Vasectomy Ligation Reversal

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When a couple decides not to have more children, despite the safe, permanent contraceptive methods of birth control, many men opt for vasectomy surgery that allows for simple and efficient male sterility. With the advancement of reproductive medicine, it is possible to reverse this situation.

The vasectomy reversal is a surgical procedure performed through a small opening in the scrotal. With the aid of a microscope, we perform the realigning of the channel (vas deferens) ligated in the vasectomy. The anesthesia is applied by means of rachidian blocking and the patient is discharged on the same day. This method does not subject the woman to any treatment. The chances of multiple pregnancy drop and of conception occurring naturally increase.

What is vasectomy? What is the procedure?

Vasectomy, also called deferentectomy, is a surgical method of contraception created by blocking the sperm output. With this procedure, which is quick and safe, man becomes sterile. The male genital organ has a canal leaving the organ adjacent to the testicle, the vas deferens, responsible for disposing of sperm. Vasectomy closes this channel and prevents the passage of gametes for semen. The operation lasts about 20 minutes and does not require hospitalization.

In Brazil, according to article 10 of Law 9263, the patients must be at least 25 years old and father of at least two children to perform the procedure. Is it true?

Yes. It is necessary that the patient be 25 years old at least and have two living children.

Can it be reversed?

In most cases yes, but it is important to ensure the conditions in which the surgery was performed. It is not possible to define precisely because the procedure is performed by another doctor. It is important to advise the patient that the longer he waits, the greater the risk of reversal failure. Therefore it is necessary to take into account the years that have passed since the surgery until the time of reversal.

What are the chances of success?

The best results occur when the reversal is done with less time. In cases where the procedure is performed in up to three years, the chances of obtaining spermatozoa at ejaculation is 90% and non pregnancy is is the order of 76%. After this period and up to eight years, the opportunities for reversing falls to 53%, from 8 to 14 years, 44%, from 14 years, 31%. There is always risk of failure. For this reason, the sooner the patient decides to do the reversal, the better.

How is the reversal done?

Microsurgery is considered the most efficient technique. Reconnecting of the vas deferens that was cut with the aid of microscopes, delicate forceps, suture materials and latest generation microscope.

How long after vasectomy can tests be conducted to check if the procedure worked?

It is estimated that it can be done in approximately two months, the equivalent of between 15 and 20 ejaculations.

How long after surgery can one resume sexual intercourse? Does the procedure interfere with male sexual performance?

A man can resume sexual intercourse in a week on average, or after the stitches fall off. The operation does not interfere with performance during intercourse.

What are the necessary precautions before performing the vasectomy reversal?

The patient must undergo a pre-operative procedure with a series of tests to check for diseases like hydrocele, varicocele, hernia or tumor of the testis, so that they are treated firstly. Furthermore, it is essential that there be eight hours fasting.

What is the role of assisted reproduction in the reversal technique?

Where there are complications (secondary obstructions, inflammatory important, etc.), which makes the procedure more complicated, reversal is recommended through the use of specific techniques of sperm puncture in assisted reproductive treatments. Through PESA, gametes are recovered directly from the testes and then injected into the oocyte.

After how long could the partner conceive?

From the first sexual intercourse.

The main reason of men resorting to reversal is the possibility of having other children within the second or third marriage?

Mostly to enable the man to be a father again. There is also the possibility of reversion due to pain generated during ejaculation. It is very rare but it can happen.