Are you thinking about having children again after a vasectomy? Let's talk about Vasectomy Reversal!

Some of the decisions we make in life can change over time. Sometimes, a person who has had a vasectomy as a family planning procedure, thinking of having children, may feel the desire to become a father again after many years. This is very common. So, the best solution for someone who feels that way is a vasectomy reversal surgery, which is called a 'vasectomy reversal'. Let's talk about this in detail today.

Simply put, what is vasectomy reversal?

To understand this, let's first remember what a vasectomy is. A vasectomy is a procedure that prevents sperm, which are produced in a man's testicles, from being released into the semen. This involves cutting and tying off the two thin tubes that carry sperm, the vas deferens, at both ends.

So, in a vasectomy reversal , the ends of the two tubes that were cut and separated are very delicately reconnected. This is called a vasovasostomy in medical science. The surgeon removes all the scar tissue at the ends of the two tubes and sews them back together very carefully using a microscope.

Sometimes, the blockage in the tube can be located elsewhere, such as in the epididymis, a structure that stores sperm. In that case, the doctor may have to connect the vas deferens directly to the epididymis. This is a somewhat complicated surgery.

Why would someone decide to have this kind of surgery?

There are several reasons why someone might consider reversing a vasectomy.

• Changing life decisions: Even if you previously thought you didn't want children, over time you may feel the desire to have your own child again.
• New relationship: If someone remarries after a divorce or the death of their spouse, they may want to start a family with that new partner.
• The need to regain fertility: Even if some people have no intention of having children, the feeling that they can have children if they want to can be psychologically important.
• Pain relief: A very small number of men may experience long-term pain in the testicles after a vasectomy. There is a chance that this surgery can relieve that pain.

How successful is this surgery?

This is a problem that many people have. Success varies depending on how long it has been since the vasectomy.

Typically, the chance of sperm re-appearing in the semen is between 60% and 95% . The chance of pregnancy after the surgery can be over 50% . However, this success rate starts to decrease slightly after about 15 years after the vasectomy.

Also, even if the surgery is successful, there are other factors that can affect your chances of getting pregnant. Your partner's age and health , as well as the health of your sperm, can all affect this.

Things to discuss with your doctor before surgery

After making this decision, the first thing you should do is meet with a skilled, experienced surgeon to discuss this. He or she will ask you a few questions.

• Why did you want to have this surgery?
• Do you have any bleeding disorders or blood-related diseases?
• Are there any allergies to anesthetics or antibiotics?
• Have you had any previous injuries or surgeries (e.g. hernia surgery) to the groin, testicles, or genital area?

Also, there are some important questions you should ask the doctor.

Questions you should ask the doctor:

• How many surgeries have you performed like this? (Experience is very important)
• Do you think this surgery will be successful given my condition?
• How should I take care of myself after surgery?
• What should I do about the pain?
• When can I resume normal activities, exercise, and sexual activity?

Don't forget to inform your doctor about any medications you are taking, as well as any medical conditions you have.

What happens during the surgery?

The doctor will administer anesthesia to ensure that you do not feel any pain during the surgery. This can be general anesthesia , which puts you completely to sleep, or local anesthesia, which numbs only the area being operated on.

Next, the doctor makes a small incision in the skin of the scrotum, often at the same site where the previous vasectomy was performed. From there, the ends of the vas deferens tubes are found and any scar tissue is removed. The fluid from the tube on the side of the testicle is then examined for sperm. If sperm are present, the ends of the tubes are held under a microscope and stitched together with very fine thread.

If sperm are not visible, meaning there is a blockage elsewhere, a slightly more complicated surgery called a vasoepididymostomy may be required, as mentioned earlier. At the end of all this, the skin incision is sutured closed. The entire procedure can take between 2 and 4 hours.

Recovery and care after surgery

You can go home the same day after surgery. Take care of these things after you go home.

• Ice application: During the first 24-48 hours, applying an ice pack for about 20 minutes at a time can help reduce swelling and pain.
• Painkillers: For minor pain, you can take paracetamol or other painkillers (NSAIDs) as prescribed by your doctor. If the pain is severe, your doctor will prescribe other medications.
• Underwear: It is very important to wear a tight-fitting underwear or athletic supporter for at least a week.
• Rest: Get plenty of rest for the first two to three days. Avoid heavy lifting or strenuous exercise for at least a week.
• Sexual activity: Avoid sexual intercourse or masturbation for 2 to 3 weeks . Rushing can cause the stitches to break, cause infection, and increase pain.
• Cleanliness: It's okay to shower. However, avoid soaking in a bathtub until the wound is healed. Keep the wound clean and dry.

What are the side effects or risks?

As with any surgery, there are some minor risks involved, but the likelihood of these occurring is low.

When can I expect results?

Six to eight weeks after surgery, your doctor will order a semen analysis to check if your sperm have returned, and to check their size, movement, and shape. After a successful surgery, sperm will be visible within a few weeks. If you had a vasoepididymostomy, it may take several months or even a year for sperm to return.

This is not a decision you should make alone. Talk it over with your spouse or partner and come to an agreement. Then, see a trusted doctor, discuss all your options, and make the best decision for your family.

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