Restoring fertility
For couples who are keen for more children after the man has previously had a vasectomy, a vasectomy reversal is an excellent option for restoring fertility.
A vasectomy reversal is more involved than a vasectomy.
It requires a general anaesthetic, as the surgery itself is very delicate.
The lumen (inside) of the vas is very small and requires an operating microscope or loupes to aid surgery.
We use very fine sutures to join the vas together
Consultation
We start with a consultation discussing the procedure, but also your individual chances of success.
Some of the factors which affect the chances of getting pregnant include;
The time since the vasectomy
Any previous fertility issues of you or your partner
The age of your partner
If there are any concerns with regard to the chances of success of a vasectomy reversal, we recommend that you have a consultation with a fertility specialist.
The Procedure
The procedure is done at Grace Hospital.
The surgery itself is done under general anaesthetic, and takes about 90 minutes.
Usually, we do this through an incision in the middle of your scrotum.
The ends of the vas are located.
Prior to joining the ends together, we make sure that there is no blockage and usually about a centimetre of each end is removed as this would have been damaged at the time of vasectomy.
The join is performed in 2 layers.
Dissolving sutures are placed in the skin.
Post-operative care
A vasectomy reversal is a delicate surgery. Overdoing things in the first 4 weeks will damage the anastomosis/join and increase the risk of scar tissue and failure of the procedure.
In addition, there is a lot more swelling and discomfort after a reversal when compared to a vasectomy.
You'll have an athletic support on after surgery, and it is important to wear this for a month postoperatively.
Complications of Vasectomy Reversal
Even though this is delicate surgery, there is significant bruising and swelling after surgery. You will need pain relief afterwards, and it is important to take this regularly. Rest will also aid recovery.
Ice packs can be very helpful.
Early and late failure
We normally do a sperm sample test 6-8 weeks after surgery. The presence of live sperm in the sample means that the reversal has been successful. The initial sperm count can be poor, with low numbers and low mobility, but this will usually improve with time. The quality of sperm is usually related to the length of time since the vasectomy procedure.
We discuss sperm storage with all men. This is because there is a risk of the join scarring up and blocking. This can occur early (within the first 4 weeks), or months or years later.
Sperm storage can be protective against late failure and can be done through a fertility specialist.
Even with a successful vasectomy reversal, with live sperm in the sperm sample, pregnancy may not necessarily occur. As part of the consultation process, we weigh up the pros and cons of a Vasectomy Reversal with fertility treatment, and if there is any doubt, a fertility consultation is highly recommended.
