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Frequently Asked Questions About Vasectomy Reversal

 

Q: Does it matter how long it has been since a man had a vasectomy?

Successful reconstruction is possible even if it has been a long time since a man’s vasectomy. The skill and training of the surgeon are critical. Our vasectomy reversal surgeons have had success reversing vasectomies for men who had theirs more than 15 to 20 years ago and even longer. This may require more complex reconstruction but one of our physicians successfully reversed a vasectomy for a patient who had a vasectomy 35 years earlier and was not only a father already, but a grandfather. 

Q: Is a vasectomy reversal painful?

For most men, a vasectomy reversal is not that painful. You may be sore for several days, but your doctor will prescribe narcotic pain medication or you may find that over-the-counter Motrin or Advil will relieve any pain.

Q: How long will after a vasectomy reversal can a couple conceive?

It depends on what type of procedure you needed for your vasectomy reversal. It can take up to three months for sperm to return to the ejaculate following a vasovasostomy and six months to one year following an epididymovasostomy. However, we have had patients who have conceived babies within weeks after the reversal. About two to three months following your reversal, you will have a semen analysis performed. Your doctor will continue to monitor your semen on a regular basis for up to one year or until your sperm count stabilizes.

Q: What is the success rate of a specially-trained microsurgeon?

The vasectomy reversal success rate of the general urologic surgeon is about 30 to 40 percent, while the fellowship-trained surgeons at Chesapeake Urology have a success rate of over 90 percent (results vary per individual). Our surgeons take on the most complex cases including re-dos and are experts at the more delicate microsurgery called epididymovasostomy, needed in many patient cases when a blockage is discovered in the epididymis. They have also had success performing vasectomy reversals on patients whose vasectomies were performed over 35 years ago and wish to become fathers again. 

Q: Why is microsurgery a preferred method for performing a vasectomy reversal?

The channel of the vas deferens through which the sperm swim is only .3 to .4 millimeters in diameter. Therefore, the most effective way to reconnect the vas deferens is by doing microsurgery with the assistance of a state-of-the-art operating microscope that provides 16 times magnification of the operating image. The surgeon uses microscopic sutures, which are so small they cannot be seen by the naked eye. The microsurgical training and precise skill of the surgeon are of the utmost importance to the success of the surgery.

Q: What can I expect throughout the vasectomy reversal experience?

During the consultation, your physician will take a detailed medical history and discuss any medical concerns and medications that you are on, in addition to learning about your fertility history.  Men are encouraged to bring their partners with them to the consultation. Your physician will take the time to explain the anatomy and production of sperm and discuss in detail the two types of blockages that may be involved as well as the reconstruction process.  You’ll be well informed about what to expect pre-operatively, on the day of surgery, and during your recovery, so you and your partner can make the most informed decision.

After your surgery, you will receive a call in the evening from either your physician or one of our nurses to check on you. For those patients who have traveled from out of town and are staying in a hotel, your physician will follow up with you before you leave for home.  Patients who are local may come for a follow-up visit to our office two weeks after their reversal.

Q: Can sperm be harvested at the time of the vasectomy reversal procedure?

Sperm can be harvested at the time of a vasectomy reversal if living, motile sperm are found in the vasal fluid or if an epididymovasostomy is performed.  Most frequently , however, the vasal fluid may not demonstrate motile sperm or sufficient numbers for cryopreservation. If a couple desires sperm harvesting and cryopreservation, this needs to be coordinated in advance with a fertility lab for processing and freezing of the sperm.  Multiple studies demonstrate that it is not cost-effective to harvest and cryopreserve sperm at the time of a vasectomy reversal. With such a high vasectomy reversal success rate, the majority of patients will not need a backup plan and would have incurred the additional fees of harvesting, sperm processing, and freezing, unnecessarily. In the small number of patients in which the vasectomy reversal is unsuccessful, sperm retrieval can easily be performed by either a simple needle aspiration or a small extraction procedure for IVF.

 

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