Vaso-Vasostomy (Reversal)

Why is it done?

• To reverse a vasectomy (sterilization).
• Please bear in mind that this procedure has a 50% success rate if performed:
  • Within 10 years of the vasectomy.
  • On younger patients (<45 years).

How is it done?

• This procedure is performed under general anesthetic.
• A single incision is made on the midline raphe of the scrotum.
• Each testis and vas deference is then individually extracted through this incision.
• The defect in the vas is identified and prepared for re-anastomosis. with 6.0 Nylon
• If semen is present, these may be sent off for analysis to confirm semen viability.
• A large suture material is placed as support inside the lumen and tied outside on the skin. This will be removed in the rooms 5-7 days after the procedure.
• A dressing is then applied, which should be removed after 72 hours.
• A local anesthetic is injected around the vas deferii and into the wound, thus giving post-operative pain relief for the next 4-6 hours.
• No strenuous movements are permitted for at least 14 days.

NB! You are required to bring 2 pairs of tight new undies for post -operative scrotal support.

What to expect after the procedure?

• Any anesthetic has its risks, and the anesthetist will explain all such risks.
• Bleeding is a common complication.
• A hematoma (blood collection under the skin) may form and needs to be reviewed by Dr Schoeman as soon as possible. Bruising is normal.
• An infection of the wound can occur and requires immediate attention.
• There is a failure rate of 50%.
• Owing to the nature of the surgery and the soft skin of the scrotum, bruising may appear to be much worse than it actually is and is no cause for alarm.
• DANGER SIGNS: A scrotum that swells immediately to size of a football, fever, puss. Contact Dr Schoeman or the hospital immediately as this may occur in up to 5% of all cases.

What next?

• The dressing should be kept dry for the initial 72 hours after surgery and then soaked in a bath until the dressing comes off with ease.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• Do not tug at the sutures!
• A semen analysis will be requested 3 months after the procedure. Hopefully there will be viable sperm. The first analysis may not always be good, and a few specimens may be required.
• PLEASE CONTACT THE HOSPITAL DIRECTLY WITH ANY POST OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

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Wes Vaso-Vasostomy