Hundreds of thousands of men undergo a vasectomy in the UK each year. More than 5% of these men sooner or later seek to restore their vasectomy through a vasectomy reversal procedure. The major reasons for a vasectomy reversal include the ability to father a child following divorce/remarriage or after the death of a child.

Vasectomy reversal procedure can also offer pain relief for the few men who experience post vasectomy pain. However, this condition should be first managed with analgesics. For those who want to undergo the procedure for psychological reasons, professional counselling is recommended.

Vasectomy Reversal Procedures

There are two major vasectomy reversal procedures:

• Vasovasostomy: the ends of the ductus deferens (vas deferens) are stitched back together.

• Vasoepididymostomy: the ductus deferens is reattached to the epididymis by surgery. This surgical procedure is more complex to perform and is often the last resort when vasovasostomy is ineffective.

The vasectomy reversal procedure is designed to restore the flow of sperms to ensure the sperm is successfully ejaculated through the urethra. Both procedures are carried out on an outpatient basis so the patient can be allowed to go back home the same day.

It is impossible to tell beforehand which vasectomy reversal procedure will be carried out. The surgeon will decide whether to perform Vasovasostomy or Vasoepididymostomy depending on a fluid sample test carried out at the start of the procedure. The fluid is extracted from the vas tip next to the testicle and studied for its look and the availability of sperm. If the fluid is transparent or the sperm is available, it shows that the epididymis is not blocked so the surgeon can perform a vasovasostomy. If the fluid is creamy and thick or sperm is absent, it shows the epididymis is blocked and the vasoepididymostomy surgical procedure can be used to avoid the blockage.

Other factors might also influence the surgeon’s decision to use reversal surgical procedure. In some cases, two surgical procedures might be necessary, with vasovasostomy carried on one side and the vasoepididymostomy procedure performed on the other.

Recovery

Pain following reversal procedure is normally not severe and mild painkillers like acetaminophen can be used to manage the discomfort.

A cold pack positioned on the scrotum area will help prevent swelling. Your surgeon might direct you to wear a jock strap for several days to help protect the surgical incisions. Most patients are allowed to go back to work and even do non-strenuous exercises within a few days, but they need to avoid heavy lifting and any other strenuous physical activity for at least four weeks after surgery. Patients must not have sex for at least 2 weeks after surgery.

Pregnancy Results Following Vasectomy Reversal Procedure

Vasectomy reversal is known to restore fertility in approximately 80 to 90 percent of men. On average, about half of couple realise as pregnancy within the first two years after vasectomy reversal surgery. Microsurgical procedures may help increase the quality of sperm and pregnancy rates in comparison to microsurgical procedures.

Several factors influence the probability of a successful result. This includes the experience of the doctor as well as the time interval between the first vasectomy and the reversal surgery. If the reversal procedure is not successful, another surgery may be carried out.