Vasectomy is minor surgery to block sperm from reaching the semen that is ejaculated from the penis. Semen still exists, but it has no sperm in it. This is performed as a birth control measure, wherein the male partner is no longer able to deliver sperm into the female partner’s reproductive tract and thereby cause pregnancy. However, in some cases, the same may be required to be reversed; the procedure to reverse the effects of a vasectomy is known as vasectomy reversal.
The reversal of vasectomy is performed on an outpatient basis, wherein a surgeon, reconnects the tubing from the vas deferens to the penis and thereby restoring the delivery mechanism for the sperm.
Because a vasectomy is a permanent birth control measure and there is no temporary measure to undo its effects, an individual should know if he chooses to undergo the procedure and rethink having children. A reversal remains the only possible alternative. Almost half the cases of vasectomies in some societies end up being reversed.
As with all medical procedures, however small, there lies an inherent risk associated with a vasectomy reversal. The commonly evidenced risks and complications include:
- Infections at the site of the procedure
- Internal bleeding within the scrotum
- Chronic pain in the testicular region following the procedure
Firstly, one must understand that reversal of a vasectomy is a slightly complicated and expensive procedure. Although it can be accomplished as a daycare procedure, it still requires a high degree of precision and training.
As a start, the patient will be required to stop taking certain medications leading up to the procedure – these include blood-thinning medicines and pain relievers. It is best to wear loose-fitting clothing, including undergarments, for the procedure.
Before the procedure
Prior to the procedure, the patient will be required to undergo a comprehensive medical check to ascertain any underlying health complications that may make the procedure either risky, or infective. It is important to be sure that the patient is not suffering from any other forms of infertility and is able to make healthy sperm – capable of fertilization prior to the procedure. Also, it is important to ascertain the fertility status of the partner. Given that vasectomy reversal is just as permanent as vasectomy itself, it is important to be doubly sure of all the other factors prior to the procedure.
During the procedure
Vasectomy reversal can be performed in one of two methods – firstly, sewing up the two ends of tubes that carry the sperm from the testicles to the penis. Secondly, attaching the vas deferens to the small organ behind the testicles that produce the sperm. This is determined by the analysis that precedes the procedure and often, the decision is made while the procedure is underway based on the condition of the patient.
The doctor will make a small incision on the scrotal area and expose the tube that carries the sperm to the penis. A similar incision on the vas deferens to examine the fluid flow is done, based on which the procedure to reattach the two is made. With the advent of robotic and microscopic surgeries, most vasectomy reversals happen by the same method.
After the procedure
Once the procedure is completed and the site of the procedure is covered up, the patient can return home with some measures for caution. It is best to avoid wearing tight clothes for a brief period, and the application of ice is suggested for 24 to 48 hours to reduce swelling. Sporting an athletic supporter helps, and it is best to abstain from physical and strenuous activity for a week. For resumption of sexual activity, take the opinion of the doctor before proceeding.
Sperm freezing is an option one must consider prior to the vasectomy itself, such that in case of a failure of the reversal there is always a backup available for your parenting dreams. Sperm freezing, or cryopreservation, is the process of preserving sperm cells for later use.
Following the vasectomy procedure, the doctor will require you to go back to the hospital to ascertain the success of the procedure. While it is possible to wait for unsuccessful conception as a proof, it is still advisable to get a sperm analysis of the ejaculate to check for the presence of sperm in the ejaculate.
In some cases of a vasectomy reversal, the procedure doesn’t work either due to an underlying cause or due to subsequent development of blockages. Some men have a second-attempt vasectomy reversal surgery if the procedure doesn’t work the first time. However, the success rates are slightly lower for the second attempt than for the initial attempt.
The best option in case of a failed vasectomy reversal would be either invitro fertilization and/or a surgical sperm recovery.