Vasectomy Reversal

What is a vasectomy?

A vasectomy is a procedure men can have to keep their partner from getting pregnant when they have sex. It makes a man sterile. When a vasectomy is done, the 2 tubes that carry sperm from the testicles to the penis are cut and blocked. (These tubes are called the vas deferens, or vas.) About 3 months after the vasectomy, the fluid that is ejaculated during sex (semen) no longer contains sperm.

What is a vasectomy reversal?

A vasectomy reversal is surgery done to reconnect and unblock the tubes after they have been cut or blocked. It may allow a man to be fertile and get his partner pregnant.

The success rate of a vasectomy reversal varies from 40 to 75%. The surgery is more likely to be successful if only a small part of the vas was damaged when you had the vasectomy. The sooner the reversal is done after the vasectomy, the better the chances are of success.

This procedure should have no effect on your sex drive. The procedure simply lets sperm flow into the semen again.

The cost of a vasectomy reversal is not usually covered by most insurance companies. It is important to talk with your healthcare provider about possible problems after the surgery. Ask what the chances are that it will be successful and allow you to get your partner pregnant.

When is it used?

Even though a vasectomy is considered a permanent form of birth control, some men change their minds and want to be able to have children again. This may happen because of a major change in their lives, such as a divorce, death of a spouse, or death of a child.

Instead of this procedure, other methods you might try to get your partner pregnant may include:

• artificial insemination, which involves taking sperm from your testicles with a needle or through a small cut in the scrotum and then putting the sperm into your partner's body
• in vitro fertilization, which involves taking eggs from your partner's body, fertilizing them with sperm outside the body, and then putting the fertilized eggs back into her body.

Couples can become pregnant much sooner with these alternative methods than after a vasectomy reversal. However, they require a special procedure each time you want to have a child. With a successful vasectomy reversal, you may be able to conceive several times without more procedures.

How do I prepare for this procedure?

• Before the surgery, you will have a physical exam and tests to see if you have sperm. Your healthcare provider will review the records from your vasectomy to see if you are a good candidate for this surgery.
• Find someone to drive you home after the procedure.
• Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• You may be asked to shave the area around your scrotum the night before the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do.

What happens during the procedure?

The procedure is done in your healthcare provider's office or at an outpatient clinic.

Before the procedure you will be given a local anesthetic to numb each side of the scrotum. You may also be given a sedative, which is medicine that will relax you.

There are 2 ways a vasectomy can be reversed. A physical exam before surgery will determine which procedure your surgeon recommends.

• Your healthcare provider may stitch the cut ends of the vas deferens together. This method is used if your exam shows that sperm are inside the tubes.
• If you have a blockage in the tubes, your provider will create a bypass of the blockage. This method has a lower success rate than the other type of reversal because it is a more complex procedure.

The rejoined tubes become passageways for the sperm, so sperm can again be carried to the penis and into your partner's body when you have sex.

What happens after the procedure?

You may go home after the procedure is done. When you go home, stay off your feet, ice your scrotal area, and prop your legs up.

Ask your healthcare provider:

• how long it will take to recover
• what activities you should avoid, including how soon you can have sex, how much weight you can lift, and when you can return to your normal activities
• how to take care of yourself at home
• what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• Anesthesia has some risks. Discuss these risks with your healthcare provider.
• You may have infection or bleeding.
• The procedure may fail and not make you fertile again.

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.