Vasectomy reversal

A vasectomy reversal is an operation to reconnect tubes that were cut or sealed in a vasectomy. A vasectomy reversal operation aims to allow sperm to enter your semen again. But there’s no guarantee that the operation will restore your fertility or that you’ll be able to have children.

How do I get a vasectomy reversal?

It’s a good idea to discuss the fact that you’re considering a vasectomy reversal with your GP. But the procedure is not usually available on the NHS nor is it usually covered by private medical insurance. You’ll need to pay to have the procedure done privately. Your GP may be able to recommend or refer you to a private consultant who performs vasectomy reversal. Or you can search for a consultant yourself.

Vasectomy reversal costs vary between clinics and the type of procedure you're having. Contact a clinic directly to get a quote. Make sure you know exactly what the fee covers, including initial assessments, follow-up and aftercare (including semen analysis after your operation).

You’ll need to book an initial consultation with a private consultant. Your surgeon will want to know about your previous vasectomy and any other surgeries or conditions you may have. They may want to do some tests and examine your genital area too.

Your surgeon will discuss exactly what to expect from a vasectomy reversal. This includes the potential risks and benefits involved. You’ll be asked to sign a consent form before the procedure, so it’s important that you feel fully informed. Be sure to ask your doctor if you have any questions. These should include details about your surgeon as well as about the procedure. For instance, you may want to ask:

• questions about your surgeon’s background, training and qualifications
• how many vasectomy reversal procedures they do each year
• their success rate
• if they do microsurgery (carry out the surgery using a microscope)

Vasectomy reversal procedure

A vasectomy reversal will usually take between one and three hours, depending on how complex the surgery is.

Once the anaesthetic has taken effect, your surgeon will make a small cut or cuts (about 2cm long) in your scrotum. They’ll find your vas deferens tubes and cut these above and below where they were previously tied or sealed. They’ll then gently open up the tubes and check the fluid inside to see if there’s sperm in it. This will show if there’s any blockage in the tubes where your sperm are stored (the epididymis).

The rest of the procedure will be done in one of the following ways.

• If there are sperm in the fluid, this means there’s no blockage in the remaining vas deferens tube. Your surgeon will join the cut ends of your vas deferens back together using dissolvable stitches. This is called a vasovasostomy.
• If there aren’t any sperm in the fluid, it means there may be a blockage in your epididymis. Your surgeon will join your vas deferens directly to a section of the epididymis that bypasses the block. This is a more complex operation, called a vasoepididymostomy.

In either case, your surgeon may perform the operation using microsurgery – when a microscope is used to magnify the tubes. At the end of the procedure, your surgeon will close your skin with dissolvable stitches.

Aftercare following a vasectomy reversal

You’ll 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. Your doctor may give you an injection called a nerve block to help provide pain relief for a few hours after the operation.

If you’re going home the same day, you’ll need someone to take you home and stay with you for the first 24 hours. Sometimes, you may need to stay in hospital overnight. This could be because you don’t have anyone to collect you or you have a medical condition that means you need to be monitored overnight. It can take a while to get over having a general anaesthetic. You might find that you’re not so coordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or make any important decisions.

Before you go home, your nurse will give you some advice about caring for the wounds in your scrotum and what pain relief you can take. They may be able to give you extra dressings to take home to use while your wound heals. They’ll also give you information about follow-up appointments.

Recovery following a vasectomy reversal

Take it easy for the first week or so after your procedure to enable vasectomy reversal recovery. You’re likely to have some swelling, bruising and pain around your scrotum for several days after a vasectomy reversal. If you need to, take over-the-counter painkillers such as paracetamol or ibuprofen. You may find ice packs helpful too, but don’t put them directly to your skin.

It’s a good idea to wear some form of support such as close-fitting supportive underwear or cycling shorts for the first few days. A scrotal or athletic support would be more supportive and your clinic may provide this. If not, you can buy one at most sports shops or online. It will protect your scrotum and help to ease any discomfort and swelling.

You can do some gentle exercise a week after your procedure. But don’t lift anything heavy or do any strenuous exercise or have sex, for the first few weeks. It’s best to wait at least two weeks before you ejaculate again to allow time for your body to heal. There might be blood in your semen the first few times you ejaculate.

It’s best to wait a couple of days until you have a shower, and a couple of weeks before having a bath. Dry your genital area gently and thoroughly afterwards.

If you have stitches, they’ll usually dissolve within two to three weeks.

Post-surgery sperm tests

It takes an average of three to six months to get good levels of sperm in your ejaculate after a vasectomy reversal. But it may take as long as a year or two. You’ll need to have your semen tested to find out if it contains sperm. Your doctor will give you instructions about this. You’ll usually be asked to do this around three months after your vasectomy reversal. If you’ve had a vasoepididymostomy, it can take longer for sperm to appear in your semen. Your doctor might need to test your semen every three months.

Ask your surgeon when you should expect to see your sperm return. If your sperm doesn’t return, your surgeon will talk to you about what your options are. It might be possible to have more surgery to try to reverse the vasectomy again. Other options include assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI). For more information on this, see our section on alternatives to vasectomy reversal.

Side-effects of vasectomy reversal

Side-effects of vasectomy reversal include:

• swelling
• bruising
• pain around your scrotum – if you need to, take over-the-counter painkillers such as paracetamol or ibuprofen