Complications are rare in this low-risk procedure. Discuss any possible problems or your concerns with your doctor.
What are the general risks?
Any surgery carries some degree of risk, but vasectomy reversal (vasovasostomy) is a comparatively low-risk procedure and complications are uncommon. Discuss any concerns and risks associated with vasectomy reversal with your physician.
It is important to note that vasectomy reversal carries a slightly greater degree of complications and risks than does vasectomy. This is because of a longer time in the operating room, which can mean an increase in risk of bleeding and infection.
Like vasectomy, vasectomy reversal does not protect against sexually transmitted diseases or AIDS.
What are some of the risks?
Allergic Reaction: Rarely, some men may experience itching and hives, as an allergic reaction to local anesthetic.
Anti-sperm Antibodies: These are proteins that can inhibit the function and movement of sperm. They have not been shown to cause any other physical harm to the body.
Bleeding: Painless bleeding may occur following vasovasostomy and collect under the skin, so that the penis and scrotum appear bruised and/or swollen. The scrotum skin is very thin, which may make bruising appear more serious than it appears, but is a normal reaction after vasovasostomy.
Body Ache: A normal potential reaction to anesthesia and surgery.
Constipation: A normal potential reaction to anesthesia and surgery.
Decline in Sperm Count: Approximately 10 percent of men experience deterioration in sperm count when followed for at least two years after successful vasectomy reversal. In some cases, the sperm count can go to zero. This may be caused by scar tissue formation due to sperm leakage at the surgical site, or from blood supply disruption. It is usually unpredictable.
Failure: Before advances in microsurgery, vasectomy reversal was only occasionally successful. Recent studies on microsurgical vasectomy reversal indicate that sperm appears present in up to 85 to 97 percent of all men following this surgery. About half of all couples subsequently achieve pregnancy. Some men may have conditions which result in a decline in their sperm production, such as varicoles (abnormal veins in the scrotum ), or an interval infection, injury or toxic exposure, or even the development of a hormone imbalance since the conception of thier last child. Consequently, they may have poor sperm production which results in poor semen test results and lack of successful natural conception despite a technically excellent reconnection. Such a situation is very difficult to reliably identify prior to surgery, or even at the time of surgery. For some of these men, artificial insemination may enable them to achieve a pregnancy without the need for invitro fertility.
Headache: A normal potential reaction to anesthesia and surgery.
Hematoma: Bleeding inside the scrotum that results in painful swelling may follow a vasectomy reversal. While seldom serious, it should be reported to a physician. This may result in a more prorolonged recovery, but will usually resolve over time without additional drainage procedures. Resuming activity too much too soon is the leading cause for a hematoma. Follow the recommendations listed under Postoperative Pain.
Infection: If blood collects under the skin after a vasectomy reversal, it can become infected, and may result in painful inflammation. Infection of the incision site or deeper tissue, occurs in less than 5 percent of all cases. Such infections respond favorably to antibiotic treatment, antimicrobial creams and/or hot baths, usually within a week.
Long-term Testicular Pain: Postoperative testicular pain lasting longer than three months can be considered long-term pain. Persistent testicular discomfort is rare.
Nausea: A normal potential reaction to anesthesia and surgery.
Postoperative Pain and Swelling: Some degree of scrotal pain or ache is normal following a vasectomy reversal. The use of acetaminophen (Tylenol®), with or without codeine or Vicodin, is usually recommended in the immediate post operative periodrather than aspirin or ibuprofen, which can cause bleeding. Several days after surgery; however, a course of ibuprofen may quicken the total recovery time and help diminish swelling and soreness. Significant discomfort normally disappears within a day or two, while a mild to moderate ache may remain a few days longer. Your doctor may recommend ice packs every half hour for the first postoperative day. A scrotal support may be required for up to a month after surgery, and strenuous activity is frequently postponed for up to four weeks.
Testiclar Atrophy: Rarely, injury to the blood supply of the testicle may result in permanent damage to that testicle resulting in scarring and fibrosis and diminished sperm and testosterone production (atrophy). In most cases, the hormone and sperm production from the uninjured testicle would suffice.
Prostate and Testicular Cancer: There is no known increased risk of testicular or prostate cancer following vasectomy reversal. However, physicians agree that all men over the age of 50 should have regular prostate examinations and PSA blood testing.
Sexual Difficulties Occasionally a man may experience sexual problems with vasectomy reversal, but these almost always have an emotional basis, and may be due to the emotional stress placed on sexual relations to achieve pregnancy. Counseling of the couple experiencing difficulty usually alleviates the problem.
In Summary:
- A vasectomy reversal is generally considered to be low-risk, and complications are usually rare.
- Any surgical procedure carries some risk.
- Some pain and discomfort may be expected, and this normally decreases and disappears within days, given routine postoperative care.
- It's important to review possible risks and complications with your physician.
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