The Vasectomy Reversal Procedure : A guide to Vasectomy Reversal

Before you arrive at the clinic or hospital, make sure that you have cleaned the area to be treated (your testicles) and have shaved there if necessary. Bring a supportive dressing or underwear such as a jockstrap as this will help to support the scrotum and aid with healing. Tight fitting sports underwear can also help. Wear loose fitting trousers on the day, for example jogging bottoms as these will not put any undue pressure on the treated area. The last thing you want is to wear something which constricts the treated area after your surgery.When you arrive at the clinic or hospital your blood pressure and heart rate will be checked. You will also be asked to provide a urine sample. You will be asked to undress and change into a hospital gown. This surgery is performed as a ‘day case’ which means that you will be able to go home afterwards. The only exception to this is if you have drains left in: these are slim tubes used during the surgery which drain off blood and fluid from the scrotum. If you have drainage tubes left in then you will have to stay in the clinic or hospital overnight.

The consent form

You should have signed a consent form by now. If not then you will given a consent form to sign before surgery. This is designed for your protection as much as the surgeon’s and is written confirmation of the procedure and the risks involved. Read through this carefully before signing it. If you are having a local anaesthetic then this will be no more than a sharp sting which helps to numb the area. But if you are having a general anaesthetic, which is usually the case then this will take the form of a pin prick from which you will drift off to sleep. You may also be given a sedative which will help to calm any last minute nerves!The surgery itself can take up to 3 to 4 hours and there are two ways of doing so.

The standard procedure: vasovasostomy

This is the most popular vasectomy reversal procedure. It involves the surgeon making a couple of small incisions either side of the scrotum. This is usually the site of your vasectomy scars.In some cases, only one incision is needed and that can be made in the middle of the scrotum. This incision reveals the vas deferens. The surgeon will pull these through the incision and remove any scar tissue. He/she will check to see if there is any semen and/or sperm in the tubes. If there is then this means that there isn’t a blockage and he/she can remove a sample of sperm for testing. The surgeon will re-connect the tubes using dissolvable stitches and replace them back through the incision. The incision is closed either with dissolvable stitches or clips. The surgeon may re-connect one vas deferens or both.

Vasoepididymostomy

This is performed if there is a blockage in the vas deferens. A blockage can occur as a result of a build up of scar tissue from a previous vasectomy procedure or a reversal. The difference here is that the surgeon will re-connect the vas deferens to the epididymis – a storage place for sperm in the testicles. This is a more complex procedure than a vasovasostomy and results in a lesser chance of fertility. The reason for this is that it requires the surgeon to trim the vas deferens even further in order to rejoin it to the epididymis. This impacts upon the ability of sperm to fully develop and be mobile which will also affect fertility. The incisions are closed with dissolvable stitches.

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