A vasectomy is a fairly simple procedure that stops the flow of sperm to the vas deferens. Most men who opt to have this procedure are happy with the results. However, there are times when circumstances change. While the process of reversing a vasectomy isn’t exactly as simple as the initial procedure, there have been advances in surgical techniques that have improved success rates for men considering reversal.
There are two types of less-invasive, microscopic vasectomy reversal procedures a urology surgeon may perform to restore the flow of sperm: a vaso-vasostomy or a vaso-epididymostomy.
With a vaso-vasostomy, the separated parts of the vas deferens are surgically reattached. This is the most common type of microscopic vasectomy procedure. Before surgery, a urologic surgeon will evaluate the quality of any remaining sperm within the vas deferens to determine if this is the best approach to microscopic vasectomy reversal for a patient.
While under general anesthesia, a special operating microscope is used to guide the surgeon to lower part of the scrotum to access the severed parts of the vas deferens. If viable sperm is found, the duct that goes from the testicles to the urethra will be surgically sewn back together. Because microscopic techniques are used, smaller, finer incisions are made, which should minimize scarring.
What Is a Vaso-Epididymostomy?
A urologist is likely to recommend a micro-surgical vaso-epididymostomy if no viable sperm are found in the vas deferens. This type of microscopic vasectomy reversal may also be suggested if there is a blockage in the sperm-carrying tubes or other issues with inflammation or scar tissue from the original vasectomy.
Also performed under general anesthesia, a vaso-epididymostomy involves restoring sperm flow in an alternate way other than directly reconnecting the separated parts of the vas deferens. Instead, the sperm-carrying tube is attached to a duct behind the testicles called the epididymis.
Doing so bypasses any obstructions in the vas deferens and connects to an area more likely to have healthy sperm. Despite being a more complex procedure, a vaso-epididymostomy can be done with improved precision when micro-surgical techniques are used to restore the flow of healthy, viable sperm.
How Long Does Recovery Take?
It usually takes a few weeks for most men to recover from either procedure. Sexual activity can usually be resumed once the surgical site has healed. Any discomfort during the initial recovery period can usually be managed or reduced with medication. A semen analysis is normally done about a month or so post-procedure. Sperm counts may be checked periodically beyond this point to ensure that levels are stable. In general, patients opting for microscopic vasectomy reversal often benefit from:
Less post-surgery discomfort
Shorter recovery periods
Fewer surgical complications and risks
Today, vasectomy reversal rates are fairly high. Part of the reason for this is the use of less-invasive procedures. The specific microscopic vasectomy reversal process that a urologist recommends will depend on factors such as whether or not there is fluid found in the vas deferens and overall urologic health. If conception after reversal is the main reason for reversal surgery, most couples are able to achieve this goal within 3 to 9 months following vasectomy reversal. Results from a post-operative semen analyses can help determine the odds of conception.