FAQ - Post-op Information
Following vasectomy reversal, common recovery includes:
- Limiting strenuous activities for 8 weeks (see below)
- No penetrative intercourse for 4-8 weeks
- Pain for a few days to weeks (simple repair) or weeks to months (complex repair)
- Time off of work will depend on the activities required at work
Your recovery time will depend somewhat on whether a simple (vasovasostomy) or complex (epididymovasostomy) repair was performed. Typically, you will experience discomfort similar to your vasectomy with the simple repair, while the complex repair can be sorer and can last for weeks or months. Chronic (long-term) pain is rare and is most often related to factors other than the reversal (baseline pain, referred pain from lower back injury, etc.)
One of the most important things to optimize your chances for success is to limit strenuous activities for 8 weeks following the surgery. That includes anything that pulls on the vas, such as arching your back, reaching up high, twisting, bending, performing lunges, coughing, sneezing, tightening your stomach muscles (such as is needed to lift something), penetrative intercourse, jogging, and so on. For the first 8 weeks, the surgical site is still healing, and so you will need to take it as easy as possible to give yourself the best chance of success. THE MOST COMMON SOURCE OF FAILURE POST REVERSAL IS THE TWO ENDS PULLING APART!
To limit the risk of the ends pulling apart, you should avoid penetrative intercourse for 4-8 weeks. At 4 weeks, the male can be on top or side with very gentle intercourse (avoid anything that pushes or pulls on the scrotum). At 8 weeks, the female partner can be on top. Ejaculation can occur and is encouraged as early as 1-2 weeks to keep the sewed tubes open.
A common question that couples often have is, "how much time will I need to take off work?" The answer to this will depend on what is required with work. If your occupation requires you to perform any of the activities listed above, you are better off taking up to 8 weeks to recover. If you are able to perform desk duties, you may return sooner. Although returning to strenuous activities earlier is not dangerous to your health, it may cause the reversal to fail.
Post-operative instructions include the following:
- Activity / lifting restrictions
- Time off of work
- Pain control
- Evaluating for signs of infection
Following reversal, patients are recommended to do everything they can to limit the amount of activity that they do for 8 weeks. As described in the section under "Why do vasectomy reversals fail," the main cause of failure of a reversal (assuming it was performed correctly) is the two ends pulling apart. Numerous activities can put strain on the vas deferens, including arching your back, reaching up high, twisting, bending, performing lunges, coughing, sneezing, tightening your stomach muscles (such as is needed to lift something), penetrative intercourse, and jogging, among others.
The area that was sewed back together also takes a significant amount of time to fully heal. The weakest stage is generally the first 3 weeks after surgery. By 4 weeks, the wound has typically healed by 60-80%, while at 6-8 weeks, it is generally 90-95% healed.
Time Off of Work
The amount of time needed off of work will depend on how much activity is required with the occupation. In general, a desk job may be resumed as early as a few days after surgery. More strenuous work may require 8 weeks to optimize the chances for success. This is ultimately a judgment call, but the key thing to assure a successful result post-operatively is limiting the amount of activity for a full 8 weeks to allow the area to heal completely
The amount of pain following surgery depends if a simple (vasovasostomy) repair or a complex (epididymovasostomy) is required. The simple repairs typically are only slightly more uncomfortable than the original vasectomy in most cases. Whereas the complex repair (if performed correctly) is often much more uncomfortable.
Some complications after surgery can cause post-operative pain as well. A hematoma is a blood collection that can occur after surgery. This will resolve on its own over time and is not dangerous, but it can take up to 2 months or more to fully resolve. Although this is not always avoidable, the chances for a hematoma can be reduced by avoiding trauma to the scrotum (4 year-olds punching the area and dogs are the most common in our experience!). Also, you should avoid heat such as with a bath or hot tub, as this can dilate veins in the scrotum.
Most men will take Tylenol or Ibuprofen after surgery for about 1 week. A prescription for stronger pain medicine will also be provided though, in case the Tylenol and Ibuprofen are not adequate.
Post-operative infections are uncommon but do occur on occasion. Typically, symptoms of an infection will begin to occur 5-7 days after surgery and may include worsening of scrotal pain, redness, warmth, drainage, or other similar symptoms. Post-operatively, you will be given phone numbers to contact if you experience any of these symptoms.
Although no one knows when the optimal time to begin ejaculating following reversal, we typically recommend starting two weeks after surgery and continuing regularly until at least 8 weeks after surgery. Penetrative intercourse may be resumed with the male on top (very gently) at 4 weeks, but the female should not be on top until 8 weeks. This is done to avoid strain on the area that was sewed back together.