Reversal of vasectomy
Like many women, men make radical decisions on their fertility that, as time passes, acquire another perspective. One of them is vasectomy, a widespread method of contraception that involves cutting the vas deferens, which oversee carrying the sperm from the testicles to the urethra.
Many of the patients who undergo this procedure reconsider their decision over the years, either because they have a new partner with whom they want to form a family because the couple lost one of their children or because of a new desire to have the children that, in the past, did not think or have. For this, there is the reversal of vasectomy, a straightforward surgery that manages, in most cases, to return male fertility.
What is vasectomy reversal?
The intervention is to re-channel the vas deferens and re-allow the passage of the sperm into the urethra. Its complexity and duration are more significant than in vasectomy. Moreover, its success will depend on how the vasectomy was done and the length of time that has passed from it. After successfully reversing vasectomy, the semen is expected to contain sperm and even achieve a pregnancy.
What are the conditions for a vasectomy reversal?
When the time elapsed since the vasectomy is a few years, there is a possibility of performing the process with a high success rate.
If the time between one intervention and the other is less than five years, the percentage of interventions in which the goal of returning fertility to man is achieved is around 90%. (We are confident it is that high)
However, this percentage is considerably reduced when the intervention was made 15 or 20 years ago, to the point that, at times, it is preferable not to opt for reversal and to apply an alternative treatment such as in vitro fertilization (IVF).
How is vasectomy reversion performed?
Vasectomy reversions are usually performed in a hospital or surgical center. The procedure is generally ambulatory, so a night of hospitalization is not necessary.
Surgery can be done with general anesthesia. Another possibility for the surgeon is to use epidural, intradural, or local anesthesia.
Vasectomy reversal is more complex than a vasectomy. It requires specialized training and experience. Physicians who perform this surgery re-attach the vas deferens as such:
Vasovasostomy. Through this procedure, the surgeon reconnects with surgical stitches the sectioned ends of each duct that carries the sperm (vas deferens).
Vasoepididymostomy. This surgery connects the vas deferens directly to the small organ behind each testicle, containing the spermatozoa (epididymis). A vasoepididymostomy is more complicated than a vasovasostomy and is usually opted for when a vasovasostomy cannot be performed or when it is unlikely to be successful.
What are the success rates of this surgery?
The success rates of vasectomy reversal range from approximately 40 percent to more than 90 percent. Many factors determine whether a reversal successfully achieves a pregnancy, including time elapsed from vasectomy, patient age, success rate, experience, and surgeon training.
What are the risks of a vasectomy reversal?
Vasectomy reversal rarely has serious complications. Some risks include:
- Bleeding inside the scrotum: can lead to blood buildup (hematoma), causing painful inflammation.
- Infection at the surgery site: Although not very common, infections are a risk of any surgery and may require antibiotic treatment in certain situations.
- Chronic pain: Persistent pain after vasectomy reversal is very rare.
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