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Vasectomy reversal

This factsheet is for men who are having a vasectomy reversal, or people who would like information about it.

A vasectomy reversal is an operation to reconnect the tubes (called the vas deferens) that carry sperm from the testicles to your penis. This aims to restore fertility after a vasectomy.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

How a vasectomy reversal is carried out

About vasectomy reversal

A vasectomy is a method of preventing pregnancy. Some men come to regret their decision to have a vasectomy and want it reversed.

It's possible to reconnect the vas deferens in most men after a vasectomy, although it's not always successful.

Illustration showing the position of the vas deferens and surrounding structures

A vasectomy reversal is more successful if it's done fairly soon after the original operation. The longer the time between your vasectomy and a reversal operation, the less likely you will be able to father a child.

Also, it’s important to understand that a successful vasectomy reversal doesn't guarantee that your partner will get pregnant. About eight in 10 men will have sperm present in their semen after a vasectomy reversal, but only half of these men will make their partner pregnant in the two years following the operation.

Factors that can affect your chances of a successful reversal include:

  • the time since your vasectomy
  • the type of vasectomy being reversed
  • the type of technique used to do the reversal
  • problems with other parts of your reproductive system
  • the presence of sperm antibodies
  • your partner's age and her fertility

It may be possible to have a second reversal operation if the first has not restored your fertility, but the chances of success may be lower.

What are the alternatives?

An alternative to vasectomy reversal is intra-cytoplasmic sperm injection (ICSI). Sperm is removed directly from your testicle or from your epididymis (where sperm are stored inside your scrotum). A single sperm is injected into your partner's egg. The fertilised egg is then transferred to your partner's womb.

ICSI means that your partner will need to have IVF (in vitro fertilisation) treatment. ICSI isn't as successful as a vasectomy reversal.

Artificial insemination by a donor is another alternative. This involves directly inserting sperm from a donor into your partner’s womb.

Ask your surgeon for more information.

Preparing for a vasectomy reversal

Your surgeon will explain how to prepare for your procedure. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection, which can slow your recovery.

A vasectomy reversal is usually done as a day case in hospital. The operation is usually done under general anaesthesia. This means you will be asleep during the procedure.

You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during a vasectomy reversal?

A vasectomy reversal can take up to three hours depending on the technique used.

Vasovasostomy

This technique is most commonly used in vasectomy reversal.

Cuts are made into each side of your scrotum, usually in the same position as your vasectomy scars. Sometimes, only one cut is needed in the centre of your scrotum.

Scar tissue is removed from the vas deferens and the tubes are carefully pulled through the cuts. Your surgeon will check to see whether there is any fluid in the tube connecting to the testicle.

If the tube has fluid, your surgeon will rejoin each tube using dissolvable stitches. The tubes are placed back inside your scrotum and the skin cuts are closed using dissolvable stitches.

If the tube is dry this could mean that there is a blockage and your surgeon may need to use another technique called vasoepididymostomy.

Sometimes it isn't possible to rejoin the vas deferens tubes in both testicles and only one is rejoined.

Vasoepididymostomy

This technique involves joining the vas deferens directly to the epididymis (the sperm collecting tubes in each testicle) to bypass any blockages in the vas deferens connected to your testicle.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready.

You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.

Your surgeon may advise you to wear supportive underwear to help relieve any discomfort.

Your nurse will give you some advice about caring for your healing wound, hygiene and bathing before you go home. You may be given a date for a follow-up appointment.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should usually disappear in about two weeks.

Recovering from a vasectomy reversal

It usually takes about seven to 10 days to make a full recovery from a vasectomy reversal, but this varies between individuals, so it's important to follow your surgeon's advice.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

General anesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

Wear close-fitting, supportive underwear, such as a jock strap, day and night, for three to four days after your operation. This will support your scrotum and help to ease any discomfort and swelling.

Don't do any heavy lifting or vigorous exercise during the first three weeks after your operation. Gentle walking can help improve your recovery.

You can have a bath or shower but dry the area gently and thoroughly afterwards.

You won't know if you are producing sperm when you ejaculate until your doctor has checked a sample of your semen. This is usually done three months after a vasectomy reversal.

After having a vasoepididymostomy, it can take longer for sperm to appear in your semen, so you may need to have your semen tested every three months until sperm are seen.

What are the risks?

As with every procedure, there are some risks associated with a vasectomy reversal. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Your scrotum will feel sore, and you will have some bruising and swelling for a few days.

Complications

Complications are when problems occur during or after an operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, infection or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Complications of a vasectomy reversal are uncommon but can include:

  • bleeding inside your scrotum (haematoma)
  • fluid building up in your scrotum (hydrocele)
  • damage to blood vessels causing the testicles to shrink (testicular atrophy)
  • long-term testicular pain
  • scar tissue forming that blocks the vas deferens

It's possible that a vasectomy reversal may not restore your fertility and you may need further fertility treatments to have a baby.

 

Produced by Stephanie Hughes, Bupa Health Information Team, March 2012.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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