Microscopic Vasectomy Reversal (reverse vasectomy)

Melbourne Urology Centre offers microscopic vasectomy reversal treatment in Melbourne to local and interstate patients. Your case will be thoroughly evaluated including discussion of other appropriate management options. We also have close affiliation with fertility clinics for those patients that are better suited to Assisted Reproductive Techniques (ART)/ IVF.

• Minimally invasive reverse vasectomy
• Able to have multiple conceptions if successful and desired
• More cost-effective than assisted reproductive techniques (ART)
• Allows natural conception
• Ease of sperm retrieval for ART in future if necessary

• Detailed pre-operative consultation to evaluate patient suitability for the procedure
• Reverse vasectomy is performed under general anaesthesia
• An incision is made in the scrotum and the vas deferens is identified on each side and delicately separated from surrounding tissue
• Depending on intra-operative findings a decision is made whether to perform vaso-vasotomy or vaso-epididymostomy. The latter is a more complex procedure, performed if no semen back-flow is identified when the vas deferens is cut close to the testicular end. A high powered microscope with up to 40 times magnification is used
• The wound is infiltrated with local anaesthetic and absorbable sutures are used to close the skin
• Protective spray and supportive dressing is applied
• Most patients will have day-case surgery although some will require overnight stay
• Strenuous activity and sex should be avoided for 6 weeks. Scrotal support with firm-fitting underwear is recommended for two weeks
• After a successful microscopic vasectomy reversal, sperm will again be present in the semen allowing for possible subsequent pregnancy

• During the first 48 hours, supportive underwear and dressings should be left intact. This can then come off and the sutures do not need to be removed but may take a few weeks to dissolve
• As the local anaesthetic wears off, the pain may increase over the first 24 hours but this subsides after a few days. Patients can return to light duties at work after a week
• Any activity that may pull on testes/scrotum should be avoided for six weeks; this includes sports/running and any other strenuous activity
• Sexual activity should be avoided for six weeks

• Follow up for semen analysis is performed after 8-12 weeks
• Viable sperm may take up to a year to appear. The presence of sperm does not guarantee successful pregnancy due to sperm antibodies, poor quality sperm and female partner sub-fertility

• Scrotal bleeding / haematoma
• Chronic testicular pain is uncommon but can happen after any scrotal surgery
• Infection and wound complications are rare

What to expect:

• Bruising and swelling may be present on the skin
• Minor bleeding may be present from the wound. You can wear a light pad in your underwear if necessary
• Scrotal discomfort should resolve within 1-2 weeks
• Suture material is dissolvable and may take a few weeks to dissolve.

Return to activity:

• Driving – no driving for 24 hours
• Work – you will require some time off work; the duration will depend on your occupation. Generally, you may return to light duties after 24-48 hours
• Lifting – avoid heavy lifting for a week following your procedure to minimize secondary bleeding
• Activities – walking is fine and encouraged following your procedure, however you should avoid strenuous activity for four weeks following your procedure
• Sex – avoid ejaculation for six weeks following surgery, to allow the join (anastomosis) to heal
• You can shower after 24 hours but avoid soaking in the bath for at least one week. Your wound must remain clean and dry.

Pain Management:

You may take ibuprofen or paracetamol if you are experiencing discomfort.

FAQ:

How long before I am fertile?

When a reversal is successful, sperm may appear in the semen within a couple of months, but in some cases it can take longer. The presence of sperm in the ejaculate does not guarantee pregnancy and in successful cases may take one year to achieve

Call our rooms if:

• You have severe bruising or swelling- this may be due to secondary bleeding
• Fevers, chills or shakes (may indicate infection)

Follow-Up Information:

Our rooms will contact you to arrange a follow-up appointment with your urologist, typically 6-8 weeks after your procedure

Your follow-up appointment is on: ____________________ at __________________.

Contact Information:

If you have any questions or concerns that are not addressed here or in the procedure information available on our website melbourneurologycentre.com.au contact our rooms on 1300 702 811 or [email protected]

Post-Operative information for this procedure can be found here: Microscopic Vasectomy Reversal (reverse vasectomy) Post-Operative Care Instructions

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

Sharlip, I.D., Belker, A.M., Honig, S., Labrecque, M., Marmar, J.L., Ross, L.S., Sandlow, J.I., Sokal, D.C., (2012), Vasectomy: AUA Guideline, The Journal of Urology, 188(6), [ [https://www.auajournals.org/doi/full/10.1016/j.juro.2012.09.080], accessed 19/02/21.

Urology Care Foundation, (2021), Vasectomy Reversal, [https://www.urologyhealth.org/urology-a-z/v/vasectomy-reversal], accessed 28/02/21.