Is a vasectomy reversal safe?

At some point in their lives, many men opt to undergo a procedure called a vasectomy as a way of preventing pregnancy without having to use condoms or other birth control. For most men who undergo vasectomies, they consider the decision to be permanent, but the vasectomy reversal procedure is growing in popularity and need.

The vasectomy itself involves the cutting and sealing of the vas deferens. It doesn’t prevent a man from ejaculating, it merely prevents any sperm from being present in the ejaculate. While vasectomies are quite common — with more than 50 million men worldwide having had the procedure — what has also become increasingly common is for men to choose to reverse a vasectomy by surgical means. For many, the question remains: is this safe?

Generally, vasectomy reversals are quite safe. For anyone considering this procedure, it is important to conduct some research and get educated, not only about the vasectomy process itself, but also about the qualifications and abilities of your surgical team. For instance, 30% of men were found to need an epididymovasostomy (complex repair) rather than just a vasovasostomy (simple repair), but there are relatively few doctors in the US who actually offer the complex procedure. It is not known what type of repair is needed until after the the time of surgery, therefore it is strongly recommended that men undergoing this procedure select a surgeon with the ability to perform both types of procedures.

It is also important to recognize the risks associated with any surgical procedure. Although uncommon, there are a few issues that could potentially arise from a vasectomy reversal. These complications are considered exceedingly rare, but are possible. They include:

• Anesthesia problems — Less than 1%
• Risk of surgical infection — 1-5%
• Granuloma — Less than 1%
• Hematoma — Less than 5%

Other risks include:

• Failed reversal — There are many factors involved in a vasectomy reversal, which makes predicting the overall success of the procedure difficult. Factors that influence success rate include whether you need a complex (epididymovasostomy) or simple (vasovasostomy) repair. Complex repairs have a lower rate of success. In approximately 15% of cases, individuals can see initial success, but the repair closes down over time.
• Chronic pain — Up to 3%. In the majority of cases, the man had scrotal pain prior to surgery. The reversal simply augments the pain.

For the most part, vasectomy reversals are recommended within 20 years of the initial vasectomy procedure in order to be effective. A rule of thumb: the longer a man waits after his vasectomy to have it reversed, the less likely it is that the reversal procedure will be successful. There are cases where the vasectomy reversal is successful, but sperm count remains low. This could be due to a number of reasons, whether they be poor sperm production to begin with or perhaps a reconnected site has developed scar tissue over the channels needed to combine the sperm with the ejaculate.

In any case, at least with the scar tissue issue, the problem can generally can be rectified, or at least addressed through alternate medical means.