Empowering Choices: The Vital Role of Pre-Vasectomy Reversal Counseling

If you are considering a vasectomy, it is important to understand the procedure and all the factors worth considering. Storing sperm before you undergo the procedure is a good idea, because nearly 20 percent of men change their minds after having a vasectomy, deciding that they do want to father a child (or another child) after all. Cryopreservation of sperm is available, and can facilitate sperm storage. Still, many men decide they want to undergo a vasectomy reversal, and this option is not only viable, but much more successful than it has been in years past. Here, we offer some information to help improve your understanding of vasectomy reversal options and the importance of pre-reversal counseling.

The Process of Vasectomy Reversal

Somewhere between two and six percent of American men will undergo a vasectomy reversal. Vasectomy reversal is done using microsurgery, and there are two different types of reversal used: vasovasostomy (VV) or vasoepididymostomy (VE). These procedures were first used in the early 20^th century, but have improved by leaps and bounds since then, and have a much higher success rate now than they had even a few decades ago. So, why is counseling for vasectomy reversal so important?

Importance of Pre-Vasectomy Reversal Counseling

Vasectomy reversals are safe and effective, but they are not something that patients should enter into without careful consideration. Rather, the process should be thoroughly discussed with a qualified vasectomy reversal surgeon, to ensure that the patient understands the procedure. Pre-vasectomy reversal education should start with statistics regarding success rates, and should also involve explanations of the different surgical techniques that could be used. For a VV, the surgeon makes a small incision in each side of the scrotum, then removes scar tissue, flushes the vas deferens, and checks for sperm. If the fluid is clear, or sperm are present, the surgeon will then carefully connect the ends of the vas deferens, which was cut during the vasectomy. If the fluid is not clear, but is pasty and thick, the surgeon will switch gears and perform a VE procedure instead. This typically happens when the vasectomy happened over 10 years prior to the vasectomy reversal, or there is scar tissue blocking the epididymis. In a VE procedure, the vas deferens is connected to one of the tubules on the epididymis, located behind the testicles. This is a more complex procedure, because the epididymis is attached to the testes, so the testes will need to be removed from the scrotum before the epididymis and vas deferens can be connected. It is a technically demanding surgery, requiring the skills of an experienced microsurgeon.

Evaluation Before Vasectomy Reversal

In addition to counseling the patient on the types of procedures, the doctor will need to evaluate the patient’s baseline fertility, because if a man had difficulty with conception before the vasectomy, infertility is likely to remain a problem. If the patient has a history of hernia repairs or other pelvic surgeries, the doctor may need to perform an intraoperative vasogram. Patients should also be made aware of the option of intraoperative sperm extraction and cryopreservation, especially for couples who have lower fertility potential. If a man requires a bilateral EV, cryopreservation with intraoperative sperm extraction may be the right option.

Commonly Asked Questions Pre-Vasectomy Reversal

• What is the likelihood that the vasectomy reversal will be successful? The success rate for a VV procedure is fairly high. It drops somewhat if you have to have a VE procedure, or if your vasectomy is more than 10 years old. Still, the success rate is between 60 and 95 percent.
• Does a vasectomy ever result in nerve damage? Sometimes, pain from nerve damage can happen after a vasectomy, so it is important for a patient to have a full workup before a vasectomy reversal, to determine whether the pain can be resolved.
• How is vasectomy reversal surgery performed? Typically, vasectomy reversals are performed as outpatient surgery, under general anesthesia, though you and the anesthesiologist will determine the best option for your anesthesia together. The surgery will take between two and three hours, and when you wake up, you will probably not have too much discomfort, because you will have been given a long-lasting local anesthetic.
• How long does it take to recover from a vasectomy reversal? It can take anywhere from five to 14 days to feel like yourself again after this procedure. It is recommended that you avoid sexual intercourse and heavy lifting for the first four weeks after the surgery.
• Is there anyone who shouldn’t have a vasectomy reversal? Some patients are better candidates than others. If the patient’s partner has had a tubal ligation, though, it is probably better to try surgical sperm retrieval and IVF, rather than trying to have a vasectomy reversal and a tubal ligation reversal.
• Does a vasectomy reversal cause any side effects? Usually, side effects from a vasectomy reversal are minimal, and include swelling, pain, or bruising. Neither the vasectomy or the reversal should impact potency or urinary function.
• Does vasectomy reversal carry a cancer risk? While there was a report several years ago linking vasectomies with prostate cancer, but this report has been largely disproven. There is no evidence connecting vasectomy reversal to a higher cancer risk.
• Is there an age limit for a vasectomy reversal?
• How can one find the right surgeon for this procedure? Look for an experienced surgeon who performs reversals regularly and has special training in male fertility and men’s health.

Center for Vasectomy Reversal Cares About Men’s Health

At the Center for Vasectomy Reversal, men’s health is our priority. We pride ourselves on helping men improve their health and fertility through uncompromising, concierge-level patient care. Dr. Green and his team provide state-of-the-art treatment for men who need a reversal of their vasectomy or have other fertility concerns. Having had extensive training in urology, microsurgery, and vasectomy reversal, Dr. Green founded the Center for Vasectomy Reversal to provide the highest level of patient care while delivering optimal surgical results. To learn more about how our experienced team can help you reach your reproductive goals, contact us through our website or call 941-894-6428.