Microscopic Vasectomy Reversal

The decision to perform a vasectomy is not normally a light decision for a couple. However, there are times when a couple has made this decision but choose to reverse the vasectomy later down the road.

A vasectomy reversal may also be done if the man has found a new partner and wants to father a child with the new partner.

A vasovasostomy is generally the first choice for a vasectomy reversal. This surgery restores the flow of sperm to the vas deferens so it can then be ejaculated. An operating microscope is necessary, as the structures being worked on are very tiny. Ultra-fine sutures are used to reattach both the inner and outer layers of the vas deferens. This is an outpatient procedure.

There are occasions when a vasovasostomy is not possible. This may be because of scarring on the epididymis or inflammation in that area. In this case, the vas deferens needs to be reattached to an area of the epididymis that is not blocked or inflamed. This may also be the procedure chosen by the surgeon if it has been many years since the original vasectomy. This is also an outpatient procedure.

Various factors will affect the success rate of the vasectomy reversal. The most important factor may be the length of time that has passed since the vasectomy was performed. If it has been longer than ten years, the surgeon may recommend sperm banking at the time of the reversal in case spontaneous pregnancy is not viable. If the surgeon finds sperm in the vas deferens during the reversal, the chances of a pregnancy after the reversal are very high.

The chances of pregnancy are, of course, also dependent on the female. The surgeon will likely take a complete history of the female partner to determine if reversing the vasectomy is the best option for the couple. If all the factors are in the couple’s favor, a vasovasostomy has an almost one hundred percent chance of resulting in a pregnancy. If a vasoepididymostomy has been performed, the chances are a bit lower, at sixty to seventy percent.

Anesthetics are used during a vasectomy reversal. Expect three hours for the surgery and a couple of hours post-surgery for recovery. Although the patient will likely be released the same day, he should refrain from physical activity, including intercourse, for two weeks. Mild pain medications will be sent home for the first few days.

Most couples who opt for a vasectomy reversal are eager to get pregnant right away. If all the factors are in place and sperm was found in the vas deferens, the couple may get pregnant within three to six months after the reversal. However, it may take some couples as long as a year to conceive. Monitoring sperm counts after the procedure will give the doctor a better idea of when the couple may hope to achieve a pregnancy.