About Vasectomy Reversal
Vasectomy reversal, also known as vasovasostomy, is a procedure used to restore fertility in men who have previously undergone vasectomy. It involves reconnecting the severed ends of the vas deferens, which are the tubes that carry sperm from the testicles.
What Is Involved in Vasectomy Reversal Surgery?
The procedure is typically done on an outpatient basis at our dedicated ambulatory surgical center by one of the Urology Center’s board-certified urologic surgeons. The operation is generally performed microscopically using a high-powered surgical microscope, a technique that has been shown to provide optimal outcomes during vasectomy reversal surgery.
The operation is performed under general anesthesia and involves making small incisions on the scrotum. The previously severed vas deferens are then brought to the skin surface where they can be cleaned and rejoined using small stitches. Fluid from the vas deferens is examined at the time of surgery for the presence or absence of sperm.
After recovering from the surgery at our facility, patients are then released to go home the same day.
What Happens After Vasectomy Reversal?
Most men recover fairly rapidly after vasectomy reversal, with nearly half reporting that the pain level is similar to what they experienced after the original vasectomy surgery. Patients typically utilize pain medicine for less than a week. While most men are able to return to work within seven days, it is advised that they avoid vigorous activity, heavy lifting and sexual intercourse for several weeks.
Are There Risks Associated With Vasectomy Reversal?
Vasectomy reversal rarely leads to serious complications. The risks are typically minor and can include bleeding within the scrotum, called a hematoma, that causes pain and swelling for a short period of time. Less common are infection at the surgical site, treated with antibiotics, and chronic pain. If you experience infection or persistent pain, consult your urologist as soon as possible.
Can All Vasectomies Be Reversed?
Almost all vasectomies can be reversed. However, if the vasectomy was done while fixing a hernia in the groin, it may not be as easy to rejoin the ends of the vas. The ends also may not be able to be reconnected if a long piece was removed during the vasectomy, but this is rare.
It is important to note that even successful vasectomy reversals may not result in conception. For instance, if a long span of time has transpired between the vasectomy and the reversal procedures, the likelihood of conception diminishes. Please take this into consideration when talking with your urologist about whether to undergo vasectomy reversal.
Is Age a Factor in Conceiving After a Vasectomy Reversal?
Your age should not affect the results of your vasectomy reversal. Most men continue producing sperm for many years after their partners stop making eggs, as women become less fertile starting in their mid-30s, with a major drop around age 37. Your partner should check with her gynecologist to see if she is still ovulating before you decide to have the procedure.
Are There Alternatives to Vasectomy Reversal?
There are other ways to conceive without undergoing surgery for reversal. Your urologist can take sperm from your testis or epididymis using a needle or by sperm retrieval surgery. However, sperm removed through these methods is not usable for standard in-office artificial inseminations. Instead, these sperm require more complex and costly in vitro fertilization (IVF) techniques using intracytoplasmic sperm injection (ICSI).
Studies show that vasectomy reversals are a more cost-effective method of achieving pregnancy than sperm retrieval and IVF/ICSI. Another plus of reversal over sperm retrieval and IVF is the opportunity for future pregnancies.
What if the Vasectomy Reversal Does Not Lead to Conception?
Vasectomy reversals sometimes fail if there is an underlying issue with the testicle(s) that cannot be recognized during surgery or if a blockage develops sometime after surgery. Some men choose to have a second-attempt vasectomy reversal surgery if the procedure doesn’t work the first time.
You may also be able to father a child through IVF by using frozen sperm. Sperm may be retrieved directly from the testicle(s) or epididymis either at the time of the reversal surgery or at a later date. Doctors do not usually recommend freezing sperm at the time of reversal surgery, as it may be an unnecessary procedure.
If My Vasectomy Reversal Fails, Should I Try It Again?
The success rate for a repeat reversal is often the same as for the initial reversal. If sperm were found in the vasal fluid the first time, your urologist will likely recommend a second vasovasostomy, which has a higher probability of success
Will Reversal Cure Testis Pain From Vasectomy?
Very few men experience chronic testicle(s) pain after a vasectomy, a condition sometimes referred to as post-vasectomy pain syndrome. While studies on the topic are limited, those that do exist suggest a high success rate for pain reduction. However, there is no way for your urologist to know beforehand if a reversal will cure your pain or not.
Is Vasectomy Reversal Covered by Insurance?
Another factor to consider when determining your course of action may be the cost of various fertility procedures, and which, if any, options are included in your health care coverage. Be aware that most health plans do not include payment for vasectomy reversals. It is advisable to contact your insurance representative early in the planning phase to find out what is or is not included in your plan.
Contact the Urology Center for More Information on Vasectomy Reversal
We hope this information will help you make an informed decision about vasectomy reversal. For more details about any aspect vasectomy or the reversal process, or to make an appointment, please call the Urology Center at 402.397.9800 or toll free at 800.882.4770.