CAN A VASECTOMY BE REVERSED?

Over a half-million American men undergo a vasectomy each year– a safe, simple, and highly effective means of contraception.  About 50 million men in the US have undergone this procedure; roughly 5% of all married couples of reproductive age.

Although a vasectomy is one of the most popular forms of contraception worldwide, it remains a subject of imagined fears for many men.  The best medicine for apprehension can be in simply knowing the facts and receiving real insight from an experienced surgeon.

It can be a measure of comfort to the man that the vasectomy is far easier for him than other surgical options would be for his wife or partner.  By contrast, sterilization for a woman (tubal ligation) is more invasive, usually performed under general anesthesia, can result in greater discomfort, and has potentially higher risks than a vasectomy procedure.  In addition, vasectomy is also the less expensive option.

This procedure is intended to be permanent.  Though vasectomy reversal procedures are available, they are technically complex, expensive, and have variable success rates.  If there is any doubt and you choose to go through with the procedure, banking your sperm is a good option to do before the actual surgery.

Can a vasectomy be reversed?
The short answer: Yes!

Vasectomies are considered a permanent form of birth control, but some men do opt to reverse them.  This is accomplished with a procedure known as a vasovasostomy.  Vasovasostomies aren’t new.  In fact, they’ve been around for more than 100 years, with the first successful operation reported in 1919.  In the US, approximately 600,000 men have vasectomies every year, and 5% of those go back for a vasovasostomy .  Very rarely, doctors will perform a vasovasostomy to ease the pain from complications of a vasectomy.

Of course, these are averages. The less time has elapsed since a guy’s vasectomy, the better his chances of success.  The pregnancy rate is 76% for guys whose vasectomy was 3 years or less before their reversal, but only 30% for guys whose vasectomy was 15 or more years before the reversal.

Vasectomy reversal can be performed two ways:
One procedure involves reattaching the ends of the vas deferens (the duct that carries sperm) back together (vasovasostomy). After your surgeon sews the ends together, the vas deferens is then attached to the epididimis — the storage area at the back of the scrotum where sperm matures.  If stitching the vas deferens back together won’t work, because of damage that might interfere with potency, your doctor may need to directly attach the sperm duct to the epididimis, bypassing the area that is blocked (vasoepididymostomy).

The exact procedure is decided after your surgeon gets a view of your anatomy during the procedure itself.  Until then, you won’t know which approach is needed.  It’s also possible that one side will result in a vasovasostomy, while the other requires vasoepididymostomy.

How does vasectomy compare with female sterilization?
Regardless of how it is performed, vasectomy offers many advantages as a method of birth control.  Like female sterilization, it is a highly effective one-time procedure that provides permanent contraception. Vasectomy, however, is medically much simpler than female sterilization, has a lower incidence of complications, and is much less expensive.

What happens after vasectomy?
After vasectomy, the patient will probably feel sore for a few days, and he should rest for at least one day. However, he can expect to recover completely in less than a week.  Many men have the procedure on a Friday and return to work on Monday. Although complications such as swelling, bruising, inflammation, and infection may occur, they are relatively uncommon and almost never serious.  Nevertheless, men who develop these symptoms at any time should inform their physician.

When can a man have sex again?
A man can resume sexual activity within a few days after vasectomy, but precautions should be taken against pregnancy until a test shows that his semen is free of sperm.  Generally, this test is performed after the patient has had 10-20 postvasectomy- ejaculations.  If sperm are still present in the semen, the patient is told to return later for a repeat test.

When should the decision about vasectomy be made?
For all of the foregoing reasons, doctors advise that vasectomy be undertaken only by men who are prepared to accept the fact that they will no longer be able to father a child. The decision should be considered along with other contraceptive options and discussed with a professional counselor. Men who are married or in a serious relationship should also discuss the issue with their partners.

How about storing semen in a sperm bank?
It is possible to store semen in a sperm bank to preserve the possibility of producing a pregnancy at some future date.  However, doing this is costly, and the sperm in stored semen do not always remain able to cause pregnancy.

If you and your partner are considering a vasectomy, clear answers and quality information can help ease concerns.  Schedule a consultation with Dr. Bellman, a Board-Certified Urologist & get answers as you make an informed decision.