Vasectomy Reversal – Will it Work for You?

Having children is one of life's greatest joys, and many men find they want to be fathers again after having a vasectomy done. I discussed a little about vasectomy reversal on the page on getting pregnant after vasectomy – but wanted to go more in-depth on the procedures and the odds of success.

Different Procedures

There are several different procedures that can be used to repair the vas deferens and restore fertility to a man. Which one the doctor chooses to use depends on both the doctor's specialty and the status of the vas deferens. Most procedures take around 3 hours to perform.

Vasectomy does not stop a man from producing sperm – the sperm is produced normally, but cannot make their way to the ejaculate. This makes a man effectively infertile. There is a chance that secondary blockages can form farther down the vas deferens than where the vasectomy was originally performed. A tell-tale sign of these blockages is total absence of sperm on one side of the incision site. Normally sperm are present on their side of the blocked tube. If there are no sperm there, a blockage farther down the tube is highly likely. This calls for more advanced reversal procedures.

Vasovasostomy

This procedure is done using an operating microscope that gives the doctor a 25x magnification for his work. This gives the doctor the best chance at precision sewing on a very tiny tube (the vas deferens is about the size of a spaghetti noodle!).

Sewing in two layers gives the best chances of restored fertility and subsequent pregnancy, so a high-powered microscope is used to make this possible. Microscopic sutures are used so that sperm don't leak out and so the suture itself doesn't block the sperm. The sutures are sewn in a tension-free manner, then a second, outer layer of sutures re-reinforce them. Very fine sutures (10-0 nylon) give a water-tight closure and prevent scarring.

This procedure can be used when there are sperm present in the testicular end of the vas deferens. Sperm are present in about 70% of cases, making this the most common vasectomy reversal procedure.

There are very high success rates for this procedure – about 95% of men who have it done are able to go on to father another child or more children.

Epididymovasostomy

Approximately 30-40% of men will have some sort of secondary obstruction occur after a vasectomy procedure. Time is often a deciding factor – the longer it has been since the procedure was performed, the more likely it is that a secondary block will form.

Again, an extremely high-powered microscope is used as the microsurgeons do their work. General anesthesia is a must for the man.

In this procedure the epididymis is opened up and one single tubule is selected to bypass the obstruction. Then the doctor uses very fine sutures (9-0 nylon) to pull the vas deferens to the epididymis. The vas deferens and the chosen tubule are now very close together.

The doctor carefully pulls the tubule to the vas deferens and sews it into the inner lining. Again, this is done with microscopic nylon sutures that provide a water-tight travel path for sperm and minimize the chances of scarring.

Another, outer layer of fine sutures are placed to secure the vas deferens and too keep tension off of the vital inner sutures.

Microdot Method

Microdot surgery uses 10-0 and 9-0 Nylon sutures just as the above procedures, but allows for easy placement of the sutures. The sutures are also place very easily.

The vas deferens is re-aligned as in the above procedures and care is taken to avoid scarring or blockage from the sutures themselves. Knots are cut carefully and precisely once the inner sutures are tied. Again, an outer layer of sutures relieves stress on the inner sutures and increases the chances of successful reversal surgery.

Healing

Vasectomy reversal surgery is not hard to recover from and healing times are not unreasonably long. Generally a man can be back to normal activities within 2-3 weeks after his surgery (return to work can be expected within 3-5 days; if your job requires lots of activity plan 10 days off). A skilled operating team makes quick recovery and minimal scarring more likely.

Swelling one week after surgery is usually minimal or completely gone. Bruising has mostly disappeared by this point and the “wrinkles” of the scrotum are back to normal, indicating healing.

Some slight scarring may be expected. The man will notice the scars are a little bigger than the initial vasectomy scarring, but will fade and minimize after time.

Semen analysis is performed around 6-8 weeks after your procedure is done (though sexual intercourse can resume after about 14 days).

Vasectomy reversal specialists recommend you pay attention to what you're eating to help boost sperm quality. Nutrients such as zinc help the body heal and boost male fertility. Soy has estrogen compounds and it's recommended that couples trying to conceive avoid it, especially after going through a reversal procedure.

For very detailed information including pictures take a look at California Vasectomy Reversal's page on vasectomy reversal. (Please note that this page includes very graphic pictures)

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(NOTE: Want the Top Easy Steps to Boosting Your Fertility? Use these 5 simple, evidence-based steps to get pregnant and carry your healthy baby to term. Get them here.)

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