Reversal of vasectomy

What is this?

Rejoining of the previously separated tubes with microsurgical techniques and fine sutures

What alternatives are there?

Other forms of assisted conception, sperm aspiration. Vasectomy reversal is ideal for men in whom the vasectomy was performed less than 15 years ago, in couples who wish to have more than one child and where the female partner is young. Sperm aspiration and artificial fertilisation will involve your partner in some manipulation as well, to retrieve eggs. The complications of sperm aspiration include haematoma of the scrotum (<5%), infection (1%) and shrinkage of the testicle (<5%). There is a 5-30% risk of multiple pregnancy following artificial fertilisation although there is no evidence of any increased risk of congenital malformation. Overall, the pregnancy rate is approximately 25-30% but this usually requires several cycles of treatment to reach these figures. Assisted conception is only performed by the Department of Reproductive Medicine (at Addenbrooke's) & by Bourn Hall. It is their recommendation that, in most patients, vasectomy reversal is the most effective method of producing a pregnancy after a previous vasectomy.

What to expect before procedure

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, the Anaesthetist and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you. The operation is normally performed through a small incision in the front of the scrotum with the ends of the tubes being re-joined using microsurgical techniques. If it is not possible to re-join the divided ends, it may still be possible to join the upper end to the sperm-carrying mechanism (epididymis) although the results of this procedure are not as good as those from re-joining the vasa themselves.

After the procedure

You may experience discomfort for a few days after the procedure but painkillers will be given to you to take home. Absorbable stitches are normally used which do not require removal. The average hospital stay is less than 1 day.

Potential side effects