While families celebrate Father’s Day this month, you may be feeling the powerful surge of paternal love. As you watch kids laugh in the sunshine or round the bases in Little League practice, your gut is telling you, you and your partner are ready for a child. But there’s one big thing standing in your way: your vasectomy.
Dr. Michael Degon, of Novant Health Urology - Wilmington, has performed hundreds of vasectomies. He said that about 5% of the 500,000 men who undergo a vasectomy in the U.S. each year will change their mind and decide they want to have a child. For these men and their partners, vasectomy reversal is an option to restore fertility.
Thinking about undergoing a vasectomy reversal to expand your family? Here he answers frequently asked questions about the procedure.
Comprehensive urology care for children and adults.
If a vasectomy is permanent, how can it be reversed?
A vasectomy involves cutting and sealing the tubes that carry sperm, the vas deferens. Degon said when he counsels patients prior to a vasectomy, he advises that they should “plan for it to be a permanent procedure.”
In cases where circumstances change and a man would like to become fertile again, a doctor can perform a vasectomy reversal, surgically reattaching the vas deferens tubes to allow sperm to travel into the semen once again. There are two different types of vasectomy reversal procedures:
- Vasovasostomy (vas-o-vay-ZOS-tuh-me) procedures account for most vasectomy reversals, Degon explained. During a vasovasostomy, the doctor will make an incision in the vas deferens tube on either side, then sew the sides back together. “This has a 90%-plus success rate. It’s pretty effective,” Degon said.
- Vasoepididymostomy (vas-o-ep-ih-did-ih-MOS-tuh-me) is what Degon describes as “a much more detailed procedure” because it involves connecting the vas deferens to the epididymis, a structure located on the back of the testicles that holds sperm. This procedure is about 60% effective.
What factors determine which surgery I need and how successful a vasectomy reversal will be?
The two factors that determine whether a vasectomy reversal will be effective are age and length of time since the vasectomy, Degon said.
“If it’s only been a couple of years since the vasectomy, it’s usually pretty straightforward. If it’s been a long time since the vasectomy, over a decade or so, then it gets a lot more tricky,” he said.
What happens after 10-plus years, Degon continued, is that over time, scar tissue builds up between the vasectomy site and the epididymis, requiring the more complex vasoepididymostomy surgery to allow sperm to reach the vas deferens. So while the latter surgery has a lower success rate by the numbers, it is sometimes the necessary avenue to ensure the vasectomy reversal is correctly completed.
During a consultation, Degon discusses both procedures. While one or the other might be more likely prior to surgery, he makes the decision at the time of surgery based on the fluid inside the vas deferens.
How much downtime should I plan for a vasectomy reversal?
Top scores for safety in NC
Novant Health received the most ‘As’ for patient safety in North Carolina from The Leapfrog Group. With a focus on safety, quality and patient experience, the national, industry-leading nonprofit, evaluates and assigns letter grades ranging from A to F to hospitals across the country. Novant Health’s hospitals with “A” grades outperform 70% of hospitals nationwide for safety and quality.
A vasectomy reversal is a “much more detailed procedure” than a vasectomy, Degon said. Whereas a vasectomy is a quick outpatient procedure requiring only local anesthesia, a vasectomy reversal is a surgery that takes, on average, two to three hours, and patients receive general anesthesia. The process, Degon explained, is much like “sewing two spaghetti noodles together.” Degon uses an operating microscope to magnify the surgical site and sutures smaller than a human hair to stitch the vas deferens back together.
For the recovery time, most men remember what it was like to recover from the vasectomy, and Degon advises that this recovery will feel similar. However, it may take a bit longer. Whereas most men go back to modified normal activities (no strenuous exercise or lifting) a few days after a vasectomy, recovery from a vasectomy reversal may take around seven to 10 days. Rest, ice and over-the-counter pain killers like ibuprofen can all help with the healing process.
Because the vasectomy reversal is performed under general anesthesia, meaning you will be asleep for the procedure, you should feel no pain during the surgery itself.
Will insurance pay for my vasectomy reversal?
Most health insurance policies do not cover vasectomy reversals, which means you will likely pay out of pocket for the procedure. There are some exceptions. Consult with your insurance provider to learn about your coverage. (This is different from the vasectomy procedure, which is covered by many insurance policies.)
How long does it take to get pregnant after a vasectomy reversal?
Following a vasectomy reversal, it will typically take at least three months for the body to produce mature sperm. It may take up to one year for sperm to “get where it needs to be,” Degon said. “Most guys at three months are successful.”
For the first two weeks following surgery, you should abstain from ejaculation to allow the surgical sites to heal. Following this healing period, it may take several ejaculations before sperm is traveling through the vas deferens again. Following vasectomy reversal, your doctor will order a semen analysis for three months after the operation to determine whether sperm are present.
What is the first step I should take if I’m interested in a vasectomy reversal?
Degon always suggests discussing it with your partner first, then scheduling a consultation at Novant Health Urology - Wilmington or Novant Health Urology - Brunswick Forest for the two of you to learn about the details of the procedure.
