Both sperm and male sex hormones are made in the paired testes testicles. The testes are in the scrotum at the base of the penis. Sperm leave the testes through a coiled tube the "epididymis" , where they stay until they're ready for use.
Each epididymis is linked to the prostate by a long tube called the vas deferens or "vas". The vas runs from the lower part of the scrotum into the inguinal canal. It then goes into the pelvis and behind the bladder. This is where the vas deferens joins with the seminal vesicle and forms the ejaculatory duct. When you ejaculate, seminal fluid and seminal vesicles mix with sperm to form semen.
The semen flows through the urethra and comes out the end of your penis. Reversals are most often done on a come-and-go basis by a urologist. Reversals can be done in an outpatient part of a hospital or at a surgery center.
If a surgical microscope is used, the surgery is done while you're asleep under anesthesia. Your urologist and anesthesiologist will talk with you about your choices. Using microsurgery is the best way to do this surgery. A high-powered microscope used during your surgery magnifies the small tubes 5 to 40 times their size.
Your urologist can use stitches much thinner than an eyelash or even a hair to join the ends of the vas. After you're asleep, your urologist will make a small cut on each side of the scrotum. Your urologist will trim the scarred ends of the vas where they were closed by the vasectomy.
Your urologist will take fluid, "vasal fluid" from the vasal end closest to the testis. Your doctor will check to see if it has sperm in it. At this point, there are 2 types of reversal procedures you can have. If there is sperm in the vasal fluid it shows that the path is clear between the testis and where the vas was cut.
This means the ends of the vas can then be joined. The term for reconnecting the ends of the vas is "vasovasostomy. Pregnancy occurs in about 55 out of partners. If there is no sperm in the vasal fluid, it may mean back pressure from the vasectomy caused a form of "blowout" in the epididymal tube.
This "blowout" can lead to a block. Your urologist will need to go around the block and join the upper end of the vas to the epididymis instead. This is called a "vasoepididymostomy" and it serves the same purpose as the vasovasostomy. Vasoepididymostomy is more complex than vasovasostomy, but the results are nearly as good. Sometimes vasovasostomy is done on one side and vasoepididymostomy on the other. Healing should be rather quick and fairly easy.
Pain after surgery is most often controlled with pills. About 50 out of men say the pain after the reversal is like after their vasectomy. Pain bad enough to need medications rarely lasts longer than a few days to a week. Most men can return to their normal routine and light work within a week. How Well It Works Chances of a successful vasectomy reversal decline over time. Has the greatest chance of success within 3 years of the vasectomy.
Risks Risks of vasectomy reversal include: Infection at the site of surgery. Fluid buildup in the scrotum hydrocele that may require draining. Injury to the arteries or nerves in the scrotum. What To Think About Before a vasectomy reversal is done, your doctor will want to confirm that you were fertile before your vasectomy. Female and male sterilization. In RA Hatcher, et al. New York: Ardent Media. Speroff L, Darney PD In A Clinical Guide for Contraception , 5th ed.
Philadelphia: Lippincott Williams and Wilkins. Credits Current as of: February 11, Current as of: February 11, Roncari D, Jou MY We would counsel this patient to reconsider having a vasectomy.
Prior to a vasectomy, the patient and his partner should be absolutely sure that they are done having children. There are no special preparations in terms of abstaining from ejaculation prior to either the vasectomy or the reversal. The patient should be aware that a vasectomy reversal is a more expensive procedure than the original vasectomy and likely will take longer to recover.
Most men will recover from a vasectomy in a couple of days. We typically recommend taking it easy for 2 days, using ice packs and scrotal support, and then going back to work 2 or 3 days later. However, vasectomy reversals tend to take longer, depending on the type of work that the patient does.
While some men can return to a desk job in 3 or 4 days, we recommend that heavy construction and lifting should be avoided for 4 weeks after a vasectomy reversal. The success of the reversal is related more to the age of the female rather than the male. Therefore, there is no age limit for a reversal.
A report on psychological factors prior to a vasectomy has suggested that most men are not worried about having a vasectomy, but they are a little concerned regarding the recovery of a vasectomy.
Very few men have reported serious psychological or emotional problems following their vasectomy. Moshe Wald, MD Urologist.
Use of Health Topics. How likely is a positive outcome from a vasectomy reversal? Is there ever any nerve damage when a vasectomy is performed? Will the nerves restore themselves after the reversal? How is the surgery performed?
What is the recovery process? Does insurance pay for vasectomy reversal? What is the typical cost of vasectomy reversal? Who is not a good candidate for vasectomy reversal? What are side effects of vasectomy reversal? What is the effective rate of reversal? What are other fertility options? How do post procedure antibodies affect pregnancy rates?
Is cancer risk increased with the reversal? How many times can a reversal be done? What if there is no sperm in the vas at the time of surgery? Six weeks post vasectomy reversal, is scarring a concern?
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