Metrowest Urology: Vasectomy Reversal

Vasectomy Reversal

Introduction | The Procedure | The Outcome |
Post-Procedure Care

Introduction

Over the past twenty-five years, vasectomy reversal has become a much more common procedure. Approximately 600,000 vasectomies are performed annually in the U.S. There are many reasons that men with vasectomies choose to undergo vasectomy reversal -- some of them include the following: divorce; remarriage; unexpected loss of a child; improved economic conditions; the family's decision to have another child; or the choice of a dual-career couple to begin a family. Occasionally, the desire for a reversal many be due to medical conditions, such as persistent testicular pain resulting from long-term congestion following a vasectomy.

Significant advances in microsurgical techniques, and the use of an operating microscope to increase the surgeon's visualization, bring greater success and predictability in vasectomy reversal.

The Procedure

Vasectomy reversal takes about 2½ hours, and is performed using local anesthesia (Novocaine) in the comfort of our private office.

After exposing the obstructed vas and removing the blockage, we visualize the fluid and sperms. The end of the tubes are brought together using the operating microscope, in preparation for attachment.

Very fine sutures are utilized to complete a meticulous attachment of the ends of the tubes. A two-layer connection is carefully employed to complete this procedure.

The Outcome

An 85% to 95% success rate in technical connection is achievable, with about 60% to 70% pregnancy rate within the first year following reversal. There is a drop in the technical and pregnancy success rate with the length of time passed since the vasectomy was originally performed.

Time After Vasectomy(in yrs)	Sperms in Semen (%)	Pregnancy Rate (%)
3	97	75
3-8	88	55
9-14	80	45
15	70	30

Post-Procedure Care

Ice bag is applied to the scrotum on and off for 24 hours.
Scrotal support worn for one week.
Shower after two days, and bath after ten days.
No strenuous physical activity and no intercourse for three weeks.
Routine light activities resumed, usually two days after the procedure.
Semen analysis obtained four weeks after the procedure, and repeated every three months for the first year.