Definition and Overview
A vasectomy is a procedure that keeps a man from ejaculating by interrupting the passage of sperm. It involves cutting the vas deferens and takes away the ability of the patient to get a woman pregnant. However, it does not cause any changes to a man’s sexual drive and can easily be reversed.
Men, who have previously undergone vasectomy but later decide to have children, can take advantage of minimally invasive vasectomy reversal, which is also referred to as vasovasostomy. This technique requires a single small incision and involves minimal bleeding, surgical pain and recovery time.
Who Should Undergo and Expected Results
A minimally invasive vasectomy reversal is an option available to all men who have undergone a vasectomy but wishes, for a variety of reasons, to reverse the procedure. Studies show that around 5% of men who have undergone a vasectomy decide to have it reversed later on. It is, however, very expensive, and this may be keeping a larger number of men from taking advantage of this procedure even if they want to.
The most common reasons for undergoing a reversal procedure are the following:
- The patient wishes to start a family with a new partner
- The patient is now in a better financial situation and can thus support a child
- The patient lost an only child.
- The patient is experiencing symptoms of post-vasectomy pain syndrome. This is a chronic condition that causes pain in the genitals and groin as well as painful intercourse or ejaculations.
While vasectomy reversal can be performed in a number of ways, the minimally invasive option, developed through recent advances in surgical technology, is highly recommended.
Compared to a traditional vasectomy reversal, a vasovasostomy causes less pain both during and after the procedure, and allows the patient to recover much faster. Once the procedure is over and the patient is fully recovered, he can again conceive a child through sexual intercourse within 12 to 18 months of the reversal. The procedure now has an average success rate of 85% with a peak rate of 97%.
How the Procedure Works
A minimally invasive vasectomy reversal, which takes about three hours to complete, is an in-office, outpatient procedure that requires only local anesthesia, but may also be performed under general anesthesia if the patient prefers it. Full recovery, on the other hand, takes about four weeks. But the patient can resume normal activities 3-5 days after the procedure and sexual activity by the second week.
While a traditional vasectomy reversal procedure requires a couple of 4-inch incisions in the scrotum, the minimally invasive procedure uses only one small opening created using a special surgical instrument designed to open the skin while minimizing the risk of bruising and swelling. The incision is so small that there is no need to use sutures to close it up. However, it is big enough to allow the surgeon to perform a microsurgical vasectomy reversal. To ensure accuracy and precision, the doctor uses a high-powered operating microscope throughout the procedure.
Following the creation of the incision, the doctor will use microsurgical technology to align and reconnect the two cut ends of the vas deferens, which is where sperm passes from the testicles to the penis. If necessary, the fluid that comes out of the testicular end of the vas deferens is tested to determine if there is an obstruction above the vasectomy site; if this is the case, the epididymis will also be connected to the vas deferens during the same procedure.
Patients will then be scheduled for a follow-up visit a few days after the procedure. Since sutures are usually not used, the small skin opening will be left to heal on its own and this usually takes around 2 to 5 days. The wound will be checked during the follow-up visit to ensure it is healing properly. If there are no problems detected during the follow -up, the patient will be asked to return after three months for a confirmatory semen sample.
Possible Risks and Complications
The main instrument used in minimally invasive vasectomy reversals is specially designed to spread skin tissue apart while minimizing the risks usually associated with this kind of procedure. These risks include:
As a result, the procedure is safer and allows patients to get back on their feet faster.
However, all surgical procedures come with risks, regardless if they are performed using traditional or minimally invasive techniques. In this procedure, the main risk is that the vasectomy is not successfully reversed. Despite its high success rates, the procedure cannot provide the patient with a 100% guarantee that he can get his partner pregnant.
Studies show that a man’s chances of conceiving after a reversal may drop over time. Thus, men are strongly advised to consider potential changes in their life and future outlook before undergoing a vasectomy.
Roncari D, Jou MY (2011). Female and male sterilization. In RA Hatcher, et al., eds., Contraceptive Technology, 20th rev. ed., pp. 435-482. New York: Ardent Media.
Speroff L, Darney PD (2011). Sterilization. In A Clinical Guide for Contraception, 5th ed., pp. 381-404. Philadelphia: Lippincott Williams and Wilkins.