Vasectomy Reversal

How is a Vasectomy Reversal candidate evaluated?

What to know before your visit to Michigan Institute of Urology in Southeast Michigan:

• The urologist will take a thorough history of both the male and female partners during the evaluation since the ability of the couple to have children depends upon the reproductive health of both partners. Going through the reversal process without this knowledge can cause frustration later if pregnancy does not result.
• Several factors determine the success rate of a vasectomy reversal, particularly the time interval between the vasectomy and reversal. The patient’s anatomy following the vasectomy may also determine the success of a vasectomy reversal and therefore physical examination of the vas deferens, testes, and epididymis will be an important part of the evaluation.

Other tests that may be performed during or after your visit:

• Patients undergoing a vasectomy reversal typically don’t need extensive testing. At times, blood work may be needed to check hormone levels and the function of the testicles.

How is Vasectomy Reversal performed?

Some men may want their sperm surgically extracted for IVF (in vitro fertilization), rather than undergo a vasectomy reversal. This is an alternative to having a vasectomy reversal but involves a procedure to extract sperm from the male and medicines/procedures for the female partner to extract eggs.

The exact surgical techniques for a vasectomy reversal depend upon the expertise of the operating surgeon. The best results are achieved with surgeons with extensive experience performing these procedures and with specific microsurgical skills. We can guide you to the physicians in our group who have this expertise.

The procedure usually takes several hours and is performed under anesthesia using an operative microscope. It typically is done at an ambulatory surgical center.

Two different surgical procedures may be performed – vasovasostomy or epididymovasostomy. The exact procedure to be performed cannot be decided until the time of surgery and depends upon what your surgeon finds in the operating room.

• Vasovasostomy is a procedure that connects the two ends of the vas deferens and may have surgical success rates as high as more than 90%.
• Epididymovasostomy is a more challenging procedure. It is needed if the obstruction is within the epididymis itself (rather than at the end of the vas deferens). Success rates are lower, but new surgical techniques still allow for favorable results.

After surgery, pain could be mild to moderate, and you may experience swollen, achy testicles for a week or so after the procedure. We recommend lying down for six to eight hours after the surgery and keeping an ice pack on the incision, even if you feel fine.

In the five days after surgery, continue using ice packs to limit swelling, rest as much as possible, and avoid heavy lifting and exercise. A small, bloody discharge from the incision site is normal. You should be able to resume normal activities, including sex, within three weeks.

The following complications might occur a few days after surgery:

• Hematoma: Though rare, a small blood vessel may leak in the scrotum, forming a clot. A small clot will probably dissolve with time, but a larger one may require reopening and draining the scrotum.
• Infection: Signs of infection include fever, chills, redness and swelling around the incision site.

A vasectomy reversal is not guaranteed to restore fertility and success rates tend to decline with time after a vasectomy. Other blockages can form, and some men develop antibodies that could attack their sperm. Success rates are greatest within three to 10 years after a vasectomy. Overall, estimated pregnancy results can range from 50% to as high as 80%.