Southeast Texas Urology Associates, LLP


Vasectomy Reversal

There are many reasons to reverse a vasectomy like remarriage following a divorce or starting a family over after the loss of a wife or child. Regardless of your reason, there are now advanced methods to restore your fertility. How do you know the options that are right for you? By arming yourself with the latest information, you can make informed decisions with your doctor.

What is a vasectomy reversal?

A vasectomy is a minor surgical procedure in which the sperm duct, or vas deterens, is cut in order to achieve sterility. Vasectomy reversal restores fertility by reconnecting the ends of the severed vas deferens, which is located in each side of the scrotum, or by connecting the vas deferens to the epididymis, the small organ on the back of the testis where sperm matures. These procedures can be accomplished through various approaches, including microsurgery, restoring the passage for sperm to be ejaculated out the urethra.

What can be expected after a vasectomy reversal?

Recovery from a vasectomy reversal should be relatively swift and fairly comfortable. Any pain that might be experienced after surgery can be controlled with oral medications. About 50 percent of men experience discomfort that is similar to the level they had after the original vasectomy. Another quarter report less pain than accompanied the vasectomy. A final 25 percent say the pain is somewhat greater than after the vasectomy. The reassuring news is that any pain severe enough to require medication rarely lasts longer than a few days to a week.

Most patients are back to normal routine and light work within a week. Urologists usually want their patients to refrain from heavy physical activity for about four weeks. I f your job requires strenuous work, you should discuss with your surgeon the earliest time you can return to work. You will be advised to wear a jockstrap for support for several weeks. You will also be restricted from having sex for at least two weeks.

It takes on average one year to achieve a pregnancy after a vasectomy reversal. Some pregnancies occur in the first few months after the reversal procedure, while others do not occur until several years later.

One of the main factors influencing pregnancy rates is the obstructive interval, which is the duration of time between your original vasectomy and the reversal.

The urologist will request a semen analysis every two to three months after surgery until your sperm count either stabilizes or pregnancy occurs. Unless a pregnancy occurs, a sperm count is the only way to determine surgical success. While sperm generally appear in the semen within a few months after a vasovasostomy, it may take from three to 15 months to appear after a vasoepididymostomy.

In either case, if the reversal works, the patient should remain fertile for many years. The possibility of subsequent pregnancies is an important advantage of this procedure over sperm retrieval techniques for in vitro fertilization (see frequently asked questions). Only approximately 5 percent of patients who have sperm appear in the semen after a vasectomy reversal later develop scarring in the reconnected area, which could block the passage of sperm again.

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Can all vasectomies be reversed?

Almost all vasectomies can be reversed. However, if the vasectomy was performed during the repair of a hernia in the groin, there may be more difficulty reconnecting the ends of thevas. Rarely, reconnection of the ends of the vas is not possible because such a long segment of the vas was removed during the vasectomy procedure.

Is age a factor in conceiving after a vasectomy reversal?

Your age should not influence the result of your vasectomy reversal. Most men continue to produce sperm from their testicles for many years after their partners have entered menopause and are no longer ovulating, or producing eggs. In fact, a woman's fertility starts declining in her mid-30s, with significant impairment beginning around age 37. If female age is a factor, your partner should check with her gynecologist to see if she is still ovulating before you agree to a reversal. Abnormal results from a simple blood test to measure hormone levels on the third day of menstruation indicate a significantly lowered chance of fertility. But do not be deceived by a normal reading. It does not always guarantee that she will be able to get pregnant.

If a vasectomy reversal fails, should I consider a repeat reversal?

The success rates for repeat reversals are generally 8 percent to 10 percent lower than for first reversals. In making a recommendation, your urologist will review the record of your previous procedure. I f sperm were present in fluid obtained from the lower end of the vas during that operation, he or she will probably perform a repeat vasovasostomy, a less complicated procedure than a vasoepididymostomy but more likely to produce success.

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