Is Vasectomy Reversal Possible?

Vasectomy reversal is a complex surgical procedure and it is not always successful. Vasectomy, or male sterilization, is performed by cutting the tubes that carry sperm from the testicles, which prevents sperm from appearing in the semen. The procedure is usually done by cutting or tying the tubes on both sides that carry sperm from the testicles toward the reproductive tract.

Vasectomy is generally considered a permanent method of contraception, because reopening the tubes later may not be successful. According to the figures cited, surgery to reopen the tubes ultimately leads to a successful pregnancy in only about 10% to 15% of cases, which is very limited in practice.

Points to Consider Before Surgery

• In surgery to reopen the tubes, or vasectomy reversal, the cut ends of the tubes are opened again and refreshed by the surgeon. These very delicate tubes are then sewn together with extremely fine plastic sutures under microsurgery.

• During vasectomy reversal, because the testicular tubes have a very small diameter, surgeons usually use an operating microscope during the procedure, which provides about 40 times magnification.

• Because the inner diameter of the testicular tubes is very narrow, in the days after surgery, as the surgical site heals and seals, scar tissue may form and block the tube again. As a result, the procedure may ultimately not be successful.

• If surgery to reopen the testicular tubes is not successful the first time, surgeons generally do not recommend repeating it a second time. To achieve pregnancy, the patient may be referred to infertility clinics for assisted reproductive techniques such as IUI and IVF. In these methods, the patient receives local anesthesia, a needle is inserted into the testicle, and sperm is retrieved from the testicle. The healthy sperm are then separated from abnormal sperm as much as possible. In IUI, these sperm are placed into the wife's uterus, while in IVF, an embryo is formed outside the uterus and then transferred into the uterus.

• IVF is time-consuming, costly, and demanding, and it may not always be successful. For this reason, considering all of these disadvantages, a person should be certain before vasectomy that they will not want a pregnancy in the future.

• Vasectomy is generally recommended for people who are sure they will not want children in the future, except in unavoidable circumstances such as the death of a child or remarriage.

• The success rate of reopening the testicular tubes generally depends on the surgical technique and on how long ago the vasectomy was performed. For example, the more time that has passed since vasectomy, the more scar tissue can form in the tubes. In addition, the testicles' ability to produce suitable sperm may decrease, reducing the success rate of vasectomy reversal.

• Studies estimate that if a person decides to reopen the tubes within the first 3 years after vasectomy, the success rate of vasectomy reversal is about 75%. After 3 to 8 years, this success rate decreases to 55%, and after 10 years, the success rate is generally less than 30% to 40%.

• After vasectomy reversal, the sperm count in the semen may reach an adequate level. However, it is sometimes seen that the sperm produced do not have enough quality to fertilize the wife's egg.

Preparation Before Vasectomy Reversal

• If the person has a blood disorder or a medication allergy, they should inform the doctor.

• Before this surgery, a semen analysis is usually performed so the doctor can make sure the testicular tubes are completely blocked.

Care After Vasectomy Reversal

For faster and better recovery after vasectomy reversal surgery, the following points should be considered:

• Avoid movement during the first 6 to 8 hours after surgery; this is one of the most important points to keep in mind.

• If there is pain and swelling in the surgical area, a cold compress should be used.

• Bruising, mild bleeding, and a small amount of discharge from the surgical site are usually not concerning.

• Doctors usually recommend staying in bed for 24 hours to 72 hours after surgery and avoiding daily activities.

• In general, sports and sexual activity are allowed 3 weeks after surgery.

Does Vasectomy Reversal Have Complications?

Like any surgery, vasectomy reversal can lead to complications, including:

1. Bleeding inside the scrotum. This bleeding usually occurs after surgery and can lead to hematoma formation and bruising inside the scrotum. Adequate rest, use of scrotal support, and cold compresses can reduce the risk of bleeding. Avoiding blood-thinning medications before and after surgery can also reduce the risk of bleeding.

2. Infection at the surgical site. Although it is very rare, it can occur and may require antibiotic treatment.

3. Chronic pain. Long-term pain after vasectomy reversal is one of the possible complications, although it is rare.

How Much Does Vasectomy Reversal Cost?

The cost of this surgery generally depends on the person's insurance coverage and the hospital where the procedure is performed. Costs in public and semi-public hospitals are always lower than in private hospitals. However, appointment waiting times may be longer, or because of the high number of visits to public centers, the person may sometimes be dissatisfied with the services provided there.

Frequently Asked Questions