Microsurgical Vasectomy Reversal
A vasectomy is a surgical procedure performed in men as a means of permanent birth control to prevent reproduction. Vasectomy reversal is a surgical procedure where the ends of the sperm carrying tubes, the vas deferens, that were cut and sealed during vasectomy are joined back together to enable reproduction.
Vasectomy reversal is a sophisticated procedure which can be attempted by two different surgical approaches:
- Vasovasostomy: In this procedure, the cut ends of the vas deferens (the sperm carrying tubes) are reconnected by the surgeon.
- Vasoepididymostomy: This approach involves the connection of the detached vas deferens to the epididymis (a tube that lies at the back of each testicle and stores sperm).
The surgeon makes the decision whether to employ either of the approaches or a combination based on the fluid sample taken at the start of the procedure.
Vasectomy reversal is generally carried out as a day procedure under general anaesthesia. The surgeon makes a small incision in the skin of the scrotum, the sac that contains the testes. The surrounding structures are retracted to expose the testicle. The vas deferens is carefully cut and inspected for fluid. This fluid will then be examined for the presence of sperm. When the surgeon confirms the presence of sperm with motility, the tubes are reconnected to enable the transit of sperm.
In cases where there is no seminal fluid or fluid is present but has no sperm, a Vasoepididymostomy would be performed in a similar manner except the detached vas deferens would be connected to the epididymis.
Following are the post-surgical guidelines to be followed after surgery:
- Apply ice packs over the scrotum to reduce the post-operative swelling.
- Your doctor may prescribe medications to help alleviate pain and make you feel comfortable.
- Wearing an athletic supporter at all times for the first four weeks help support the testicles and reduces swelling and movements.
- Keep the surgical area clean and dry.
- Recreational activities such as sports and lifting heavy weights are restricted for a few weeks.
- Return to work depends on how well you are healing and the type of work or activity level you perform.
- Sexual activity can be resumed after about six weeks following surgery.
Risks and complications:
The potential risks and complications of vasectomy reversal include:
- Excessive blood loss
- Chronic pain
- Nerve injury
- Hydrocele, an abnormal collection of fluid in the scrotum