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Vasectomy reversal — or vasovasostomy — is a surgery that restores a man’s ability to make a woman pregnant. This procedure is performed by the microsurgical reweaving of the tube that was severed when the original vasectomy was performed. This tube, called the vas deferens, allows the sperm to pass from the testes to the penis during ejaculation.

Reasons

Since a vasectomy reversal is performed to restore the ability for a man to father a child, this procedure is obviously for men who wish to reconsider their original decision to have a vasectomy.

Risk

If you are planning to have a vasectomy reversal, your doctor will review a list of possible complications, which may include:

• Infection
  
• Swelling
  
• Bruising
  
• Bleeding
  
• Chronic pain in and around the testes
  
• Sperm granuloma (lumps due to immune system response to sperm leaking from the reproductive organs)
  

Factors that may increase the risk of complications include:

• Local infections
  
• Bleeding disorders
  
• Prior surgery in that area
  

What is the Chance for Success?

Success can be defined by the presence of sperm in the ejaculate after surgery or by pregnancy. Using either definition, the experience of the surgeon(s) is the most significant indicator for surgical success. Other factors that influence success are the time since vasectomy, patient age and the quality of the fluid found in the tube (vas deferens) during the surgery. Overall success at obtaining sperm after surgery for Drs. Costabile and Howards exceeds 95% for men less than 10 years after vasectomy.

Expect

Prior to the Procedure

Your doctor may do the following before the procedure:

• Physical exam
  
• Medical history
  
• Review of medicines
  
• Discuss the effects of this procedure

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure. Such medications may include:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
  

In the days leading up to your procedure:

• Arrange for a ride to and from the procedure.
  
• Wear comfortable clothing.
  
• Take any medicine as ordered by your doctor. A mild sedative before the procedure may be recommended.
  
• Shower before leaving home.
  
• You may be asked to clip your scrotal hair.

Anesthesia
Any anesthetic technique from local anesthesia with sedation to general anesthetic can be used with vasectomy reversal based on surgeon and patient preference. Modern anesthetic techniques are very safe with few side effects and no long-term risks.

Description of the Procedure

Vasectomy reversal consists of microsurgical reconstruction of the spaghetti-shaped tube (vas deferens) which was cut during vasectomy. The tube that the sperm moves through is the size of the period at the end of this sentence, therefore precise microsurgical techniques using an operating microscope and sutures thinner than a hair are needed to carefully realign the tube.

How Long Will It Take?

The vasectomy reversal procedure takes about an hour to an hour and a half.

Will It Hurt?

No. Anesthesia prevents pain during the procedure. You can expect some soreness for a few days after the procedure. Take pain medicines as directed by your doctor.

Post-procedure Care

Vasectomy reversal is performed through a very small (less than one inch) incision in the scrotum. The procedure is done on an outpatient basis with patients leaving the surgery center the same day.

After surgery, the following advice and information is noteworthy:

• Wear a scrotal support (jock strap) for a week & decrease vigorous activity for two weeks.
  
• You can get around the house for activities of daily living the same day as their surgery.
• Ice packs and pain medication can be used for the first two days after surgery for comfort.
• Refrain from ejaculating for 21 days following the vasectomy reversal procedure.

Call

After arriving home, contact your doctor if any of the following occurs:

• Signs of infection, including fever and chills
  
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  
• Difficulty urinating
• Pain that you cannot control with the medicines that you have been given

In case of an emergency, call 911.