About the Procedure
A vasectomy is when the tube that transports sperm from the testicles is cut and blocked.
During a vasectomy reversal, these tubes are reconnected.
This is performed using a high-powered microscope to allow the microsurgeon to precisely sew the two ends back together while keeping the hollow part of the tube open.
The tiny stitches reconnect the perimeter of the vas tubes to permit sperm to travel through them again.
The goal is to reconnect your tubes, so sperm can flow to the semen and allow you and your partner to become pregnant.
Possibility of Secondary Blockage
When a vasectomy is performed, the tube carrying the sperm called the vas deferens, is blocked. However, the testicle continues to make sperm, and this can lead to a pressure build up in the storage tubes called the epididymis.
In some men, these very small tubes may rupture and create another blockage. The risk of this secondary blockage increases over time.
If this occurs, a regular vasectomy reversal will not work, and a more delicate connection is required for success.
This is diagnosed at the time of vasectomy reversal. The surgeon may examine the fluid in your tubes using a special microscope to determine which procedure is needed specifically for each testicle to optimize your chance of success.
Multiple Vasectomy Reversal Techniques
For a typical vasectomy reversal where the two ends of the tubes are to be reconnected, the multi-layer microdot technique is used. This technique has a high reported success rate in the medical literature. This technique can be used in the majority of men undergoing vasectomy reversal. Success rates are over 90% for this technique.
If the doctor determines that a secondary blockage is present in the epididymal tubes, he will perform an intricate procedure connecting the vas deferens tube, to one of the smaller epididymal tubes.
The LIVE technique is generally used in the case of a secondary blockage, which for this situation has a relataively high success rate in the medical literature.
This technique is successful in up to 50% of cases where a conventional reversal would fail.
Possible Risks and Complications
Often this procedure is well tolerated. However, as with all surgical interventions, potential complications may arise:
- Mild bleeding into the scrotum (~1-4%).
- Scrotal hematoma. A bleed in the scrotum that can swell to the size of a grapefruit. This can be tender and disabling for a couple months, or require a secondary surgical procedure (1-4%).
- Infection. This may be mild and require antibiotics, or more serious where an abscess forms and requires intravenous antibiotics and possible drainage (1-3%).
- Failure of procedure. In some cases, the tubes cannot be successfully joined in some cases, (1-10% if recent vasectomy; 30-50% if vasectomy is decades previous).
- Late failure of procedure. Some men may have a successful procedure initially, but the connection continues to scar and block off resulting in no sperm in the semen, (1-15%).
- General anesthetic complications.