Sometimes a Vasectomy Can Be Reversed
In some cases, fertility may be restored in men who have undergone a vasectomy through a reversed surgical procedure; however, it is important to know the facts.
What is a Vasectomy Reversal?
Vasectomy reversal is a procedure to restore fertility after a man has undergone an elective vasectomy. In rare instances, it can also be performed for men who experience chronic pain following a vasectomy.
How do we evaluate patients for a Vasectomy Reversal?
What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:
- The urologist will take a thorough history of both the male and female partners during the evaluation since the ability of the couple to have children depends upon the reproductive health of both partners.
- Several factors determine the success rate of a vasectomy reversal, particularly the time interval between the vasectomy and reversal. The patient’s anatomy following the vasectomy may also determine the success of a vasectomy reversal and therefore physical examination of the vas deferens, testes and epididymis will be an important part of the evaluation.
Other tests that may be performed during or after your visit:
- Patients undergoing a vasectomy reversal typically do not require extensive testing. At times, hormonal blood work may be indicated if there is concern regarding testicular function
How is a Vasectomy Reversal performed?
Although there are no medical treatments available for men who have undergone previous vasectomy (voluntary sterilization), some men may choose to have their sperm surgically extracted/aspirated to be used for IVF (in vitro fertilization), rather than undergo a vasectomy reversal.
The vasectomy reversal procedure is a microsurgical procedure to restore fertility. The exact surgical techniques performed depend upon the expertise of the operating surgeon. The best results are achieved with surgeons with extensive experience performing these procedures and with specific microsurgical skills. The procedure usually takes several hours and is performed under anesthesia in either a hospital operating room or ambulatory surgical center (ASC).
Two different surgical procedures may be performed – vasovasostomy or epididymovasostomy. The exact procedure to be performed cannot be determined until the time of surgery and depends upon findings in the operating room.
- Vasovasostomy is a procedure that connects the two ends of the vas deferens and may have surgical success rates as high as more than 90%.
- Epididymovasostomy is a more challenging procedure which may be indicated when the blockage following a vasectomy is within the epididymis itself (rather than at the end of the vas deferens). Success rates are lower, but new surgical techniques still allow for excellent success rates.
What is the Vasectomy Reversal healing process?
Pain could be mild to moderate and patients may experience swollen, achy testicles for a week or so after the procedure. Physicians recommend lying down for six to eight hours after the surgery and keeping an ice pack on the incision.
In the five days after surgery, patients should continue using ice packs to limit swelling, rest as much as possible and avoid heavy lifting and exercise. A small, bloody discharge from the incision site is normal. The patient should be able to resume normal activities, including sex, within three weeks.
A vasectomy reversal is a more complex procedure than a vasectomy and it might not be covered by health insurance. The following complications might occur a few days after surgery:
- Hematoma: Though rare, a small blood vessel may leak in the scrotum, forming a clot. A small clot will probably dissolve with time, but a larger one may require reopening and draining the scrotum.
- Infection: Signs of infection include fever, chills, redness and swelling around the incision site.
A vasectomy reversal is not guaranteed to restore fertility and success rates tend to decline with time after a vasectomy. Other blockages can form, and some men develop antibodies that could attack their sperm. Success rates are greatest within three years and up to 10 years of a vasectomy. Overall, estimated pregnancy results can range from 50% to as high as 80%.