Vasectomies are a long-term and minor surgery that blocks sperm from reaching the semen that is ejaculated from the penis. Semen is still present, but the sperm is not in the semen. After a vasectomy, the testes still produce sperm, but it is ultimately absorbed into the body. Every year, more than 500,000 men in the U.S. choose to undergo a vasectomy as a form of birth control, and this can be quite effective. Only one to two women out of 1,000 will get pregnant in the year after their partner has received a vasectomy. Although, in some cases, some men may choose to undergo a vasectomy reversal.
There are several reasons that a man may choose to have their vasectomy reversed. The man may desire to father children after a divorce or the loss of a spouse or child or it could simply be due to the fact that they and their spouse have had a change of heart and want more children. Whatever the reason may be, almost all vasectomies are reversible and can be performed by a urologist.
What is Vasectomy Reversal?
A vasectomy reversal is a procedure that reconnects the pathways for sperm to enter the semen. In most situations, the cut ends of the vas are reattached, and in some cases, the ends of the vas are joined to the epididymis. Vasectomy reversals are usually done under a special microscope, and once completed, the sperm can once again flow through the urethra.
Treatment Options for Vasectomy Reversal
Most of the time, a vasectomy reversal is done on an outpatient basis, under general anesthesia, through a hospital or at a surgery facility. If the surgery is done by microscope (microsurgery), the surgery will be done while you are under anesthesia. The doctor and anesthesiologist will discuss the options for your particular surgery with you.
There are basically two types of vasectomy reversals that are performed most regularly, vasovasostomy and vasoepididymostomy, and they can be differentiated the process. If there is sperm in the vasal fluid it shows that the path is clear between the testis and where the vas was cut. This allows the doctor to determine that the ends of the vas can be reconnected. The term for reconnecting the ends of the vas is “vasovasostomy.” When this procedure is performed through microsurgery, vasovasostomy is about 85% effective and pregnancy occurs in about 55 of 100 partners.
In the event that there is no sperm in the vasal fluid, it may mean that back pressure from the vasectomy created a form of “blowout” in the epididymal tube. This issue can lead to a blockage. The urologist will cut the tubes back proximal and dismally until healthy tissue is encountered. This procedure is referred to as a “vasoepididymostomy” and it ultimately serves the same purpose as the vasovasostomy.
A vasoepididymostomy is more complex than the vasovasostomy, but the end results are about equal. In some cases, vasovasostomy is done on one side and a vasoepididymostomy is performed on the other.
What to Expect After a Vasectomy Reversal
Healing time after a vasectomy reversal should be rather quick and easy. Pain post-surgery is most often controlled with over-the-counter pain medication. About half of men that undergo a vasectomy reversal say the pain is similar to the pain after the initial vasectomy. Another quarter of men say the pain is greater. Pain that is great enough to require medication usually subsides within a few days and in some cases no more than a week.
It is common for most men to return to their normal schedule and light work within a week, but you’ll likely be told to take it easy and not have sex for two to three weeks. If you partake in strenuous work, ask your urologist when you are able to return to work. A jockstrap for support will most likely be required for support for a few weeks.
Pregnancy after a Reverse Vasectomy
Now for the big question. Pregnancy. It may take up to four months for your partner to get pregnant after the vasectomy reversal. Some women may get pregnant in the first few months, while others may take several months or even years. Pregnancy rates depend on the amount of time between the initial vasectomy and the vasectomy reversal. Sperm return to the semen faster and pregnancy success rates are highest when the reversal is done sooner after the vasectomy.
If you’re considering undergoing a vasectomy reversal and want to learn more, contact the Urology Centers of Alabama to schedule a consultation with one of our skilled urologists and begin the path to vasectomy reversal.