Vasectomy reversal is requested by around 6% of men who have previously undergone a vasectomy. We appreciate that circumstances can change, and restoring fertility may be extremely important. A vasectomy normally involves removing a segment of the tube that carries sperm from the testis to the outside (called the vas). The vasectomy reversal procedure involves joining these two ends back together. What to expect , contact information and useful links can be found here.
Diagrammatic representation of vasectomy
Vasectomy reversal procedure
The vas is a very small, thick-walled tube and the hole in the tube is very fine (only a few millimeters). During a vasectomy reversal, the two ends are joined together with very fine stitches.
To enhance the vision during this surgery, we use either magnified glasses (loupes) or a microscope. The microscope allows very magnified vision that can offer the best results for a successful vasectomy reversal. The surgery is normally done under a general anaesthetic where you are asleep during the procedure, but we can also administer a local anaesthetic which numbs the immediate area. It can be a day-case procedure, or sometimes an overnight stay if required.
The operating microscope
As the largest Urology private healthcare group in the Northwest of England, we have a dedicated surgeon assigned to our vasectomy reversal procedures, thus ensuring an increased level of specialist care, as well as providing better outcomes.
Success rates following the procedure
The chance of getting a good sperm count following the procedure is influenced by the length of time since the original vasectomy operation. As the period of time since vasectomy increases, then success rates fall. However, the procedure may still be successful even after more than 20 years following vasectomy.
If the reversal procedure is done within around 15 years of the vasectomy, we would expect to achieve sperm in the ejaculate in 90% of cases. However, this does not mean that there will be a pregnancy in all of these cases.
The chance of a successful pregnancy is influenced by many factors, including the age and fertility potential of the female partner. Overall it is around 50%, but may be higher in cases where there is a shorter interval between vasectomy and its reversal, and a younger female age.
Your Urologist will assess you and discuss with you the chances of a successful outcome in your case. A sperm count is usually carried out at about 12 weeks following the procedure in order to determine whether the operation has been a success.
Alternatives to vasectomy reversal, including surgical sperm retrieval
It is extremely important that you are offered all of the options when considering a reversal vasectomy. This includes surgical sperm retrieval which can be performed as an alternative to vasectomy reversal or which can be carried out during the vasectomy reversal.
Sperm which are retrieved can then be used in assisted reproductive techniques, similar to IVF (in vitro fertilization). This may be a more appropriate treatment option, particularly in cases where there is advanced female age. If sperm is taken at the same time as the vasectomy reversal, this can be stored and used at a later date if the reversal is not successful or no pregnancy is achieved.
We are able to offer a full range of vasectomy reversal techniques as well as surgical sperm retrieval.
Patient information: what to expect following a vasectomy reversal
There will be dissolvable sutures in the skin which take several weeks to heal. There may be some swelling and bruising, but this on the whole is minimal and pain is usually similar to that of the vasectomy.
We advise at least four weeks off from any strenuous activity, but you could do a desk job, even on the next day after the surgery. We would advise against driving if there is significant pain in the scrotum, otherwise this should not be a problem.
We also advise wearing tight-fitting underpants for around six weeks following the surgery so that there is no undue pressure on the delicate joins. You can normally resume sexual activity after around two weeks following the surgery, depending on the level of discomfort.
Contact Information
For any queries or information regarding prices, please contact Jo Smith on 0161 495 7791 or email n.fuller@manchesterurology.org.uk
Links
Information on Vasectomy reversal through the British Association of Urological Surgeons can be found here: http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Reversal%20of%20vasectomy.pdf
Comparison of standard vs microscopic reversal:
http://www.ncbi.nlm.nih.gov/pubmed/?term=Jee+SH%2C+Hong+YK.+One-layer+vasovasostomy%3A+microsurgical+versus+loupe-assisted.+Fertil+Steril.+2010+Nov%3B94(6)%3A2308-11.