Welcome to your Complete Guide to a vasectomy reversal, as brought to you by Ironwood Urology in Phoenix, AZ. Whether your click to this page was brought on by curiosity, or you are starting to feel anxious about your choice to undergo a vasectomy, the good news is: you made it!
What is a vasectomy reversal?
Vasectomy reversals are procedures that restore the flow of sperm to the semen. They are common for patients who have changed their minds about their vasectomy, remarried and want to have children again, or are experiencing chronic pain from their original procedure.
There are two types of vasectomies. The first is called a vasovasostomy. In a vasovasostomy, the vas deferens is reconnected where it was originally separated. This procedure is best when the urologist can find the sperm.
If not, the surgeon will use the second vasectomy type, called Vasoepididymostomy. In this procedure, the vas deferens is connected directly to the epididymis. This is best when the urologist cannot find the sperm, because it usually means there is a blockage in the epididymis tube.
Why a vasectomy?
Approximately 1,500 patients undergo a vasectomy reversal per year. There are many reasons a patient might choose to do so: chronic pain from a vasectomy, a change of heart, or to restore fertility in the hopes of having children.
Additionally, many patients choose a minimally invasive vasectomy reversal because of its simplicity, smaller incision site, fewer complications, reduced costs, and shorter recovery time.
Are you a candidate?
To understand if you are a viable candidate or not, your urologist will want to know if you had any complications during your vasectomy, or if there is any scarring from the original procedure. If so, the chances for success are theoretically smaller, but you still have options and may be able to attempt the vasectomy reversal anyway.
This is a part of the initial process that will take place with your urologist, who will determine your success factors and help you set realistic expectations.
That said, there are several factors which go into a successful vasectomy reversal:
• Activity levels of the sperm: The more active a patient’s sperm, the more likely a successful vasectomy reversal will occur. Without active sperm, there is a smaller chance of conception.
• Length of time since Vasectomy: Ideally, a patient will attempt their reversal within the first three years immediately following the vasectomy. However, there have been many successful vasectomy reversals that go beyond the three-year window. In general, vasectomy reversal results in pregnancy over 50% of the time.
• Skill of Surgeon and Technique: As the vas deferens is essentially a very small tube, reattaching the ends, or attaching it to the epididymis is a complicated and sometimes tricky procedure. Therefore, finding a skilled urologist is an important aspect of the surgical procedure.
• Blockage or scarring: Blockages can make vasectomy reversals more complicated, and the surgeon will likely decide to perform the more complicated of the two procedures, the vasoepididymostomy. Additionally, scarring may result in the same choice, or in not attempting the procedure at all.
What to Expect Before, During, and After a Vasectomy Reversal
Before the Procedure
There are many ways to prepare for a vasectomy reversal, but if you did your homework right, you will have found a surgeon you are comfortable with, and that has the talent, skill, and experience needed in order to put you at ease and give you a great shot at success. You should also let your doctor know the list of medications you are currently on. You don’t want to accidently mix medications that can have harmful side effects.
Another item on your to-do list should be to talk to your partner. Together, learn the risks involved in the procedure, and be sure you want to go through with the surgery.
Additionally, research, research, research! This article is a great start, and in addition to this, check out some of our other blogs on vasectomy reversal. Finally, know the risks and set realistic expectations with your doctor.
When you arrive on the day of your operation, wear comfortable clothes, but make sure your undergarments are tight fitting. This will help with support. Have a friend or spouse bring you to the facility or hospital, as you will not be able to drive yourself home.
During the Vasectomy Reversal
During a minimally invasive reverse vasectomy, you will undergo local, general, or regional anesthesia. A microscope will either reconnect the vas deferens ends, or connect the vas deferens to the epididymis tube. The procedure typically lasts between 2 and 3 hours, depending on the method chosen.
After a Vasectomy Reversal
Finally, the vasectomy reversal is complete! There are many points to keep in mind after your surgery, and they should all be taken seriously in order to ensure optimum healing for success. First, you will need to get a ride home from a friend or partner, as there will likely be some pain, swelling, bruising, or discomfort. Driving after surgery can be dangerous to you and to others on the road.
Your urinary function should remain normal, and be sure to avoid intercourse and heavy lifting for the following 4 weeks.
Finally, have patience with your recovery, and take it slow! There is no sense in engaging in compromising activity. After all, you worked so hard to become a father!
At Ironwood Urology, we want to make sure you get your best shot at a second chance. Dr. Desi Avila specializes in microscopic vasectomy reversals, and is a fellowship-trained urologist with a high success rate. Take advantage of our online appointment requests, or call our Phoenix office at (480) 961-2323.
