Vasectomy Reversal

What is a vasectomy?

A vasectomy is an operation men have to prevent pregnancy when they have sex with their partner. When a vasectomy is done, the 2 tubes that carry sperm from the testicles to the penis are cut and blocked. These tubes are called the vas deferens, or vas. Within a few months after the vasectomy, the fluid that is ejaculated during sex (semen) no longer contains sperm.

What is a vasectomy reversal?

A vasectomy reversal is an operation to reconnect the vas deferens after a vasectomy. It may allow a man to be fertile and father children again.

The cost of a vasectomy reversal is not usually covered by most insurance companies. Much thought must go into the decision to have this surgery. It is important to talk with your healthcare provider about possible problems after the surgery. Ask what the chances are that it will be successful and allow you to make your partner pregnant.

When is it done?

Even though a vasectomy is considered a permanent form of birth control, some men change their minds and want to be able to have children again. This may happen because of a major change in their lives, such as a divorce, death of a spouse, or death of a child.

Before the surgery, you will have a physical exam, tests to see if you have sperm, and a review of the records from your vasectomy to see if you are a good candidate for this surgery.

Are there other ways to get my partner pregnant?

Besides a vasectomy reversal, there are several other choices if you decide you want to father more children. For example, sperm may be taken from your testicles with a small cut in the scrotum or a needle. (Anesthesia is given so that you will not feel pain during the procedure.)The sperm may then be put into your partner's body. This is called artificial insemination. Or eggs may be taken from your partner's body, fertilized by sperm outside the body, and then put back into her body. This is called in vitro fertilization. An advantage of these procedures over a vasectomy reversal is time. Couples can become pregnant much sooner with artificial insemination. However, with a successful vasectomy reversal, you may be able to conceive several times without additional procedures.

How do I prepare for a vasectomy reversal?

Find someone to drive you home after the procedure.

You may be asked to shave the scrotal area the night before the procedure.

What happens during the vasectomy reversal?

The surgery is done in your healthcare provider's office or at an outpatient clinic.

Before the procedure you will be given a local anesthetic to numb each side of the scrotum. You may also be given a sedative, which is medicine that will relax you.

There are 2 types of vasectomy reversal procedures: vasovasostomy and vasoepididymostomy. A physical exam before surgery will determine which procedure the surgeon performs.

• For a vasovasostomy, the surgeon stitches the cut ends of the vas deferens together. It is done if your exam shows that sperm is inside the vas deferens.
• A vasoepididymostomy is done if a blockage is found in the vas deferens. This procedure creates a bypass of the blockage. It has a lower success rate than a vasovasostomy because it is a more complex procedure.

The rejoined vas deferens becomes a passageway for the sperm, so sperm can again be carried to the penis and into your partner's body when you have sex.

What happens after the vasectomy reversal?

When you go home after the surgery, stay off your feet, ice your scrotal area, and prop your legs up.

You can take a shower 1 to 2 days after the surgery. Do not take a bath or swim for 2 days because it increases your risk of infection at the surgery site.

After the surgery, you will have pain, swelling, and bruising in your groin area for 1 to 2 weeks. You will need to stay at home several days while you recover from the procedure. Wearing a jock strap or tight underwear for 1 to 3 weeks may help decrease discomfort.

Wait 4 to 5 weeks before you return to strenuous activities. Avoid having an orgasm and ejaculating for 1 month.

Your healthcare provider will want to test your semen every 2 to 3 months after the procedure to check your sperm count. If the vasectomy reversal is successful, it will take about 1 to 2 years to conceive a child after the surgery. Some pregnancies occur earlier than this, and others take longer to happen.

How effective is a vasectomy reversal?

The effectiveness of a vasectomy reversal varies from 40 to 75%. Vasectomy reversal has been reported to be more successful when a surgeon uses a microscope to do the surgery. The surgery is also more likely to be successful if only a small part of the vas deferens was damaged when you had a vasectomy. The sooner the reversal is done after the vasectomy, the better the chances of success.

Will there be any effect on my sex drive?

There should be no effect on your sex drive. The procedure simply lets sperm flow out of the penis again.

What are the benefits of a vasectomy reversal?

If the surgery is effective, you will be fertile and able to have a child.

What are the risks?

The risks of this procedure are:

• infection
• pain after surgery.

There is also a possibility that the procedure will fail and will not make a man fertile again.

When should I call my healthcare provider?

Call your provider right away if:

• You have bleeding.
• You have redness or pus around the wound site.
• You have more pain.

Call during office hours if:

• You have pain.
• You have fever over 100°F (37.8°C).

For more information, visit the American Urological Associations Web site at http://www.urologyhealth.org.