The vasectomy reversal operation
The Principle
Around 3 to 4 men out of 100 who have undergone a vasectomy will seek a reversal of their vasectomy. Men seek a vasectomy reversal
for many different reasons, and at any time following the original vasectomy. During a vasectomy the tubes (the vas deferens)
that lead from the testicle which the sperm swim along are divided, and deliberately blocked to halt their passage. In simple
terms a vasectomy reversal involves joining the tubes back together to allow the sperm to swim along them again to reach the
outside world.
This sounds like a fairly straightforward task. However, the difficulty lies in the fact that the internal diameter of the vas
deferens is tiny (in some cases just 0.25mm) and in order to produce the best results the tubes have to be joined back
together accurately to produce a leak proof join with minimal chances of scarring. This can only be achieved reliably by
using microsurgery so that ultrafine sutures (less than the width of a human hair) can be used with the help of an operating
microscope. This allows layers of stitches to be placed into the vas deferens to minimise the chances of leakage.
How we perform the operation
At the Yorkshire Vasectomy Reversal Clinic we perform a microsurgical vasectomy reversal which allows us to get the best
results. The operation is performed under a general anaesthetic (the patient is asleep) and can take between 2 and 3 hours
to perform.
At the beginning of the operation cuts are made in either side of the scrotum. The site of the previous vasectomy is located
and the scar tissue is removed to give two healthy ends of tube (the vas deferens) which can be joined back together. Using an
operating microscope we are able to join the tubes back together with the upmost accuracy using ultrafine needles
and sutures. In order to produce a strong, leak proof anastomosis we join the inner layer (the mucosa) and the muscular
layer of the vas deferens using at least 12 stitches on each side. The wounds are then closed and a dressing applied along with a support.
After the operation
We normally discharge patients on the same day as the operation, although occasionally patients stay overnight.
We advise men having this type of surgery to take it easy and rest up for the first three to four days post op. There may be a
minor degree of swelling in the scrotum, and occasionally a cold compress can be helpful. Simple analgesia (e.g. paracetamol
and or ibuprofen) taken regularly can be helpful in the early phases. Light exercise is fine after this time and we would
advise against any form of strenuous exercise for the first three to four weeks post op. Occasionally men can develop a
significant bruise in the scrotum (a haematoma) after this type of surgery which is more likely to happen in men who
overdo it in the first 2 weeks after the operation.
We normally advise men to avoid intercourse and ejaculation for at least 3 weeks after the surgery.
Sperm may appear in the ejaculate 6 - 8 weeks after the operation, although in men who have had an epididymovasostomy it can
take longer.
Want to know more?
What are the alternatives to Vasectomy Reversal?
In Vitro Fertilisation (IVF) is an alternative to a vasectomy reversal. In this procedure the female partner undergoes
treatment to stimulate the ovaries to produce eggs. A procedure is performed to retrieve the eggs.
The man then requires a surgical procedure to retrieve sperm from the epididymis or testicle and a single sperm is injected
into an egg to fertilise it and produce an embryo. The embryo is then replaced into the uterus and with luck a pregnancy
may result. A pregnancy will occur in about 30-40% of IVF cycles and the results are dependent on the age of the female partner.
In men who have had a vasectomy, a vasectomy reversal has been shown to be a more cost effective method for achieving
a pregnancy and allows a more natural form of conception. In addition, if a couple want any more children, no further
treatment is necessary following a successful vasectomy reversal.
Find out more about IVF from our partner Hull IVF Unit.
Contact us today