Overview
Vasovasostomy (vasectomy reversal) is often the best option to restore fertility in men who have had a vasectomy. According to the National Institutes of Health (NIH), the number of men who undergo a vasectomy each year in the United States is approximately 500,000. This type of birth control is popular among adult males who are interested in preventing future pregnancies. For a variety of reasons, nearly 10% of men who undergo a vasectomy later decide to have it reversed. There are many factors that must be considered when deciding to have a vasectomy reversal.
The following are a few examples to consider:
- Vasectomy reversal is not a guaranteed procedure. The longer it’s been since your vasectomy, the less likely it is that your fertility will be restored.
- Even if sperm return to the semen, pregnancy is not guaranteed. Since your vasectomy, your body may have created sperm anti-bodies. These substances may prevent you from fathering a child, even if your sperm count returns to normal.
- Has your partner had fertility problems? If so, another procedure (such as in vitro fertilization) may be more likely to result in pregnancy.
Restoring the Flow of Sperm
Testicles make sperm, which are male reproductive cells. Sperm travel from the testicles to the penis through one of two tubes called the vas deferens. On the way, sperm mix with other fluids to form semen, which leaves the body during ejaculation. During a vasectomy, each vas deferens is cut, blocking sperm from leaving the body. This makes you sterile (unable to make a woman pregnant). A vasectomy can sometimes be reversed, restoring the flow of sperm out of the body.
How the Procedure Works
During a vasectomy reversal, the two cut ends of the vas deferens are stitched back together. With the sperm pathways restored, sperm can once again travel through the vas deferens and leave the body during ejaculation. You may then be able to father a child.
You will receive medication to keep you comfortable. This procedure is always done under anesthesia in our ambulatory surgery center located directly next door from our medical group. Once the anesthesia takes effect:
- An incision is made in your scrotum
- The cut ends of each vas deferens are lifted out and examined. A section of each cut end may be removed
- The end closer to the testicles is cut until fluid flows freely. This fluid may be looked at under a microscope to see if sperm are present.
- The two cut ends are stitched together. If needed, the vas may be attached directly to the epididymis (tissue behind the testicle)
- When both of the vas deferens are reconnected, the incisions in the scrotum are sutured closed.
Post-Operative Instructions
Activity
Physical activity is to be restricted immediately following your vasectomy reversal. This is particularly true during the first five days after surgery. During that time you should remain relatively inactive and avoid lifting objects heavier than 10 pounds. Apply an ice pack wrapped with a terry cloth towel directly to the scrotum off and on the first 48 hours. It is extremely important that you do not engage in sexual intercourse and do not ejaculate for at least three weeks following the surgery. The vas deferens must be kept “at rest.”
Diet
You may return to your normal diet immediately. It is suggested that you eat fresh fruits and vegetables (roughage) to avoid constipation.
Wound Care
As mentioned above, an ice pack should be applied to the scrotum off and on for the first 48 hours following surgery. You will go home with an athletic supporter and gauze fluffs to protect the scrotum and incision sites. The gauze should be changed on a daily basis for at least three or four days. You should wear an athletic supporter for 7-10 days since it will give you additional support and protection. You may shower at any time following the surgery, but avoid scrubbing the scrotum vigorously, and do not take tub baths until told to do so.
Medications
You may be discharged with a narcotic analgesic. If the pain is not too uncomfortable, then it is advisable to simply take Tylenol (acetaminophen) or Advil (ibuprofen). You may also be discharged with a five day supply of antibiotics, which you should take according to the directions on the bottle.
Please report the following problems to your urologist:
If you experience any of the following call our office as soon as possible.
- Fever over 101 degrees Fahrenheit
- Excessive swelling of the scrotum and/or bleeding
- Drug reactions (hives, skin rash, nausea, or vomiting)
Follow-Up
You will be given a post-operative follow-up appointment to see Dr. Leung within a couple weeks of your surgery. Since it takes over 70 days for sperm to develop, the first postoperative sperm analysis is not performed until 8-10 weeks following surgery. Please remember that it is very important that you do not ejaculate during the first three weeks following surgery.
Yuk-Yuen Leung , M.D
Aside from being a quality general urologist, Dr Leung joined Urology Associates several years ago to bring his micro surgery skills to Central California.
Dr. Leung is board certified by the American Board of Urology. At this time, he is our only urologist that performs the vasovasostomy procedure.
A graduate from the University of Texas at Austin in electrical engineering and then completing his Master’s Degree in Biomedical Engineering Dr Leung went on to Johns Hopkins University and The State University of New York for his medical education. While Johns Hopkins University, he was involved in progressive medical research using advanced engineering technologies. He built machines and computer systems to study biological processes, and in an effort to combine and apply his engineering and biomedical research background, he attended the State University of New York and graduated with a doctoral degree in Medicine with “Distinction in Research”.