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Microsurgical vasectomy reversal operation

Sperms are made in the testicles and are transported through tubes called the vas deferens. When you have a vasectomy, the vas tube is surgically divided and blocked off. In order to reverse a vasectomy, the ends of the vas tubes have to be joined back together again so that sperms can again be transported out of the testicle.


Vasectomy operation
The operation is quite delicate and time-consuming. You will need a general anaesthetic (ie deeply asleep). The first step is to locate the site of the vasectomy operation and remove the scar tissue from around the ends of the vas tubes. The two ends have to be joined back together very accurately and with extremely thin sutures, and this is only really possible using the high magnification of an operating microscope. Joining together the ends of the vas in this way is called a vaso-vasostomy. The European Association of Urology recommendations for this procedure are that it should be done using an operating microscope.

Before performing the repair, it is important to check that the tubes are not blocked, else the operation will fail. If it appears that the ends of the vas tubes cannot be joined together successfully, then the vas can be joined directly to the epididymis (epididymo-vasostomy). Most specialist surgeons are able to perform both types of procedure and will decide during the operation which is most suitable. Once the repair has been completed, the incision is closed, usually with self-dissolving sutures.


Other factors 
If the vasectomy was performed more than 10 years ago, the success rate for vasectomy reversal is lower. It may be helpful to consider retrieving some sperm cells at the time of the vasectomy reversal operation so that other fertility treatments can be tried if the procedure doesn’t fully restore fertility.


Sperm retrieval and storage for fertility treatment
Some vasectomy reversal clinics can offer this sperm saving service if required. This can also be considered if your partner is slightly older or has fertility problems. The removed sperm are frozen and stored, and can be used for IVF at a later date if needed. If you want to consider this, make sure you discuss it well in advance, and you will require blood tests beforehand.


What happens after the operation?
A vasectomy reversal generally takes 1½ to 2 hours to perform and an overnight stay is usually recommended. You may feel bruised for a day or two and it is important to avoid any vigorous activity for 1 to 2 weeks. By 2 weeks, the wound should be fully healed.


Sperm test
A sperm test performed at 3 months will establish if the operation has been successful, but sometimes it can take longer for sperm to appear in the semen again. Most couples conceive at around the 12 month mark.

Source: vasectomyreversaluk.co.uk