BEFORE
You will be pre-assessed by our admission team before you attend for your reversal. This may be over the phone or in person depending on individual circumstances. Make sure you tell us if you have high blood pressure, heart problems, diabetes, are overweight or take any medications. We really need to know if you are taking warfarin or other blood thinning medications such as Clopidogrel (known as anti-platelet drugs).
SHAVE you pubic hairs from around your scrotum about THREE days before you attend. This allows time for the hairs to be rinsed away; otherwise they play havoc with the stitches when magnified during surgery!
ON THE DAY
You should stop eating and drinking for 6 hours before the start time of surgery. You will be asleep for the operation (known as a general anaesthetic), typically 2 hours.
Vasectomy reversal should ONLY be performed using an operating microscope. The huge magnification and better lighting provides allows tiny, tiny stitches to be placed into the tubes using a technique known as microsurgery, providing the best possible results.
The operation can take several hours.
Usually an incision is made in the middle of the scrotal sac, but if the tubes have a wide gap or they have been destroyed by heat (diathermy) at the time of your vasectomy you may need two separate incisions extending from the scrotum up towards the groin so as to provide enough length of tubing to allow a tension free join.
The tube on either side of the area where the vasectomy was made is divided and inspected to make sure it is healthy and open (patent). A fluid sample from the end of the tube closest to the testicle can be inspected using a digital microscope to make sure there are sperm present.
The operation aims to reconnect the two ends of the vas tube back together (called vasovasostomy). Sometimes it is necessary to use an area of the epididymis to connect to the vas (known as an vas0-epididymostomy).
Very fine permanent internal stitches are used to join the tubing.
Towards the end of the procedure the surgeon will place local anaesthetic into your wound and the theatre team will fit you with a ‘jock strap’ for support before you wake up. The wound (or wounds) is about 3cm long and the stitches are invisible, dissolving themselves over a few weeks.
You will be kept on the ward until you have had something to eat and drink and are happy to return home to your family.
The anaesthetist will prescribe you pain killers to take home with you. If necessary you can use additional pain killers such as ibuprofen for a few days after the short supply we give you finishes.
You will be given a brief discharge summary for when you leave but the surgeon will also write to your GP separately.
You should be able to go home that same day but cannot drive yourself home.
RETURNING HOME
As few men develop complications and, as patients often travel a long way for their operation, you will not routinely be sent a follow up visit. If you do need to return to clinic you will not be charged for any visits by the surgeon. Appointments can only be at the St Edmunds Hospital
The hospital will cover you for 30 days in the unlikely event that you need re-admission to the St Edmunds Hospital.
Wear the support supplied (or similar close fitting underwear) for 2 weeks. You can buy a spare pair from sports shops such as Sports Direct – based on your WAIST size!). The stitches dissolve on their own. If you need to use additional painkillers then use Ibuprofen. We will send you home with some that contain paracetamol.
Complications
Very few men get serious complications after surgery. You will feel tender initially and can develop bruising so do restrict your physical activity for the first couple of weeks and continue to wear your support. If you can avoid riding a bicycle for 4 weeks this can only help. We advise refraining from sexual activity for about 3-4 weeks.
It is common to feel some swelling above the testicle where the tubes were joined. Should you develop a red wound you may need antibiotics from your GP. Failing that we are happy see you and advise.
Post op semen testing
We do not check post-vasectomy reversal sperm counts sooner than 3 months after surgery.
- Should you choose to perform the test through ourselves, we will send you the paperwork to book a sperm count at the Cambridge IVF Unit. This is an accredited laboratory that specialises in fertility. You use the form to book the appointment directly with the lab. You only need to produce one sample. The results are posted to us a day or so later and we will write to you with the results directly after.
- If you wish to use a local hospital we will arrange this by writing to your GP, asking him to make the referral at 3 months.
We cannot give out results over the phone for reasons of confidentiality but will be more than happy to discuss by phone or in person any queries that arise from the results letter subsequently. Again you will not be charged for any appointment that follows should you need one.
If you chose to perform your sperm counts nearer to home and not in our local lab please tell us so we can contact your family doctor.
Our recommendations follow standard US practice
Have a look at the link below which offers a nice recovery plan, US style
Please note: currently the cost of the post-op semen test is not included in the hospital or outpatient fee. This is because we have found that most patients prefer to have the test undertaken nearer to home.
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