Is He a Candidate for Vasectomy Reversal?

Men who choose vasectomy are usually certain that they do not want to have children (or more children), but some men could have second thoughts years after they have had the procedure. For example, a couple could decide to pursue vasectomy and tubal ligation as forms of birth control then, years later, the marriage could end. The man may remarry and, with his new wife, be interested in having children.

Although the vasectomy is considered permanent, it is possible to reverse the procedure. According to the Mayo Clinic, there is generally a 40 to 90-percent success rate.

How it is Done

While a vasectomy can be done in a doctor’s office using local anesthesia, a vasectomy reversal requires more complicated surgery and the doctor typically performs the procedure while you are under general anesthesia.

There are two different procedures for reversing a vasectomy:

  • Vasovaostomy: The surgeon sews the cut ends of the vas deferens (or vasa deferentia) tubes back together
  • Vasoepididymostomy: The surgeon bypasses the cut tubes and joins the vas deferens (the main tubes or ducts in the penis that carry sperm) directly to the epididymis (the organ that produces sperm).

The doctor may not know which procedure is needed until he actually makes his incision and can see the tubes and where or how they were cut. He could choose one or the other procedure, or use both—one for each testicle—depending on which he feels will be most successful.

After Surgery

Once you have had a vasectomy reversal procedure, you will be required to follow certain steps to ensure proper healing:

  • Wear an athletic supporter for several weeks after the surgery, to prevent your testicles from moving around.
  • Keep your bandages clean and dry for two days by avoiding showering, bathing, or any other activity that might get your bandages wet.
  • Avoid sexual intercourse or anything else that might cause ejaculation until your doctor gives you the green light.
  • Avoid sports and heavy lifting for several weeks.
  • Take over-the-counter analgesics or medication prescribed by your doctor to manage your pain.

Results

The doctor will be able to tell if the surgery was successful approximately six weeks after surgery. He will view a sample of your semen under a microscope to see if there are any living sperm in the sample.

Sperm should appear in the sample within a few months, but it could take a year or longer. So if sperm does not appear at first, do not lose heart. Also, your doctor will check your semen levels every few months to make sure everything is working properly.

A clear indication of whether or not the reversal was successful is if your partner becomes pregnant once you get the green light to have sex. The Mayo Clinic indicates that approximately half of couples become pregnant within two years of a vasectomy reversal.

The age of the vasectomy can determine the success rate. The more recent the vasectomy, the greater your chance of success.

Risks

As with all surgical procedures, there are certain risks and complications:

  • Bleeding. You could experience bleeding into the scrotum, which can cause painful swelling. Getting adequate rest and following your doctor’s post-surgical instructions can reduce your risk. You should also consider avoiding aspirin and other blood thinners before surgery and during the healing period.

If you are required to take blood thinners to manage another health condition, you should consult with your physician before having vasectomy reversal surgery.

  • Infection. Infection isn’t common with this type of surgery but, because the surgeon is breaking the skin, it is a possibility.
  • Granuloma. Sperm could leak into the scrotum and trigger your immune system to create an inflamed mass called a granuloma. The granuloma should disappear with time, but it could be a sign that the surgery was not successful.
  • Chronic pain. A small number of men could experience recurring pain in the testicles long after the surgery.

Contact your physician immediately if you experience severe abdominal pain and fever, or severe pain, swelling, and discharge at the site of the incision.