Can You Reverse A Vasectomy? 5 Things You Need To Know
Vasectomy reversal surgery is an option for most men.
Many choose to have a vasectomy reversal procedure after the loss of a child or a remarriage.
Some men opt for the surgery to treat testicular pain that may be linked to the initial vasectomy.
When successful, sperm usually appear in the semen after a few months, but it can take up to a year or more.
The likelihood of achieving pregnancy after a vasectomy reversal depends on a variety of factors, such as the length of time that has passed since the vasectomy, whether or not there was tissue or tube damage during the original surgery, and the female partner’s age.
Generally, the doctor will examine the patient’s semen under a microscope about six to eight weeks post-op to see if it the reverse vasectomy was successful.
Vasectomy reversal facts:
- Vasectomy reversal surgery has relatively few complications, according to the American Society of Reproductive Medicine (ASRM), which says “Hematomas and both superficial and deep infections are rare; they can be managed with standard methods and rarely require surgical drainage.”
- Vasectomy reversal success rates are relatively high. The ASRM reports that after microsurgical vasovasostomy, sperm return to the semen in about 80 per cent of men, and 20 to 40 per cent of their partners conceive. Microsurgical vasovasostomy has a success rate of 85 to 90 per cent, and 50 to 70 percent of partners conceive, according to the ASRM.
- Vasectomy reversal is more difficult than the original surgery. Vasectomy
reversal is more difficult than a vasectomy. It requires specialized skills and
expertise. - There are two surgical techniques to vasectomy reversal. Doctors performing vasectomy reversal surgery do so in one of two ways: Vasovasostomy (vas-o-vay-ZOS-tuh-me) involves a surgeon sewing back together the severed ends of each tube that carries sperm (vas deferens). While vasoepididymostomy
(vas-o-ep-ih-did-ih-MOS-tuh-me) involves attaching the vas deferens directly to the small organ at the back of each testicle that holds sperm (called the epididymis). A vasoepididymostomy is more complicated than a vasovasostomy and is generally chosen if a vasovasostomy can’t be done or isn’t likely to work. Sometimes a
combination of the two surgical techniques is needed. - Innovative techniques are offering new ways for men to achieve vasectomy
reversal safely. The Montreal Vasectomy Clinic offers the “No-Needle, No Scalpel” method. They report it’s “virtually painless, using forced air to distribute a local anesthetic under the skin.” And, because the vein isn’t punctured, there’s no bleeding or bruising. It is also said to significantly reduce the risk of complications from bleeding or infection.
How does reverse vasectomy work?
A vasectomy reversal procedure is usually done on an outpatient basis.
The Reversal Clinic, which claims to be the largest vasectomy reversal clinic in the United States, says that local anesthetic is placed in the skin and soft tissues of the scrotum using a very small, fine-tipped needle, said to be “less painful than a pinch.”
Some surgeons may use general anesthesia to make the patient unconscious for the surgery.
In most cases, the procedure is painless.
An incision less than an inch long is made in most cases on the scrotum, exposing the vas deferens (which is the tube that carries sperm).
The surgeon then cuts open the tube and examines the fluids found inside.
If sperm is found, the ends of the tube are connected to recreate a passageway for sperm.
According to the Mayo Clinic, “If the fluid is thick or pasty, or if it contains no sperm or partial sperm, scar tissue may be blocking sperm flow. In this case, your doctor may choose to perform a vasoepididymostomy.”
Patients should expect to be sore and swollen for several days, and stitches are typically
fully dissolved after 10 days.
Vasectomy reversal safety
The Turek Clinic says vasectomy reversal is generally a safe procedure.
“In healthy men, the risks of having a significant problem with anesthesia are very unusual (less than 1%). Regarding the procedure, hematoma occurs in less than 5% of men,” their website states.
In cases where significant scar tissue is found during the vasectomy reversal, fluid can build up in the scrotum, though that’s in less than five percent of cases, according to the clinic.
And vasectomy reversal risks of surgical infection are said to be less than one percent. Fever and an uptick in pain in the scrotum are symptoms of infection.
The Mayo Clinic reports bleeding in the scrotum as another potential risk, which can cause painful swelling. Resting is said to reduce the risk, as is avoiding blood-thinning medication both before and after surgery.
Vasectomy reversal surgery can sometimes fail if there’s an underlying issue that isn’t known until beginning surgery, or if blockage develops.
What if vasectomy reversal doesn’t work?
While most procedures are successful, in some cases, vasectomy reversals don’t work.
There is another alternative, but it must be considered before the surgery.
If doctors find sperm during the procedure, they can be frozen. This is called sperm cryopreservation.
This means that even if the vasectomy reversal fails, vitro fertilization is an option that’s still on the table.
Click here to read more about semen cryopreservation.
Vasectomy reversal cost
In Canada, vasectomy reversal cost can vary, but many patients report paying in the neighbourhood of $5,000.
Insurance may or may not cover the costs of a vasectomy reversal so a good first step is to inquire with any health benefit plan about potential coverage.
Then all that’s left to do is seek out a doctor with a good history and positive patient reviews.
Medically reviewed by Dr. Gerardo Sison, Pharm.D.
Gerardo Sison, Pharm.D., is a registered pharmacist who has worked in clinical and retail settings providing drug education for healthcare professionals and patients alike. He graduated Cum Laude from the University of Florida where he earned a Doctorate of Pharmacy (Pharm.D.). He piloted a longitudinal clinical research program and completed his clinical internship at St. Joseph’s Hospital in Tampa, Florida. Read More >>
