Patient Concerns About Vasectomy Reversal

Vasectomy Reversal Concerns
I would love to work with holes this big, says the microsurgeon (Courtesy: Unsplash.com)

She sat at the edge of her seat way tucked away in the corner of his room. Legs together and knees bobbing, she was very nervous about what was about to happen. “I feel a little guilty about putting him through a vasectomy reversal just for me,” she quipped. With an aim to reassure, I looked at her and said: “He’s doing this for both of you. I’ll take good care of him.” Concern coming from a place of love.

Gotta Love Love

We do lots of things for love. And although love guides many decisions, the resulting reality can be a source of concern and lots of questions. Here are the most common questions patients and their partners have about vasectomy reversal:

How long is the surgery?

While no-scalpel vasectomy takes only about 8-10 minutes to perform, vasectomy reversal runs anywhere from 1.5 to 3.5 hours, the average being around 2 to 2.5 hours. That’s because we place about 40 different sutures on each side for a total of about 200 knots — kinda like fashioning a handmade suit. Although lengthy, vasectomy reversal doesn’t require all that much anesthesia; certainly much less than for abdominal or robotic surgery. It’s small parts stuff. A crafty surgery.

How much pain will he/I have?

Using a digital “house call” app, I have tracked over 1,500 men daily for 3 weeks after their procedures. They average 4-5 pain pills after surgery, generally taking them within the first 2 days. They may feel discomfort for 3-4 days after that. Although they can go back to desk work as soon as they stop taking pain pills, they shouldn’t exercise or do any heavy lifting for 2-3 weeks, depending on the complexity of the surgery.

When will he/I feel normal?

“Normal” is different for everyone, but most patients stop thinking about how they’re healing after 1 week. If feeling “normal” means having sex again, then it’s more like 3-4 weeks, again depending on procedural complexity.

What can go wrong?

Lots can go wrong, but very little does. In expert hands, fewer than 1% of patients will have bleeding or infection requiring treatment. Far, far fewer than that have chronic pain. I’ve heard about but have never seen the loss of a testicle from interruption of the blood supply. But please choose a surgeon who is well-trained and experienced to avoid such mishaps, as complications are largely related to surgical skill and not bad luck.

Will it work?

This is a relevant concern. The answer has several key determinants, including patient biology and health, type of vasectomy, surgical skill, and vasectomy age. Here’s where you should plan a deep dive with your surgeon. Find out exactly what the surgeon’s experience has been. Better yet, ask if they have published their results in peer-reviewed literature, the ultimate mark of authenticity. For reference, see ours. With a vasectomy performed fewer than 15 years ago, we can get sperm back 90-100% of the time. With vasectomies performed 16-40 years ago, return of sperm occurs in 80-85% of cases.

From my own experience with thousands of cases over nearly 3 decades, I can say for certain that I will take great care of him, if that’s your concern. If you love what you do, you tend to do it well.

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