Vasectomy and Reversal
Vasectomy is a male form of contraception which is very safe. It is usually performed under either local anaesthesia or general anaesthesia. Prior to any planned vasectomy patients should be advised that they should consider other contraceptive means.
Patients are also advised during a vasectomy consultation that there is a failure of the procedure which may be early failure, where motile sperm is found within the sperm test after surgery. In these instances the surgery would usually need to be re-done.
In other cases there is a spontaneous re-cannalisation where the sperm tubes can join up in possibly 1 : 2,500, but overall is a very safe technique. The other risks of surgery are bleeding, infection and bruising, which generally occurs in less than 5% of patients. On occasions it may take quite some time before the sperm disappears from the ejaculation, and this is a phenomenon known as ‘rare non-motile sperm’.
Patients are advised used to give a sperm test at 14 and 16 weeks following vasectomy. If the sperm tubes (vas deferens) are easily felt the procedure can be performed under local anaesthesia as a day case. In some cases where the sperm tubes are difficult to feel or the patient has needle-phobia, then the vasectomy can be performed under general anaesthetic.
However, circumstances can change, and some people do later wish to try and have more children. Here, Mr Suks Minhas, a vasectomy and vasectomy reversal specialist, outlines some of the key points.
Reversing a vasectomy involves rejoining the sperm-carrying tubes that were cut or blocked during a vasectomy.
Mr Minhas performs a micro-surgical vasectomy reversal using an operating microscope and has extensive experience of this technique. The procedure takes up to 3 hours to perform. In some instances a micro-surgical vasectomy reversal is not possible and a more complex procedure called a vaso-epididostomy is necessary which Mr Minhas can also perform at the same time. While performing vasectomy reversal, Mr Minhas is able to retrieve sperm directly from testes (TESE), which can be frozen as a back-up if the vasectomy reversal is not successful.
Due to the length of the anaesthetic procedure we normally advise patients that they should stay overnight in hospital, although some centres will do this as a day case, or alternatively under sedation. Using very fine suture material, which is not visible to the naked eye, the two ends of the vas deferens are joined up under the microscope. Patients should be aware that they need to take one week off to recover following such surgery.
1: Can you reverse a vasectomy?
Yes, generally speaking, a vasectomy can be reversed. However, the procedure is more complicated than a vasectomy and there are a number of important points to be aware of. It’s usually done via microsurgery carried out under a microscope, whereby the tubes that carry sperm are reconnected, although the exact technique used can vary depending on a range of factors, such as how much scar tissue there is, and can take up to three hours. Some clinics perform vasectomy reversals as a day case, but we usually advise an overnight stay in hospital due to the length of time under anaesthetic.
2: Are there any risks involved?
All surgical procedures carry a degree of risk, including infection and bleeding. While generally minimal, it’s important to be fully aware of the risks. Your surgeon will discuss these with you before you decide to go ahead.
3: What is the recovery time?
Vasectomy reversal recovery time is relatively quick and straightforward but there are a few important things to consider. You’ll need about a week off work, and heavy-lifting and strenuous exercise should be avoided for a few weeks – your surgeon will be able to advise what’s best for you.
Rest and painkillers can help with the initial soreness, along with wearing close-fitting underwear for at least the first 24 hours – although some men find it useful to carry on with this until the discomfort and swelling reduce entirely, which may take up to a few weeks.
4: How soon can you have sex after a vasectomy reversal?
It’s usually advised that you wait around a month before having sex, as this may hinder the healing process and possibly the success of the procedure too.
5: What is the vasectomy reversal success rate?
Vasectomy reversals are not always successful. One of the biggest factors here is the length of time that’s passed since you had your vasectomy. If it’s been five years or less then success rates are generally high, but the odds reduce as the time in-between gets longer. The success of the procedure won’t be fully clear until sperm tests are carried out further down the line. Our ‘Vasectomy reversal success rates: Why does it decline over time?’ explains more.
6: What options are there for getting pregnant if a vasectomy reversal doesn’t work?
Sperm retrieval techniques – for example, where sperm is retrieved directly from the testes via a needle – might still be an option if vasectomy reversal does not work, or for men who want to try for a baby again but wish to avoid reversal surgery. Mr Minhas is usually able to retrieve some sperm during the reversal procedure, which can be frozen as a back-up option in case the reversal proves unsuccessful. Our Sperm Retrieval Techniques treatment page explains more.