A vasectomy (link to vasectomy page) is a surgical procedure that is used as permanent male birth control. The procedure cuts off the flow of sperm from the testicles to semen by cutting the vas deferens.
In a vasectomy reversal, the severed ends of the vas deferens are reattached to restore the flow of sperm to the semen, making it possible for the man to conceive a child.
Almost all vasectomies can be reversed in the structural sense, but they do not guarantee the successful conception of a child. The longer it has been since the vasectomy, the less likely it is for the reversal to be successful. Pregnancy rates after vasectomy reversal can range between 30% and 90% depending on the individual and the type of procedure used.
Candidates for Vasectomy Reversal
In order for a vasectomy reversal to be successful, certain things need to be checked before the procedure. To determine whether or not vasectomy reversal is a viable option, the doctor will do the following:
- Complete a physical exam and take a medical history to make sure there are no conditions that may cause complications during the surgery.
- Ensure that sperm production is sufficient and that the sperm are healthy. Fathering a child prior to the vasectomy may be proof enough for some doctors, but if you do not have any existing children or there are other concerns, testing may be required.
- Make sure your partner is able to have a child. The doctor will check to confirm that your partner does not have fertility problems. A gynecological exam or fertility tests might need to be performed.
Vasectomy Reversal Procedures
Vasectomy reversals are performed in a surgical center or hospital, usually on an outpatient basis. The procedure may be performed in the clinic if the doctor has access to the needed supplies and equipment if a more complex repair is needed.
Depending on the procedure, general anesthesia may be used to make the patient unconscious during surgery or local anesthetic may be used to block pain but allow the subject to remain conscious.
Vasectomy reversal is a more complicated procedure than the vasectomy, so microsurgery is often used. In this technique, a surgical microscope is used to magnify the surgical area so the doctor can visualize the vas deferens for the repair.
The surgeon will first make an incision in the scrotum to expose the vas deferens. Then the tube is cut open so the doctor can examine the fluid inside. Depending on whether or not sperm is present in the fluid, one of two repair methods will be used to reattach the vessel:
- Vasovasostomy: The surgeon sews the previously severed ends of the vas deferens back together. This is the most simple method used when there are no complicating factors requiring more involved repair.
- Vasoepididymostomy: If the vasovasostomy is not possible or is unlikely to be successful, the surgeon may opt for a vasoepididymostomy. This procedure is more complicated and requires the surgeon to attach the vas deferens directly to the epididymis, which is the organ at the back of the testicles which holds sperm.
Going into the surgery, it is usually unknown which procedure will be required. If the fluid inside the vas deferens does contain sperm, then the repair can be made with a vasovasostomy. If there is no sperm present, then there may be scar tissue blocking the flow from the testicles, and a vasoepididymostomy may be necessary.
Risks of Vasectomy Reversal
Vasectomy reversals rarely have serious complications or side effects. However, there are some possible risks, which include:
- Infection at the surgery site
- Bleeding inside the scrotum with the possibility of hematoma and swelling
- Persistent or chronic pain after the procedure
For More Information
The board-certified physicians at Alliance Urology Specialists provide patients state-of-the-art medical care in a caring environment. Our services including vasectomies and vasectomy reversals. To schedule an appointment, call (336) 274-1114.