Vasovasostomy

Vasovasostomy is a surgical procedure that reverses the interruption of the seminal tract that occurs after a vasectomy . It is the only medical or surgical procedure that can reverse the effects of a vasectomy. Only with vasovasostomy can we regain fertility and have more children without resorting to other alternatives such as assisted reproduction.

Three months after a vasectomy, when the semen analysis becomes negative, the patient ceases to be fertile. Over time, some men choose to have the vasectomy reversed to regain their ability to father children.

Pre-operative preparation for a vasovasostomy

Vasovasostomy does not require any special preoperative preparation. The required preoperative tests include an electrocardiogram, blood work, and a chest X-ray, in addition to an evaluation by an anesthesiologist.

No special precautions or procedures are necessary before surgery. Urologists generally prefer to shave the scrotal and genital area themselves, so we usually do this in the operating room, and the patient does not need to do it beforehand.

How is the surgery?

Vasovasostomy is performed under local anesthesia, although depending on the patient's preference or if we think the procedure may be very long, alternatives such as sedation can be offered.

A scrotal incision is made, and the structures of the inguinal cord are dissected until the severed ends of the vas deferens are located. The vas deferens are the tubes responsible for transporting sperm from the testicles to the prostate gland and seminal vesicles.

Once located, the testicles are dissected and revived to obtain healthy tissue. Subsequently, microsurgical suturing is performed using very fine material in several layers until seminal continuity is restored. This procedure is performed on both testicles.

How is the postoperative?

Post-operative recovery from vasovasostomy is usually outpatient in most cases. The use of a scrotal support is common to minimize hematoma and pain after the procedure. Bladder catheterization is not required.

After surgery, the patient is taken to a recovery unit where we ensure they are properly acclimated to their post-operative environment and that there are no immediate complications. After a short time, they are usually able to leave on their own. It is generally advisable to have someone accompany you to the hospital.

The most common complication of vasovasostomy is pain, as bleeding and infection are very rare. To limit pain, as mentioned earlier, a scrotal support or supportive underwear is usually worn during the first few weeks. Additionally, the use of common anti-inflammatory medications is generally recommended. If inflammation and pain are present, indirect local cold therapy can be applied.

In any case, while vasovasostomy is a very complex procedure requiring advanced technology and surgical skill, it typically does not have a long or complicated recovery period. Physical and sexual activity can usually be resumed within a few weeks.

Your urologist will tell you how to perform the semen analysis tests to evaluate the success of the treatment.

Results

Vasectomy is a surgical procedure with a virtually 100% success rate. In contrast, its reversal—vasovasostomy—has success rates closer to 50%. Several factors can influence the outcome, such as the surgeon's experience, the use of a surgical microscope, the patient's age, and the time elapsed since the vasectomy.