West Coast Urology  –  Geelong   |   Hamilton    |   Colac   |   Winchelsea

A. PROF RICHARD GRILLS

DR KATHRYN MCLEOD

MR PATRICK PREECE

Urological Surgeons

Vasectomy Reversal (Microsurgical)

To download a PDF document about ‘microsurgical vasectomy reversal’ please click:

  • A procedure to restore the fertility of a man who has previously undergone a vasectomy.
    • Approximately 2-5% of men who have a vasectomy choose to have it reversed at a later time.
    • Vasectomy reversal allows couples to potentially conceive naturally.
    • Vasectomy reversal is typically more cost effective than IVF treatment.

  • The vas deferens (‘vas’) is the small tube through which sperm travel, connecting each testicle to the ejaculatory ducts behind the prostate. This is what is severed during a vasectomy to achieve sterility.
  • The cut ends of the vas lumen have a diameter of only 500 microns. They are re-joined with microsurgery using extremely fine (0.03mm) sutures.
  • It is completed through a small incision on the scrotum.
  • The procedure takes approximately 3 hours and is performed under a general anaesthetic.
  • It is typically a day-case procedure.
  • Infrequently, fluid can’t be expressed from the downstream end of the vas indicating extensive scarring. In such cases the blockage is bypassed by attaching the vas to a tiny tubule in the epididymis (‘vaso-epididymostomy’). These outcomes tend to be less favourable. 
  • Microsurgery success rates are very positive.
  • If it’s been less than 3 years since vasectomy, 95% of men can expect to see a return of sperm.
  • If it’s been more than 15 years since vasectomy, return of sperm is seen in approximately 70% of men.
  • Subsequent pregnancy rates are typically greater than 50%.
  • Bleeding- Some bruising of the scrotum is expected and usually settles quickly. Significant bleeding is rare.
  • Wound infection
  • Altered lie/ high sitting testis within the scrotum
  • Failure to achieve return of sperm

Medications to stop before the surgery:

  • Notify your surgeon if you take any blood thinners, medications for diabetes or medicationsthat weaken your immune system as these may need to be withheld in the lead up to surgery.

Wound care

  • All the stitches are dissolvable.
  • A waterproof dressing will be applied to the wound. If the dressings become wet or soiled, take it off and keep the exposed wound clean and dry.
  • You can shower as normal, but ensure the wound is dry afterwards (pat dry with a towel or use a hair dryer).


Recovery

  • Minor swelling, bruising and pain can last for a few weeks.
  • Tight supportive underwear (classic briefs style) should be worn to help minimise swelling and post operative discomfort.
  • The vasectomy reversal join is VERY FRAGILE. REST AT HOME for the initial 48-72hrs. Strenuous activity (including sex) should be avoided for 4 weeks.


Medications

  • When you leave hospital you will be given:
    • Pain relief medication
      • Take regular Panadol and ibuprofen
      • Stronger pain relief can be used if needed
    • Laxatives to prevent constipation


Driving

  • It is safe to resume driving when you are off strong pain medication, and are moving around freely.

Follow up appointments

  • You will be seen in the rooms:
    • 1 week after surgery
      • to review the wound
    • 12 weeks after surgery
      • with a semen analysis to be completed beforehand
        • The semen sample must be received by the lab within 1 hour
        • Avoid ejaculation for 3 days prior to producing the sample

 

If you did not receive an appointment when leaving hospital, please contact reception staff at West Coast Urology to make one.


Cause for concern

  • Contact your surgeon if you notice any of the following during the recovery period:
    • Fever
    • Tense scrotal swelling, bruising or bleeding
    • Worsening pain, redness or wound discharge