Vasovasostomy is the standard form of vasectomy reversal. During this procedure, the micro surgeons of Academic Urology and Urogynecology of Arizona reconnect the disconnected ends of the vas to restore the flow of sperm into the seminal fluid. This delicate procedure is performed with the aid of a microscope and requires the precise alignment of the vas tubes and placement of ultra-fine sutures. In general, this outpatient surgery is near painless and safe.
Before surgery, the doctors of Academic Urology and Urogynecology of Arizona will sit down with patients to ensure they understand potential outcomes and risks. Patients will be given a simple list of pre-surgery recommendations, including, but not limited, to:
Though a vasovasostomy is performed in an outpatient setting, patients will not be permitted to drive themselves home, so it is imperative that driving arrangements be made before undergoing surgery.
Immediately before surgery, the operating site will be thoroughly cleaned and shaved to prevent infection. The patient is then administered anesthesia and the disconnected ends of the vas are located within the scrotal sac and an incision is made. The cut vas is lifted out of the scrotum and fluid is removed from the vas leading from the testes. If the presence of sperm is detected, a blockage of the epididymis is not evident and therefore the vasovasostomy can commence. Under the magnification of a microscope, surgeons carefully align the disconnected ends of the vas, suturing them together using a single-layer or multi-layer technique with sutures that are thinner than a human hair and nearly invisible to the naked eye.
After surgery, pain is typically mild and controllable using prescription or over-the-counter analgesics. Cold packs can be applied to the scrotum for a period of one to two days to relieve post-operative swelling. Patients can return to work approximately one week after surgery though strenuous activity and heavy lifting should be avoided for up to four weeks after reversal surgery. Patients should wait two to four weeks before attempting ejaculation or having sex. Fertility after vasectomy reversal surgery is not immediate. Your doctor will schedule a follow-up consultation in which your sperm levels will be evaluated. Typically, sperm reappears in the seminal fluid two months after surgery.
As with any surgery, success is not a guarantee. Many factors impact the likelihood of potency, including the time that has passed since original vasectomy, the age and virility of the patient, and the condition of a patient’s tissue at the vasectomy site. In general, if a reversal is performed within 15 years of vasectomy, the chance of rebuilding the vas channel and pregnancy after surgery is higher. Each case is unique; speak with the doctors of Academic Urology and Urogynecology to determine if vasectomy reversal success is likely for your personal circumstance.