What is Vasovasostomy

Vasovasostomy is a surgical procedure that reverses a vasectomy. During the procedure, an incision is made on both sides of the scrotum and the ends of the sperm ducts (vas deferens) are reconnected. This is done to restore the flow of sperm from the testicles to the semen.

In most cases, this surgery is successful, meaning that there is sperm found in the semen after the surgery. The success rate of this procedure depends on the amount of time between vasectomy and vasovasostomy.

The shorter the time between the two procedures, the higher the chance of success. This procedure is usually done at an outpatient surgical center.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Any chemotherapy or radiation you have had.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding inside your scrotum (hematoma).
• Allergic reactions to medicines.
• Testicle shrinkage (testicular atrophy).
• Continued testicle pain after surgery.
• Failure to have sperm in your semen after surgery.
• Scarring of your sperm duct, resulting in a blockage (stenosis).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be given antibiotic medicine to help prevent infection.
• Your health care provider may examine your testicles to make sure they are a normal size.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • The skin around your scrotum will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• An incision will be made near the site of your vasectomy, on one side of your scrotum.
• The cut ends of your vas deferens will be located, and the closed ends will be removed.
• A microscope will be used to check for sperm in the part of the vas deferens that is connected to your testicle. If sperm is not found, your surgeon may make another incision higher up in your scrotum and check for sperm there.
• After sperm is found, an operating microscope will be used to reattach the ends of your vas deferens with small stitches (sutures).
• After your vas deferens is reconnected, your incisions will be closed with small sutures or clips. A small bandage (dressing) may be placed on your scrotum.
• The procedure will be repeated on the other side of your scrotum.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will have pain and soreness at the incision areas. You may be given pain medicine for this.
• You may be given scrotal support to wear, such as a jock strap or underwear with a supportive pouch. This raises your scrotum to help reduce discomfort.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Vasovasostomy is a surgical procedure that reverses vasectomy and restores fertility by reestablishing the flow of sperm.
• The success rate of this procedure depends on the amount of time between vasectomy and vasovasostomy. The shorter the time between the two procedures, the higher the chance of success.
• During the procedure, a microscope is used to help reconnect the ends of the sperm ducts (vas deferens) that were cut during vasectomy.
• After the procedure, you may be given scrotal support to wear, such as a jock strap or underwear with a supportive pouch. This raises your scrotum to help reduce discomfort.

Vasovasostomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have pain and soreness around the incision area.

Follow these instructions at home:

General instructions

• Do not ejaculate or have sex until your health care provider says it is safe. You may need to wait 3–4 weeks before resuming sexual activity.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Driving

• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths until 48 hours after the procedure, when you may be able to start taking showers.
• Do not shower while wearing your scrotal sling (if your health care provider says you may take showers).

Incision care

• Wear your scrotal support at all times, except when in the shower. This is important. You may be given a jockstrap or underwear with a supportive pouch (scrotal sling). You may need to wear the scrotal support for up to 6 weeks. After that, you may only need to wear it while exercising.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or more pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.

Managing pain, stiffness, and swelling

• If directed, put ice on the incision area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Activity

• For 2–3 weeks or until your health care provider says it is safe, avoid exercise and activities that take a lot of effort or put strain on your surgical area. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

Contact a health care provider if:

• You develop new pain.
• You have redness, swelling, or more pain in your scrotum.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• There is pus or a bad smell around your incision.
• You have a fever.
• You have problems urinating.
• You have nausea.
• You have pain in your abdomen.
• You have pain or swelling in your testicles.
• Your testicles seem smaller.

Get help right away if:

• You have severe pain that does not get better with medicine.

Summary

• After the procedure, it is common to have pain and soreness around the incision area.
• Wear your scrotal support at all times, except when showering (if you are told that you can shower).
• Do not ejaculate or have sex until your health care provider says that this is safe.
• If directed, put ice on the incision area to help with pain and swelling.
• For 2–3 weeks or until your health care provider says it is safe, avoid exercise and activities that take a lot of effort or put strain on your surgical area. Ask your health care provider what activities are safe for you.