As a male fertility doc, I’ve heard all the questions about what goes on Down There…and then some. When it comes to vasectomy reversals, those questions—and their answers—are extremely important. After all, most couples have heard of vasectomies, but not many know the nitty gritty when it comes to vasectomy reversals.
First off, you should know that vasectomy reversals are actually quite common. Thousands are performed every year in the US alone. That’s not so surprising when you consider that up to 350,000 vasectomies are performed in the US each year, and about 6% of men change their minds! Due to a variety of factors, including vasectomies, one in six couples are infertile and looking for ways to get the help they need to build their families. And here’s the biggest secret: male infertility plays a large role in a couple’s infertility for nearly half of these cases.
So how about those questions? These are some of the most common ones I hear:
What exactly is a vasectomy reversal?
A traditional microsurgical vasectomy reversal involves sewing the severed ends of the vas deferens back together. The idea is to restore the natural flow of sperm in what’s called a vasovasostomy.
Sometimes, however, this method isn’t possible, usually due to scarring left over from the vasectomy. That means it’s time for option two: a procedure that bypasses that scar tissue and connects the vas deferens to a non-scarred part of the epididymis. This is called a vasoepididymostomy—and happens to be my specialty. The advantages of these microsurgical vasectomy reversals include its low invasiveness, high success rate, low risk of scarring, and shorter recovery time.
Who is a good candidate for a vasectomy reversal?
There are a variety of factors when it comes to determining who would be a good candidate for a vasectomy reversal. Some can be determined before the surgery by looking at things like how long it’s been since the man had a vasectomy, whether or not he’s had other surgeries in the general groin area, and whether or not he has the same partner he had before the vasectomy.
Other determining factors come up based on the consult with the surgeon: how much fluid and sperm is in the vas deferens and the nature of the original vasectomy, for instance. The key is to consult a knowledgeable surgeon who can make suggestions based on your specific situation.
How do I know the vasectomy reversal will work?
As with a lot of medical procedures, there’s no way to be 100% certain a vasectomy reversal will work. However, the stats in general are good: My ability to successfully line up the tubes so sperm is flowing again is about 95%, but the birth rates still will be higher or lower depending on how long its been since the vasectomy and how fertile the partner is. Men undergoing a vasectomy reversal less than three years after their vasectomy typically have about an 80% chance of a baby being born. At 10 to15 years out it’s about 50%, and at 20 years out it’s about 30 to 35%. There is no time after which a vasectomy reversal cannot work.
But isn’t a vasectomy permanent?
This is a common misconception. Reversing a vasectomy is actually a very common practice.
Can a vasectomy reverse itself?
It’s extremely rare, but yes, a vasectomy can reverse itself. This is called recanalization. But it doesn’t guarantee that you’ll be fully fertile again, since the new channel is likely to be much thinner than the original vas deferens was.
Is a vasectomy reversal safe?
Absolutely. And best of all, it requires no in-hospital stay.
How long does the surgery take?
A vasectomy reversal is a more complicated and technical procedure than a vasectomy, which means it can take longer—anywhere from about 2 ½ to 4 hours.
What does recovery from vasectomy reversal look like?
You may experience swelling and tenderness for up to four weeks after your vasectomy reversal, although most patients are only sore for the first three to five days after the procedure. You’ll want a good supply of ice packs, but other than that, recovery is really about just taking it easy.
How long do I have to wait to have sex with my partner after a vasectomy reversal?
You should give yourself four weeks before jumping in the sack again.
How long do I have to wait to get back to the gym?
You should allow yourself about three to four weeks before returning to vigorous exercise or other heavy physical exertion. If your job requires it, consider some extra time off or modifying your work to more office-level responsibilities while you’re recovering.