Vasovasostomy: Procedure, Risks, Side Effects and Results

Surgeon performing vasovasostomy microsurgery.

What Is A Vasovasostomy?

A vasovasostomy is a type of micro-surgery performed by a urologist that is used to reverse a vasectomy. This procedure involves making a small incision in the scrotum that allows the surgeon to locate and reconnect the vas deferens (the tubes that carry sperm from the testicles which are cut and closed off during a vasectomy).

Men who have had a vasectomy can often regain fertility by having a vasovasostomy. The success rate for sperm being present in the semen again after a vasovasostomy is approximately 85%, and the and the pregnancy rate following the procedure is around 53%.

This procedure is also used to relieve pain experienced by some men who have had a vasectomy (commonly referred to as post-vasectomy pain). It is important to note that a vasovasostomy should not to be confused with a vasoepididymostomy, which is another type of procedure used to reverse a vasectomy.

Vasoepididymostomies are a more complex type of surgery compared to vasovasostomies. This procedure is used when the epididymis (which stores sperm) has a blockage, or in other situations where a vasovasostomy might not work.

Before the actual surgery begins and the surgeon is able to determine if sperm is still present in the vas deferens, there is no way be certain which procedure you will need to undergo.

Continue reading to learn more about the vasovasostomy procedure, its side effects, and potential results from undergoing a vasovasostomy.

Before The Surgery

To ensure you are a suitable candidate for surgery, your healthcare provider will ask about your medical history and perform a physical exam. Additionally, you should gather correct information about the date of your vasectomy and how long it has been since you had the procedure.

Also, if you have had any penile or scrotal surgery, be sure to let your doctor know. Your healthcare provider will also ask about your reproductive history, including if you’ve ever had children or previous pregnancies, and at what age.

If the goal for having a vasovasostomy is to father children, your healthcare provider may recommend that your partner be tested to determine if she’s still producing eggs. Your doctor might also recommend that you have a testicular biopsy if you were infertile prior to having a vasectomy.

The testicular biopsy (which involves the removal of a little tissue from your testicles for testing) may be performed one day prior to your vasovasostomy, or at the start of the procedure.

During The Procedure

A vasovasostomy typically takes between 2-4 hours. However, it is possible to take longer if the procedure is more complicated. It also depends on the skill of the surgeon who is performing the surgery. It is possible to expect to spend some time filling in consent forms.

The vasovasostomy procedure is performed on an outpatient basis at the hospital or in a surgery center. You can usually return home the same day.

Most vasovasostomies are performed under general anesthesia, meaning you will be asleep during the surgery.

After you have received the anesthetic, the surgeon will make a small incision in your scrotum and then locate your vas deferens using an advanced operating microscope. With the aid of this sophisticated microscope, the surgeon can get a clear and detailed view of the area in order to make tiny, exact incisions and stitching.

The surgeon will then trim off the ends of the vas deferens that were cut and closed off from the vasectomy. The vasal fluid from the vas deferens opening that is closest to your testicles will then be tested for sperm.

Once sperm are determined to be present, the surgeon will continue with the vasovasostomy. At this point, the cut ends of the vas deferens will be reattached using tiny stitches.

However, if no sperm is detected, the surgeon will make a determination based on other factors and could decide to perform a vasoepididymostomy instead.

Following The Procedure

Bandages may be used to cover the area of surgery following the procedure. You may experience some pain, swelling and discomfort as the anesthesia wears off, but it shouldn’t be too severe.

Most likely, you will be prescribed painkillers to ease the pain. You may be advised by your doctor to wear support clothing such as a jockstrap for up to several weeks.

After resting for two or three days, you will be OK to resume light activities. Ask your doctor when you can resume work if your job involves strenuous or heavy labor.

Talk to your doctor about when it is appropriate to remove the bandages and discontinue wearing the scrotal support. He or she may also advise you to refrain from having sex for a couple of weeks.

Side Effects

You can expect to have some mild pain or discomfort following surgery, which is normal. This should subside within a few days to a few weeks at most. To help with this, you will be prescribed painkillers.

Some swelling is also normal and should subside within 1-2 weeks. You should contact your doctor if your pain becomes severe or you have swelling that persists for more than a few weeks.

Risks

Having a vasovasostomy is relatively safe and has few risks. Even so, it is still possible to experience the some of the following problems after the surgery:

  • Persistent pain
  • Infection
  • Hematoma (caused by bleeding in the scrotum that pools under the skin).
  • Blockage or strictures of the vas deferens

You should notify your doctor right away if you experience any persistent pain, swelling and/or bleeding.

Getting Results

It can take several months, or even as long as a year or more for sperm to be present again in your semen and your partner to become pregnant. After 2-3 months following the procedure, you will be asked to give a semen sample for analysis to check for the presences of sperm.

An additional follow-up appointment could be scheduled 4-6 months following the procedure for a further semen analysis. You may be asked to return for additional testing every 2-3 months if your sperm hasn’t yet appeared or your sperm count is low.

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