Vasectomy

How Does a Vasectomy Work?

Can a Vasectomy Be Reversed?

Individuals and couples are strongly recommended to think very carefully whether to have a vasectomy or not. This is because the operation itself is generally regarded as a final or permanent birth control method.

However, it is now possible to reverse or undo vasectomies. Reasons for doing so may be personal (change of heart or remarriage) or, in rare cases, medical (post-vasectomy pain treatment).

Vasectomy reversal, albeit a much more complex procedure than vasectomy taking about 3 hours using a microscope, is generally safe and poses few to no complications under the skillful hands of a urologist. The success rate of a vasectomy reversal ranges from 40 to 90 percent. The longer the period between a vasectomy and reversal, the less likelihood for reversal success.

How Is a Reversal Vasectomy Done?

Vasectomy reversal is an outpatient procedure that is performed under general anesthesia. It usually takes about 2 to 3 hours using a microscope, and can be done using two methods:

• Vasovasostomy – The two ends of the vas deferens that were cut previously during the vasectomy are sewn back together.
• Vasoepididymostomy – The vas deferens is attached directly to the epididymis (tube that stores and carries sperm from the testes).

During the procedure, the vasectomy surgeon first creates an incision on the scrotum and takes a fluid sample from the vas deferens. If sperm is present in the fluid, a vasovasostomy is performed. If there is none, or if scar tissue is present in the vas deferens, which can block sperm passage, vasoepididymostomy is done instead. Sometimes both methods are performed, vasovasostomy on one testicle and vasoepididymostomy on the other, depending on which technique works best to regulate smooth sperm flow.

Once the reversal procedure is done, the incision is stitched close and the scrotum is bandaged to stop bleeding. The stitches should dissolve within 10 days. Full recovery can take up to two weeks.

Following the surgery, the patient is advised to refrain from strenuous physical and sexual activities for up to 4 weeks and wear tight underwear to prevent the incision from reopening. Cold compresses and non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce initial swelling and ease pain.

Follow-up appointments after the vasectomy reversal will enable the vasectomy doctor to check the patient’s semen for sperm. Under normal circumstances, sperm should appear in the semen after a few months or within a year.

Dr Michael Wong is a medical director and senior consultant Singapore urologist specializing in the complex medical areas of male and female fertility, and female bladder and pelvic floor issues. He is also known for his success in reversal vasectomies. For more information or appointments, please contact our 24-hour hotline at (+65) 6535 8833 or message us at email@drmichaelwong.com.