Microsurgical vasectomy reversal at Nuffield Health at St Bartholomew's Hospital

What is microsurgical vasectomy reversal?

Also known as male sterilisation, a vasectomy involves cutting both of the tubes that carry sperm from your testicles to your penis. A microsurgical vasectomy reversal is a more complicated procedure to reconnect the tubes.

What are the benefits of a microsurgical vasectomy reversal?

Rejoining the tubes should allow sperm to mix with your semen, making you fertile again.

Some men have the procedure to treat testicular pain due to their vasectomy.

Is a microsurgical vasectomy reversal right for me?

• Deciding to have children, or more children
• A new marriage
• Losing a child.

What are the chances of success?

• scar tissue forming where the tubes are joined, blocking the sperm
• the quality of your sperm not returning to normal
• not being able to produce sperm due to complications.

What happens during microsurgical vasectomy reversal?

Vasectomy reversal is performed under general anaesthetic, so you'll be asleep. The procedure usually takes 1–1.5 hours.

Before the procedure

There are a few things you can do in the lead up to the procedure to make sure everything goes as smoothly as possible:

• Let your doctor know about any medication you take and follow their instructions
• If you smoke, stop smoking several weeks before the operation
• Try to maintain a healthy weight
• Exercise regularly
• Don’t drink alcohol in the week leading up to the procedure
• Have a bath or shower on the day of the operation and make sure your scrotum is clean
• Shave your scrotum beforehand, or the healthcare team will do it for you in hospital.

When you arrive in hospital, you’ll see your surgeon, anaesthetist (who’ll put you to sleep) and nurse (who’ll perform your health checks). 

During the procedure

1. Your surgeon will locate the site of your vasectomy
2. They'll usually make cuts on each side of your scrotum
3. After examining each testicle, they'll free up the tubes and remove any scar tissue
4. Using a special microscope, they'll stitch the ends of the tubes back together
5. Finally, they'll close the cuts with stitches.

After the procedure

You’ll be taken to the recovery room where you’ll wake up. A nurse will be there to check your wounds, blood pressure and pulse.

You shouldn’t feel any pain, but you might be groggy and slightly uncomfortable as you come around. When you’re ready, you’ll be taken to your room, where the healthcare team will look after you.

Recovery from microsurgical vasectomy reversal

Your scrotum may be quite sore for 1–3 weeks, but you should be able to return to normal activities after about a week.

Short-term recovery

Back in your room, you may feel some pain as the anaesthetic wears off, which you can take painkillers for.

To ease discomfort and reduce bruising, you can:

• hold an ice pack against your scrotum
• wear a scrotal support or firm underwear.

You should be able to go home the day of your procedure. If so, for the first 24 hours:

• you’ll need someone to take you home and stay with you overnight
• don’t drive, operate machinery, or do any potentially dangerous activities (like cooking) until you’ve fully recovered feeling, movement and co-ordination
• you shouldn’t sign legal documents or drink alcohol.

Managing your recovery at home

You should get plenty of rest for the first 24 hours, but then it’s important to stay active to avoid blood clots. Make sure you follow the instructions from our healthcare team on medication or special compression stockings. 

Your testicles will probably ache for a few days, so take over-the-counter painkillers if you have any discomfort. Your scrotum may also be bruised and swollen, but this will go down after about a week.

Here are a few other things you can do to help you recover:

• Carry on wearing tight-fitting underwear for a week afterwards
• Gradually increase your activity with low-impact exercises like walking
• Avoid any strenuous activity or heavy lifting for at least 3 weeks after your surgery
• You can shower, but don’t have a bath for the first 5 days
• Don't ejaculate for the first week
• Wait 3–4 weeks until you have sex.

You should call your doctor if:

• the swelling doesn't go down
• you have discharge from your wounds
• you’re still in pain after 4 weeks.

Time off work

You should be able to return to work after about a week. If your work involves strenuous exercise, you may need to stay off work for up to 3 weeks.

Follow-up appointments

About 6–8 weeks after your surgery, you’ll need to return to the clinic to give a semen sample, which we’ll examine for sperm:

• If no sperm are present, or your sperm count is very low, we’ll ask you to return for another test after 3 months, as it may improve over time
• If your sperm count was high, but you and your partner are having problems becoming pregnant, you should get another test done, as scar tissue may have formed.