Somewhere around 500,000 men have vasectomies each year in the United States.
While most men are happy with the results following a vasectomy, approximately five percent of patients who’ve previously had this procedure end up changing their minds at some point if circumstances change.
When performed micro-surgically by a urologic surgeon, patients have an increased chance of enjoying the desired results with vasectomy reversal since less-invasive and more precise techniques are used.
Vaso-vasostomy and vaso-epididymostomy are the two possible options with microscopic vasectomy reversal.
The most common form of vasectomy reversal, a vaso-vasostomy involves the reconnection of the separated ends of the vas deferens. The procedure is performed after the vas fluid is examined. A vaso-vasostomy is more likely to be effective if the fluid is of good quality, meaning it should contain healthy sperm.
If this is the case, a urologist will likely recommend this type of vasectomy reversal. During the procedure, a small, one-inch incision is made in the original vasectomy site. An operating microscope guides the surgeon to the severed tubes in the scrotum so they can be reattached with a series of small sutures.
Sperm acquire their swimming ability after passing through the epididymis, a long, coiled tube behind the testis. Sperm then go through the epididymis the vas deferens, ejaculation ducts, and urethra that takes sperm out of the body through the penis. If no viable sperm are discovered when vas fluid is examined, a urologist surgeon may recommend a procedure that indirectly restores sperm flow. Performed under general anesthesia, a vaso-epididymostomy may also be recommended if:
There is a blockage affecting sperm flow
There are issues with infection or inflammation
There’s scar tissue from the original vasectomy
During surgery, the vas deferens is attached to the epididymis in a way that bypasses any obstructions affecting sperm flow. It’s estimated that 20 to 25 percent of men who had a vasectomy develop a blockage in glands located behind testicles that can make it difficult to directly reattach the separated vas deferens. With a microscopic approach to a vaso-epididymostomy, stitches are hidden under the skin, so there’s no need for post-surgery stitch removal.
Aftercare and Recovery
Men typically recover from either a vaso-vasostomy or vaso-epididymostomy after a few weeks. Because microscopic techniques are used, the surgical site usually heals fairly quickly. There may be some lingering discomfort following vasectomy reversal, although it’s often manageable with pain or anti-inflammatory medication.
Some men find it more comfortable to wear loose-fitting clothing and take warm baths following surgery. About a month after vasectomy reversal, semen quality is assessed to make sure reconnected structures are functioning as expected.
Benefits of Microscopic Vasectomy Reversals
In addition to smaller incisions, men opting for microscopic vasectomy reversal often notice less post-surgery pain and experience fewer risks during the procedure. Recovery times are also typically shorter than what’s normally experienced following a traditional vasectomy reversal performed with open surgery techniques.
If conception is the main reason for microscopic vasectomy reversal, the majority of couples where a partner had surgical reversal report being able to achieve this goal within less than a year after having a successful procedure. A urologist can work with men attempting to father a child post-surgery by performing periodic semen analyses and other evaluations to ensure that sperm counts are at levels conducive to fertilization.