North Bay Ontario

Vasovasotomy

A Vasovasotomy (also called a vasectomy reversal) is a procedure where the vas deferens (the tube that carries sperm from the testicles to the urethra) has been previously intentionally cut, clipped and cauterized to achieve permanent sterility as a form of permanent male birth control.  A vasovasotomy is performed to re-attach the previously cut ends of the vas deferent to allow sperm to travel from the testis to the urethra during ejaculation, making the man fertile again.  

This is done by making a small hole in the scrotal skin.  Through this hole the two cut ends of the vas deferens is then identified and delivered.  Once the cut ends of the vas deferens has been isolated they are prepped and then with the assistance of a large, specialized surgical microscope a microscopic anastomosis is created to bring together the two cut ends.  This is then repeated on the other side.    

The Procedure

Please arrive at the outpatient unit on time. You can expect to be at the hospital for several hours; however the surgery itself will last between 2-3 hours.  

Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

Vasovasotomy is a very safe procedure, however, the risks do include anesthetic complications such as adverse drug reactions or even death.  Specific to the surgery, blood loss and the need for a transfusion are an extremely small risk.  Hematoma and blood pooling in the scrotum is a common occurrence and can be mitigated by not performing any heavy physical activity in the days following the procedure.  Surgical wound infection can occur and may require treatment with antibiotics if this were to occur.  Prolonged scrotal tenderness can occur rarely.  Surgical failure rates depend on how long it has been since the previous vasectomy.  Success rates for vasovasotomy range from greater than 90% to less than 30%.  This should be discussed prior to deciding to proceed.   

When you arrive

Due to the need for microscopic anastomosis, vasovasotomy is performed under a general anesthetic in most cases.  You should not experience any discomfort during the procedure.  To optimize fertility results, the procedure must be repeated on both sides.

After Vasectomy

After your vasovasotomy you will be able to resume light activities including driving within a few days.  Heavy lifting, physical exercise, and sports, should be refrained for a minimum of 3-4 weeks.  We will test your sperm count ~ 3 months after the procedure to look for the presence of sperm in the ejaculate.  Depending on the sperm counts following the procedure will help to determine how successful the procedure was.  Some patients will still require some form of reproductive assistance following vasovasotomy.

When Should I Call my Doctor?

You should contact our office if significant pain persists for more then a few days, if you are having a hard time passing your urine, or if you develop a fever.  If there are any signs of infection, such as significant redness, tenderness, the presence of pus at the wound site, or fever, seek medical attention.  

Q&A

1. What are the success rates?

     Vasovasotomy rates vary greatly.  The success rate is due to a number of factors such as how long ago the vasectomy was performed, how old the patient is, and what technique was used for the vasectomy.  We will do our best to provide you with a reasonable success chance given your specific factors to aid you in the decision making process.  While surgical reversal of vasectomy can be performed, there is no guarantee of success and it is NOT covered under OHIP, as such, we advise patients to be as certain as possible before proceeding.  

2. Will it hurt?

     The procedure is often described as somewhat uncomfortable.  If it common to take pain medication for a few days following the surgery. 

3. How long will it take?

     The procedure length is usually between 2-3 hours to complete both sides.

4.  Will my sex drive be effected?

      No.  Vasectomy removes the passageway for the sperm to travel from the testicles but it has zero effect on the male hormones released by the testicles.  As such, other than the short term discomfort associated with the procedure, no long term effects should be had on your sex drive. Vasovasotomy simply reconnects thesse tubes.  This still has no effect on hormone production of the testicles and should not effect your sex drive in any way.  

5. How much does it cost?

     There are 3 separate fees associated with vasovasotomy.  These include 1) the hospital fee 2) the anesthetist fee 3) the surgical fee.  This is not covered under OHIP.  Typically when these 3 costs are combined the total cost is approximately 5000$.

Urology North

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