What is a vasectomy?
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. After a vasectomy the testes still make sperm, but they are soaked
up by the body.
Each year, more than 500,000 men in the U.S. choose vasectomy for birth control. A vasectomy prevents pregnancy better than any other method of birth control, except abstinence. Only 1 to 2 women out of 1,000 will get pregnant in the year after their partners have had a vasectomy. (Source, Urology Health, 2018)
A vasectomy reversal is employed to reinstate the ducts that carry sperm commencing the testicles into the semen that were separated due to a prior vasectomy. Most often, the cut ends of the vas are reattached. In some cases, the ends of the vas are joined to the epididymis. These surgeries can be done under a special microscope. When the tubes are joined, sperm can again flow through the urethra.
Vasectomy Reversal Techniques
Reversals are most often done on a come-and-go basis by a urologist. Reversals can be done in an outpatient part of a hospital or at a surgery center. If a surgical microscope is used, the surgery is done while you're asleep under anesthesia. A high-powered microscope used during your surgery magnifies the small tubes 5 to 40 times their size. Your urologist can use stitches much thinner than an eyelash or even a hair to join the ends of the vas.
Vasovasostomy
Standard procedure and most commonly implemented vasectomy reversal surgery. The separated ends of the vas deferens (muscular tubes responsible for moving sperm) are re-joined after inspection of the vas fluid. The vas fluid is tested under the microscope and is measured to be good quality if it has a clear non-opaque stability and contains entirely molded, healthy sperm.
Vasoepididymostomy
Required when no vas fluid or poor quality fluid is established during the procedure resultant of a blockade near the testicles. The blockade will not tolerate sperm to pass through to the muscular tubes. Blockage may have been triggered by swelling, high pressure in the epididymis or scarring resultant of the vasectomy. The procedure allows the vas deferens to be re-connected directly to the tube in the epididymis to avoid the blockade.
This is one of the most complex and demanding procedures and you should look for doctors who execute vasoepididymostomies on a consistent basis to explore the surgery.
Are there Vasectomy Reversal Risks?
Hematoma, infection, and testicular atrophy are the foremost impediments of both procedures. Hematoma is essentially escapable by careful attention to hemostasis during the procedure.
Testicular atrophy remains the most dreaded risk. Atrophy results from injury to the internal artery as it passes through the spermatic cord.
This injury can occur in patients receiving vasoepididymostomies if meticulous care is not taken when the vas is channeled through the spermatic cord and located in immediacy to the epididymis.
What Happens after the Vasectomy Reversal Procedure?
Pain and discomfort following the vasectomy reversal procedure is well managed, and may be similar to the pain experienced after the initial vasectomy. Inflammation and bruising of the scrotal area is ordinary.
Ice packs placed on the scrotal area will reduce any swelling and pain. A prescription pain medication will be prescribed after the vasectomy reversal procedure and can be taken as needed.
What are the Vasectomy Reversal Costs?
In these challenging times, most vasectomy reversal doctors try to maintain a lower overall cost for a vasectomy reversal surgery to help reinstate your goal of having a child. The costs will vary depending on the clinic or doctor.
Vasectomy Reversal Costs Example
Vasectomy Reversal Total: **** (comprised of the following)
- Surgeon’s Fee: (typically paid in full prior to procedure).
- Anesthesia Professional Fee:
- Surgery Center Facility Fee:
If a Vasectomy Reversal Fails, Should I Try it Again?
When done by skilled microsurgeons, success rates for repeat reversals are often the same as for first reversals. Your urologist will review the record of your prior surgery to help you decide. If sperm were found in the vasal fluid then, he/she will likely do a repeat vasovasostomy, which is more likely to succeed.