Introduction
A vasovasostomy or vasectomy reversal allows the sperm to pass through the semen to enable pregnancy. The success rate of this procedure depends on the duration after the vasectomy. It is a surgical procedure that helps reverse vasectomy, which is performed to prevent pregnancy. This procedure is performed in men. This procedure is commonly done when the person decides to have a biological child.
What Is a Vasovasostomy?
Vasovasostomy is a surgical procedure that reverses a vasectomy procedure. A vasectomy is a surgical procedure performed in men to prevent pregnancy. The method involves blocking the vas deferens or tubes, preventing sperm cells from passing into the semen. Sperm cells help in reproduction in men. The procedure involves cutting and occluding the vas deferens. In vasovasostomy, the surgeon will remove the scar tissues and suture the ends together; in some cases, this is not possible, and the vas deferens will be attached to the epididymis.
What Is the Purpose of Vasovasostomy?
The purpose may include:
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Restore Fertility: Individuals decide to have biological children after a vasectomy.
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Post Vasectomy Pain: This is a condition where the individual experiences chronic pain, which can last even three months after the procedure. Vasovasostomy is performed to relieve the pain.
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Emotional Changes: When an individual starts a new relationship with a new partner and wants to start a family.
What Are the Risks and Contradictions of Vasovasostomy?
The possible risks of the procedure involve the following:
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Individuals may experience chronic pain.
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Risk of infection.
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Hematoma formation is caused due to pooling of blood in the scrotum. This can be avoided by promptly following postoperative care.
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Stricture.
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Blockages (caused due to the blockage of vas deferens).
Is the Procedure Successful?
The success rate depends on the time interval after the vasectomy. Vasovasostomy has a success rate of 60 % to 95 % for the sperm to return to the ejaculate. After vasovasostomy, there is a 50 % success rate for pregnancy. There is a decline in the success rate if the vasectomy has crossed 15 years.
Other factors involve:
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Age of the partner.
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The health of the sperm.
What Happens Before Vasovasostomy?
The healthcare provider usually takes a brief medical history, and then a decision may be taken on whether to perform the surgery. The medical history and a physical exam may confirm whether the individual is a good candidate for surgery. For example, suppose the individual or the family has a history of hypogonadism (a condition in which the body does not produce enough sperm or hormone responsible for growth and development during puberty).
In that case, they should inform the health care provider. The individual should give an accurate history of when the vasectomy was performed and how long it has been since the procedure. The history of any scrotal or penile surgery should be mentioned to the health care provider. If a vasovasostomy is to have children, the health care provider may suggest tests to check for the partner's fertility.
Specific factors that depend on whether the surgery has to be performed or not:
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History of bleeding disorders.
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Allergy to local anesthesia or antibiotics.
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Injuries like a hernia on the groin area.
Individuals should inform their healthcare provider about preexisting health conditions, over-the-counter medications, and herbal supplements. Certain herbal supplements and anti-inflammatory drugs can cause bleeding.
How Long Does the Procedure Take?
The vasovasostomy may take up to two to four hours or longer if any complications arise. However, it is an outpatient procedure, and the individual need not require hospital admission.
How to Prepare for the Procedure?
The individual may be requested to shave the pubic hair in the groin area. It is advised to refrain from using an electric razor as it may cause cuts or irritation on the scrotum. Instead, the individual can use a single-blade disposable razor. To prevent infection, the individual can thoroughly wash the scrotum before surgery.
What Happens During the Procedure?
Pre-procedure:
A urologist usually performs the procedure, and the anesthesiologist discusses anesthesia options beforehand. The procedure is generally performed under general anesthesia, but local anesthesia may be preferred in a few cases.
Throughout the Procedure:
The individual is administered anesthesia and placed flat on the back of the surgical table. The urologist marks the area of the incision on the scrotum. An operative microscope provides an enhanced view of the vas deferens. Because of this, vasovasostomy is called microsurgery. The operative microscope enables the urologist to make tiny, precise cuts and stitches. During the procedure, the vas deferens are opened, which were closed during the vasectomy. After opening the vas deferens, the vasal fluid is checked for sperm, and if sperms are found, the urologist performs the vasovasostomy. If there are no sperms found in the vasal fluid, then the urologist may perform a vasoepididymostomy.
Post-procedure:
The site of the surgery is covered with bandages. The individual may experience discomfort, pain, soreness, and swelling when the anesthesia wears off. If severe, contact the health care provider immediately. Painkillers may help in easing the pain. Wearing scrotal support garments such as jockstraps may be advised. The individual is advised to abstain from sexual intercourse and other vigorous physical activities until a few weeks or as suggested by the health care provider.
What Is a Vasoepididymostomy?
Vasoepididymostomy is also a procedure done for vasectomy reversal. This procedure is performed when there are blockages in the epididymis. The blockages occur post-vasectomy when the is no longer able to absorb the sperm cells, which creates pressure on the epididymis and vas deferens. Vasoepididymostomy is performed to create a bypass to the blockage.
What Are the Advantages of Vasovasostomy?
Vasovasostomy is a safe procedure with no or little complications.
The advantages include the following:
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The chances of conceiving through sexual intercourse are higher.
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Recovery after vasovasostomy is similar to recovery after vasectomy.
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No requirement for additional surgeries to increase the chances of fertility.
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The vasovasostomy procedure is cheaper than fertility treatments such as in-vitro fertilization.
How Is the Recovery Period After Vasovasostomy?
The person will feel better two days after the procedure. Individuals are advised to abstain from sexual activity, including masturbation, for two to three weeks. If not, it may lead to complications such as ripping off the stitches, infection, and pain. While bathing care should be taken of the surgical site, it should be kept clean and dry.
Conclusion
Vasovasostomy is the surgical reversal of a vasectomy procedure. Changing the mind after the vasectomy procedure is quite common. Discussing the options with the healthcare provider and spouse helps choose the best option.
