Recreational activities, such as sports and lifting heavy weights, are restricted for a few weeks.
  • Return to work depends on how well you are healing and the type of work or activity level you perform.
  • Sexual activity can be resumed after about six weeks following surgery.

What is the success rate of vasectomy reversal?

The chances of vasectomy reversal success depend on how much time has passed between the vasectomy and the reversal. Over time, additional blockages can form, and some men develop antibodies to their own sperm.

  • Leads to overall pregnancy rates of greater than 50%.
  • Has the greatest chance of success within 3 years of the vasectomy.
  • Leads to pregnancy only about 30% of the time if the reversal is done more than 10 years after vasectomy.