If you are thinking about getting a vasectomy, there are many things to consider. For some men, this might be considering whether you are really sure you’re not wanting children (or any more children). In this article, we’re going to discuss if vasectomies are reversible, and if they are, how likely they can be reversed, if at all.
What is a Vasectomy?
A vasectomy is a sterilization method that has become increasingly popular because of its safety and effectiveness. By permanently disrupting the flow of sperm from the testicle to the ejaculatory ducts within the prostate gland, a vasectomy blocks sperm from reaching ejaculated semen. Eventually, the production of sperm within the testicles gradually will slow down over time and will be reabsorbed by the body.
Are Vasectomies Reversible?
Vasectomies can be reversed but it comes with the caveat of time, the longer a man waits the more difficult it becomes to successfully reverse. Thus a man should be certain about his decision to have one before he does and understand what the chances of success are.
The longer it has been since the vasectomy, the less likely it is that a reversal will be successful. Because of this, most doctors recommend that you see this as a permanent surgery, and don’t go into it hoping to reverse it later. Reversal surgeries can also be costly, even if they aren’t effective in the end, meaning that you may put money into a surgery that may not be effective.
Regret rates have been found to be highest in men who got vasectomies before the age of 30, and their reversals usually happen around 5 years later when they meet a new romantic partner. Depending on the type of reversal procedure, reversal success rates can range from 30% to over 90%. Some factors that may impact reversal success rates are:
• Time passed since initial vasectomy surgery
• Age
• Surgeon’s experience and training
• Previous fertility issues experienced before vasectomy
Reversal Risks
While the reversal might be successful, there are other risks that come with a vasectomy reversal. While they aren’t often serious complications, some risks include:
• Infection at the surgery site: Much like any other surgery, infections are always a risk. In this case, infections are most often treated with antibiotics.
• Chronic pain: While uncommon, chronic pain after vasectomy reversals can occur.
• Bleeding within the scrotum: A collection of blood (also called hematoma) can cause painful swelling in the scrotum. To reduce the risk of hematoma, your doctor will recommend a rest schedule and other recovery treatments like the use of ice packs, and by potentially avoiding aspirin and other blood-thinning medications.
How to Prepare for a Vasectomy Reversal
• A reversal may not be covered by insurance and can be expensive. Find out about pricing ahead of time.
• A reversal is most likely to be successful when it is done by a surgeon who is trained in and uses no scalpel techniques.
• Naturally the procedure is more successful when performed by a surgeon who does the no scalpel procedure regularly and performs it often.
• The procedure may require a more complex type of repair which is known as a vasoepididymostomy. Ensure that your urologist can perform this procedure if it’s required.
Medications & Food
Your doctor will ask you to stop taking medications like blood-thinning medications and pain relievers, such as aspirin or ibuprofen, because they increase your risk of bleeding post surgery. It is important that you eat a full meal prior to the procedure to reduce the risk of getting light headed during or after the reversal.
What you can expect prior to the reversal
• Your medical history will be taken and a physical exam will also be performed. Your surgeon will want to make sure that you do not have existing health issues that could complicate or make you ineligible for the procedure.
• You will need to get tested to identify whether you can produce healthy sperm in the first place. For most men, fathering a child before is typically proof enough. Even after a vasectomy you will continue to produce sperm in the testicals. However, the amount of sperm that you produce currently may have lowered. Diet, how old you are, whether you exercise, smoking, among other factors can affect how much healthy sperm you can produce.
• Confirm that the potential mother is still capable of bearing a child. Your doctor will want to check if she has any fertility issues, especially if she has never had a child or is over the age 40. This can require an exam by a gynecologist and other tests.
The procedure is usually performed at a surgery center or hospital and it is typically an outpatient, does not require an overnight stay, surgery. Some doctors can perform the surgery at the clinic, but it is necessary to ensure the surgeon is able to do a more complex repair (vasoepididymostomy) if that becomes necessary.
This procedure typically uses a local anesthetic that will not put you to sleep but will numb you to pain at the surgery site.
Something to keep in mind is that a vasectomy reversal is a more difficult procedure than a vasectomy and will need to be done using microsurgery, where the urologist uses a surgical microscope to magnify the vas deferens up to 40 times its actual size.
Reattaching the vas deferens is done in one of two ways:
• Vasovasostomy – With this procedure, the surgeon will suture the severed ends of each tube that carries sperm (vas deferens).
• Vasoepididymostomy – This surgery will attach the vas deferens to a small organ at the posterior of each testicle that contains sperm (epididymis). This procedure is more complicated than a vasovasostomy and will be performed if a vasovasostomy cannot be done or has a low chance of success.
The decision whether to perform a vasovasostomy or a vasoepididymostomy will depend on whether sperm are seen when fluid from the vas deferens is analyzed at the time of surgery.
You will not know which procedure is needed ahead of time and will be determined by your physician on which will be the best course of action. There is also a chance that a hybrid of the two procedures is needed, where one type of surgery is performed on one side the another on the opposite side. If it has been a great deal of time since you had your vasectomy performed, the greater the likelihood you will need a vasoepididymostomy performed on one or both sides.
If you happen to be in the Phoenix, AZ area a great urologist who is skilled in any of the procedures you may need performed is Dr. Howard Tay.
