Vasectomy reversal (vasovasostomy)
Vasectomy reversal, clinically referred to as a vasovasostomy, is a safe procedure which is used to restore fertility to male patients who have previously had a vasectomy. There are several reasons why men opt to have the procedure performed – most commonly is the desire to have another child after finding a new spouse. Due to recent developments in microsurgical techniques vasectomy reversals are become safer and easier to perform and are quickly growing in popularity.
There are several factors which may affect the success of vasectomy reversal so patients should consult their physician regarding their suitability and likely outcomes should they continue with surgery. Success rates are commonly reduced in patients in which a blockage has formed in either end of the divided tube. Outcomes tend to improve if the original vasectomy was performed within the last fifteen years with success rates declining over subsequent years.
During the operation itself the surgeon begins by cutting off the ends of the divided tube to provide a clean cut with which to work. Then, using laparoscopy and microsurgical techniques the surgeon careful reconnects the two loose ends allowing sperm to freely flow from the testes into the semen. In cases where the part of the tube has been blocked as a result of the original vasectomy a procedure called a vasoepidyostomy is performed where the blockage is bypassed by reconnecting the tube directly into the epididymis. The procedure is performed under general anaesthetic and typically takes 2 -4 hours.
After your operation
Vasectomy reversals are usually an outpatient procedure so patients can likely return home within only a few hours of completing the operation. Mild discomfort can be expected over the following few weeks with patients being able to return to normal activities, including sex, after 3 -4 weeks.
Long term outcome
In men in which the interval between vasectomy and reversal is less than fifteen years sperm is returned to the ejaculate in about 70% - 90% of cases with rates gradually declining as the interval increases. Of those cases about two thirds result in a successful pregnancy. Success rates are also significantly reduced if a blockage is present and a vasoepidymostomy is required or in men who have developed anti-sperm antibodies following their vasectomy.
Vasectomy reversal is a low risk procedure with complications occurring in less than 10% of patients. If complications do arise they are usually relatively harmless and easy to control. Some patients react to the anaesthesia and may develop itching or hives, and occasionally blood seeps under the skin giving the penis and scrotum bruised appearance. This painless complication typically resolves itself within a week or two. In a very small number of patients (about 5%) blood can accumulate inside the scrotum causing painful swelling requiring immediate medical attention. In a similar proportion of cases infection may develop, however such infections can be easily dealt with within a few days with the use of antibiotics and antimicrobials.