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Reversal of vasectomy

Like many women, men make radical decisions on their fertility that, as time passes, acquire another perspective. One of them is vasectomy, a very common method of contraception that involves cutting the vas deferens, which oversee carrying the sperm from the testicles to the urethra.

Many of the patients who undergo this procedure, over the years reconsider their decision, either because they have a new partner with whom they want to form a family, because they lost one of their children or because they definitely want to have the children that, in the past, they did not think to have. For this, there is reversal of vasectomy, a very simple surgery that manages, in most cases, to return male fertility.

The intervention to rechannel the vas deferens and re-allow the passage of the sperm into the urethra. Its complexity and duration are greater than in vasectomy. Moreover, its success will depend on how the vasectomy was done and the length of time that has passed from it.

After a successful reversion of vasectomy, the semen is expected to contain sperm and even achieve a pregnancy.

When the time elapsed since the vasectomy is a few years, there is a  possibility of performing the process with a high success rate.

If the time elapsed between one intervention and the other is less than five years, the percentage of interventions in which the goal of returning fertility to man is achieved is around 90%. (We are certain it is so high)

However, this percentage is considerably reduced when the intervention was made 15 or 20 years ago, to the point that, at times, it is preferable not to opt for reversal and to apply an alternative treatment such as in vitro fertilization (IVF).

Vasectomy reversions are usually performed in a hospital or surgical center. The procedure is usually ambulatory, so a night of hospitalization is not necessary.

Surgery can be done with general anesthesia. Another possibility for the surgeon is to use epidural, intradural or local anesthesia.

Vasectomy reversal is more complex than a vasectomy. It requires specialized training and experience. Physicians who perform this surgery usually re-attach the vas deferens as well as:

Vasovasostomy. By this procedure, the surgeon reconnects with surgical stitches the sectioned ends of each duct that carries the sperm (vas deferens).

Vasoepididymostomy. This surgery connects the vas deferens directly to the small organ behind each testicle and containing the spermatozoa (epididymis). A vasoepididymostomy is more complicated than a vasovasostomy and is usually opted for when a vasovasostomy cannot be performed or when it is unlikely to be successful.

The success rates of vasectomy reversal range from approximately 40 percent to more than 90 percent. Many factors determine whether a reversal is successful in achieving a pregnancy, including time elapsed from vasectomy, age of partner, success rate, experience and training of the surgeon.

  • Vasectomy reversal rarely has serious complications. Risks include:

    Bleeding into the scrotum: this can lead to blood buildup (hematoma), causing painful inflammation.

    Infection at the surgery site: although they are not very common, infections are a risk of any surgery and may require antibiotic treatment in certain situations.

    Chronic pain: Persistent pain after vasectomy reversal is very rare.

    Sources:

    • Mayoclinic.org
    • Reproducciónasistida.org
    • Inser.com.co

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