A vasectomy, also known as male sterilization, is a permanent contraception method many Americans opt to have when they decide they no longer wish to have children. Although vasectomies are considered a permanent procedure, a surgery called a vasectomy reversal offers to men who choose to reverse their previous vasectomy for several reasons. Here’s how they work.
Vasectomy reversal surgery: a quick rundown
A vasectomy is a procedure where tubes known as the vas deferens carrying sperm from the testicles to the penis are cut or sealed to prevent sperm from being ejaculated together with semen on climax. Vasectomy reversal surgery, as the name implies, attempts to reverse this procedure by reconnecting the previously excised or blocked vas deferens.
Why do some men get a vasectomy reversal?
More than half a million American men undergo vasectomies each year. At the same time frame, up to 30,000 individuals opt to undergo vasectomy reversals for the main reason that they wish to have children. Certain life events or changing attitudes towards having children may drive “fixed” men to undergo a vasectomy reversal.
However, a section of men who wish to undergo vasectomy reversal is due to the pain caused by the original vasectomy procedure. It is estimated that as much as 2% of men who receive vasectomies experience a condition called post-vasectomy pain syndrome, characterized by acute or chronic testicular pain lasting for more than three months. Vasectomy reversals often help treat the pain.
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How should I prepare for a vasectomy reversal?
Looking to get a vasectomy reversal? Consult a urologist with experience in this type of surgery. They will examine your medical history and determine what you want to achieve with the procedure. They may also run you through several questions about your vasectomy, any previous surgeries in the area, any underlying medical conditions, your and your partner’s ages, and if you have any biological children, among others.
Your healthcare provider may run additional tests based on your answers to their questions.
For instance, you might be asked to take a testicular sperm aspiration, where sperm is taken directly from your testicles in a procedure, which may be used to check your sperm quality and quantity. Additional blood tests may also check your hormone levels and if testosterone replacement therapy is needed to boost your sperm counts if needed.
What should I expect from a vasectomy reversal procedure?
Vasectomy reversals are done at a hospital or medical facility. Your healthcare provider will give you a thorough briefing before and after your procedure and give you specific instructions based on your needs.
Before the procedure, your doctor may instruct you to refrain from taking pain medication or blood thinners a week before the operation. You may also be asked to bring tight-fitting underwear to help support your scrotum post-surgery.
During the procedure, your surgeon may perform a vasovasostomy (VV), which involves the reconnection of the vas deferens. An alternative procedure your surgeon may perform is a vasoepididymostomy or epididymovasostomy (EV), where one of the tubes may be connected to the epididymis – a gland behind the testicle that stores sperm.
Post-procedure, you may be instructed to use ice packs to reduce inflammation, take analgesics as needed, prevent the site from getting wet, wear tight-fitting underwear or a jock strap to provide additional scrotal support and avoid activities that put pressure on the operation site – including sexual activity and ejaculation.
Your doctor will have you come back to test your semen, with ongoing monitoring until you’re able to conceive or when your semen levels stabilize.
How successful are vasectomy reversals?
Vasectomy reversals enjoy a relatively high success rate when done by trained and qualified urologists using surgical microscopes. Sperm tends to return to ejaculate after two to six months after the vasectomy reversal, but rates tend to vary depending on the individual.
Cases treated with VV registered up to a 99.5% success rate, while cases treated with EV enjoy a success rate ranging from 48% to 92%. On the other hand, conception or pregnancy rates for individuals who get basic vasectomy reversal range sits at 42% to 92%.
The success rates indicate that while vasectomy reversals have a good success rate, it doesn’t necessarily follow that conceiving is a walk in the park for all men. Male reproductive health problems involving sperm quality and the female partner’s fertility may make it harder to induce pregnancy. In short, the presence of sperm in your ejaculate does not guarantee a successful conception.
What are the risks of vasectomy reversal?
Generally, vasectomy reversals are considered a safe procedure with a low risk of developing complications. But your healthcare provider may ask you to keep an eye out for signs of infection, fever, or bruising around the scrotum after undergoing your procedure. Your doctor may put you on a regimen of antibiotics if any symptoms of infection arise.
Is it possible for all vasectomies to be reversed?
Generally, vasectomies have a good chance of being reversed. The results may be better if it has been less than 10 years since you had the procedure.
However, there are cases where vasectomy reversals fail. Such cases may involve an underlying health issue with the testicles or otherwise involve a blockage. Undergoing another vasectomy reversal may be able to remove any residual blockages.
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How much do vasectomy reversals cost?
It all depends on your surgeon, where you live, and what kind of facility you choose to get your procedure done in. Typically, vasectomy reversals aren’t covered by insurance.
A good ballpark figure for a vasectomy reversal in a health clinic with light anesthesia may have you shelling out somewhere between $5000 to $6000. Doing it in a hospital under general anesthesia can go upwards of $15,000.
However, when compared to in vitro fertilization and similar assisted reproductive methods, which can easily cost upwards of $20,000, vasectomy reversal is relatively more affordable.
What alternatives do I have other than a vasectomy reversal?
Several alternatives to reversing vasectomies exist, which can lead to successful conception. For instance, sperm retrieval techniques take sperm straight from your testicles and frozen or used for IVF or other assisted reproductive techniques. This may be a potential option if you’re dealing with low sperm quality or motility. In the end, it’s ideal for both partners to take each other’s fertility into consideration before making the decision to reverse a vasectomy.
