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Vasectomy (cont.)

Can vasectomy be reversed?

Almost all vasectomies can be reversed. In a reversal, the cut ends of the vas deferens are reattached. Or, one end of the vas deferens is connected to the part of the testicle where mature sperm are stored.2

Vasectomy reversal is usually done in an outpatient surgery center or the outpatient area of a hospital. The surgeon may use general anesthesia.2

To reverse a vasectomy, the surgeon makes a small cut in the side of the scrotum and finds the closed ends of the vas deferens. Then a fluid sample is taken from the end closest to the testicle to test for the presence of sperm. If sperm is found in the fluid, the two closed ends of the vas deferens can be reattached.2

Many doctors perform the reversal using a microsurgical approach. Here, a high-powered microscope is used to magnify the ends of the vas deferens. It allows the surgeon to use smaller stitches - as small as an eyelash - which reduces scarring. Microsurgery returns sperm to the semen in 75% to 99% of reversals.2

If no sperm is found in the fluid, there is a blockage in the epididymis or vas deferens. The surgeon gets around this by attaching the upper part of the vas deferens to the epididymis in a place that bypasses the blockage. This procedure is more involved but has nearly as high a success rate as a standard reversal.2

Recovery from a reversal usually takes 1 to 3 weeks. As with vasectomy, complications from surgery are possible. Most men who undergo vasectomy reversal report the same or less discomfort during recovery than they had after vasectomy.2

Sperm start appearing in the semen about 3 months after the surgery. However, if the surgeon has to work around a blockage, it can take as long as 15 months for sperm to reappear.2

On average, it takes 1 year to achieve a pregnancy after a vasectomy reversal.2 However, a successful reversal (sperm is returned to the semen) does not guarantee pregnancy. The chance of restored fertility and pregnancy is highest when the reversal is performed not long after the vasectomy. The likelihood of restored fertility and pregnancy decreases as more time elapses between the vasectomy and the vasectomy reversal.

Medically reviewed by Michael Wolff, MD; American Board of Urology

Last update date: 4/19/2007 REFERENCES:

1. MedlinePlus. (2010). Vasectomy. Retrieved May 22, 2012.

2. American Urological Association Foundation. (2011). Vasectomy. Retrieved May 22, 2012

3. FamilyDoctor.org. (2010). Vasectomy: What to expect. Retrieved May 22, 2012.

4. American Pregnancy Association. (2003). Overview: Birth control. Retrieved May 23, 2012.

5. U.S. Centers for Disease Control and Prevention. (2012). Reproductive health: Contraception. Retrieved May 22, 2012.

6. Christiansen, C. G., & Sandlow, J. I. (2003). Testicular pain following vasectomy: A review of postvasectomy pain syndrome. Journal of Andrology, 24, 293-298.

7. Dassow, P., & Bennett, J. M. (2006). Vasectomy: An update. American Family Physician, 74, 2069-2074.

8. American Academy of Family Physicians. (2010). Vasectomy: What to expect. Retrieved June 25, 2012.

9. Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2006). New study finds vasectomy does not increase prostate cancer risk. Retrieved May 24, 2012

10. Eunice Kidney Shriver National Institute of Child Health and Human Development. Vasectomy.

Last Editorial Review: 4/19/2007

Source: MedicineNet.com

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