Your Consultant will explain to you how to prepare for your procedure (e.g. if you smoke you will be asked to stop since smoking increases your risk of getting a wound infection, which slows your recovery).
Vasectomy reversal is usually done as a day case at the Hospital of St John & St Elizabeth and is usually done under general anaesthesia so that you will be asleep during the procedure. You’ll be asked to follow fasting instructions by not eating or drinking for about six hours befor surgery.
Your Consultant will discuss with you what will happen before, during and after your procedure, and any pain you might have.
Vasectomy reversal can take up to three hours depending on the technique used.
Vasovasostomy is the technique most commonly used for vasectomy reversal. Cuts are made into each side of your scrotum, usually in the same position as your vasectomy scars. Sometimes only one cut is needed in the centre of your scrotum. Scar tissue is removed from the vas deferens and the tubes are carefully pulled through the cuts. Your Consultant will check to see whether there is any fluid in the tube connecting to the testicle. If the tube has fluid, the Consultant will rejoin each tube using dissolvable stitches. The tubes are placed back inside your scrotum and the skin cuts are closed using dissolvable stitches. If the tube is dry this could mean that there is a blockage and your surgeon may need to use another technique called vasoepididymostomy (see below). Sometimes it isn’t possible to rejoin the vas deferens tubes in both testicles and only one is rejoined.
Vasoepididymostomy involves joining the vas deferens directly to the epididymis (the sperm collecting tubes in each testicle) to bypass any blockages in the vas deferens connected to your testicle.
You will need to rest at the Hospital until the effects of the anaesthetic have passed and you may need pain relief to help with any discomfort as the anaesthetic wears off. You will usually be able to go home when you feel ready; however you will need to arrange for someone to drive you home and you should ask a friend or relative to stay with you for the first 24 hours.
Your Consultant may advise that you wear supportive underwear to help relieve any discomfort. The nurse will give you some advice (e.g. caring for your healing wound, hygiene, bathing) before you go home. Your Consultant will offer you a date for a follow-up appointment.
The length of time your dissolvable stitches will take to disappear is usually about two weeks, but this can depend on what type you have.
It usually takes about seven to 10 days to make a full recovery from a vasectomy reversal, but this varies between individuals, so it’s important to follow your Consultant’s advice. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen.
General anesthesia temporarily affects your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards.
You are advised to wear close-fitting, supportive underwear day and night, for three to four days after your operation. This will support your scrotum and help to ease any discomfort and swelling.
Don’t do any heavy lifting or vigorous exercise during the first three weeks after your operation. Gentle walking can help improve your recovery. You can have a bath or shower but dry the area gently and thoroughly afterwards.
You won’t know if you are producing sperm when you ejaculate until your doctor has checked a sample of your semen. This is usually done three months after a vasectomy reversal. After having a vasoepididymostomy, it can take longer for sperm to appear in your semen, so you may need to have your semen tested every three months until sperm are seen.
As with every procedure, there are some risks associated with a vasectomy reversal. Ask your Consultant to explain how these risks apply to you.
Your scrotum will feel sore, and you will have some bruising and swelling for a few days.
Possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, infection or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Complications of a vasectomy reversal are uncommon but can include:
Vasectomy reversal won’t affect your ability to have an erection or affect your sex drive. Vasectomy reversal is an operation to reconnect or unblock the vas deferens so that the tubes can carry the sperm from your testicles to your penis.
Most men have occasional problems getting or keeping an erection, but for some men the problem can be more serious. Often erection problems are caused by physical and emotional issues. For example, feeling anxious about your fertility or the emotional pressure of trying for a baby.
If your vasectomy reversal is unsuccessful, your Consultant will talk to you about your options. It can take several months for sperm to return in your semen, particularly if you have had a vasoepididymostomy. So, if a test shows no sperm after three months your surgeon will suggest to repeat the test every few months thereafter. If sperm haven’t returned by 12 months then it’s unlikely that your vasectomy reversal has worked.
Limiting your alcohol consumption, giving up smoking, eating a healthy, balanced diet and doing regular exercise will help to improve your fertility. The quality of sperm doesn’t just depend on the count, but also on how healthy they are and how fast they can move.
Men who smoke have a lower sperm count and more damaged sperm. Drinking too much alcohol can also affect the quality of your sperm. Various medicines, such as those used to treat heart disease or high blood pressure, can also damage sperm.
Leading a healthy lifestyle, eating a balanced diet and keeping active will improve your health and fertility. Sperm develop best at a lower temperature than the rest of your body, which is why your testes are outside of your body. Wearing loose underwear, such as boxer shorts, or loose-fitting trousers may also help.