Vasectomy reversal at a glance
- A vasectomy reversal reconnects the vas deferens tube that was cut during a vasectomy, a procedure that prevents sperm from reaching a man’s semen, rendering him infertile.
- A vasectomy reversal is typically an outpatient operation requiring no hospital stay.
- Although a reversal almost always requires general anesthesia, discomfort from the surgery is relatively mild and pain is often no greater than that of the original vasectomy.
- Sometimes the procedure requires only reconnecting the ends of the vas deferens to the sperm tract; other times a more complex procedure is required in order to bypass a blockage.
- In some cases a vasectomy reversal enables patients to impregnate their female partners in a few months; other cases may require a year or longer.
- When successful a vasectomy reversal usually is effective for decades.
What is a vasectomy reversal?
A vasectomy is a form of male sterilization in which a surgeon cuts the vas deferens, the sperm transport tubes located on each side of the scrotum that connect the testes with the urethra, prohibiting the sperm from mixing with semen, which means the man is infertile.
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Although a vasectomy is generally considered a form of permanent sterilization, it can often be reversed by a vasovasostomy (vasectomy reversal). Reasons for having a vasectomy reversal are varied. Men who have had a vasectomy may have many reasons, such as marriage, which changes their mind about having children.
Usually, a vasectomy reversal is an outpatient procedure requiring no overnight hospital stay. This operation usually takes place either in an outpatient surgery center in a hospital or in what’s called an ambulatory surgical center, a special stand-alone facility not part of any hospital.
A vasectomy reversal almost always requires general anesthesia, meaning the patient is asleep during the entire procedure. After the patient is anesthetized, the urologist uses a microscope for viewing, makes a small incision on each side of the scrotum and removes any scarred tissue in the vas deferens.
Next the surgeon samples fluid from the vas deferens next to the testicle to check for sperm. If there is sperm, the surgeon can simply reconnect the ends of the vas deferens to the epididymis, a collection of coiled tubes that transport sperm from the testes.
If there is no sperm in the fluid, the urologist may have to use a more complex technique known as a vasoepididymostomy or epididymovasostomy. This requires the surgeon to bypass the blockage in the epididymis and connect the upper end of the vas deferens to the epididymis above the blockage.
The operation usually takes from two to four hours. Most patients also need a few more hours to recover from the surgery before going home the same day.
Recovering from a vasectomy reversal
In the vast majority of cases, patients recover quickly and relatively comfortably from a vasectomy reversal. The level of pain is often no greater than that experienced during the original vasectomy. Oral medications help control any pain, which typically subsides after a few days.
Patients should avoid sex and strenuous physical activity for two to three weeks. Most urologists also advise men to wear a jock strap during the recovery.
Anyone who’s undergone a vasectomy reversal should exercise patience in terms of regaining fertility. While some men are able to impregnate their partners within months, others require a year or more.
Of course, the female partner’s age and health are also crucial factors in achieving conception. While men can produce healthy sperm for decades, women begin experiencing a decline in fertility in their mid-30s. In more difficult cases, a couple may need in vitro fertilization (IVF) in order to conceive.
The time it takes to achieve pregnancy also depends on how long it’s been since the original vasectomy. A sperm count is the only technique for determining the rate of progress. For this reason, the urologist may ask for a sperm sample every two to three months.
Once a vasectomy reversal has become effective, the patient should be fertile for years to come.