Side Effects of Vasectomy Reversal

According to the Cleveland Clinic, a vasectomy is a surgical procedure that involves blocking the tubes that sperm uses to pass into semen. Vasectomies are performed under local anesthesia and are considered outpatient surgery. The doctor finds the vas deferens, or firm carrying tubes, by feel. The doctor then uses a tiny instrument to make a small puncture in the skin and the opening is stretched. The vas deferens are then cut and tied. The procedure is relatively painless, although some men report a slight tug. By cutting off the sperm's access to the semen, vasectomies are designed to make men permanently sterile.
After a vasectomy, the body continues to produce sperm. However, with no place to go, the sperm cells simply die and are reabsorbed into the bloodstream. Because the body continues to produce sperm cells, a vasectomy is reversible. The procedure to reverse a vasectomy, called a vasovasostomy, is a bit more complicated than a vasectomy but is still considered outpatient surgery with relatively few risks.

Reverse Vasectomy Procedure

• A patient who intends to have a reverse vasectomy or vasovasostomy reports to the surgeon's office and is then anesthetized. Several different options are available for anesthesia. A patient given general anesthesia is completely unconscious. Regional anesthetics do not cause the patient to lose consciousness, but they do numb the patient from the waist down. Local anesthesia is the final option and involves injecting a drug directly into the area to numb the tissue where the surgery will be performed. Patients who choose local anesthesia are often given a sedative in addition to the injection.
  Once the patient is anesthetized, the physician makes an incision in the scrotum that is large enough to explore the vas deferens and identify the blocked area. The surgeon then removes scar tissue on the vas deferens caused by the vasectomy. The two tubes, now freshly cut from the scar tissue removal, are carefully aligned and stitched together. The tubes must be sewn carefully in order to avoid leaks or the formation of excessive scar tissue.
  Once the ends of the tube are sewn together, the vas deferens is returned to the scrotum and the small incision is sealed with stitches.

Complications

• Occasionally a vasectomy does not block only the vas deferns, but also blocks other sperm paths. For example, blockages can occur in the epididymis, the delicate coiled tube that lies adjacent to the testicles. Sperm cells mature in the epididymis, and if the epididymis is blocked during a vasectomy, excess sperm may be produced that the body is unable to absorb. This excess sperm creates pressure inside the epididymis and vas deferens, causing a leak and a subsequent blockage. This complication is especially likely to occur in vasectomies that were performed many years before the reverse vasectomy. If this complication occurs, the reconnecting of the vas deferens tubes will not be able to reverse the vasectomy.

Treatment for Complications

• If the epididymis is blocked, the surgeon must perform a different surgery called a vasoepididymostomy. In order to do this, the surgeon must connect the vas deferens tube directly to the epididymis, instead of to the severed end of the other vas deferens tubes. Because the epididymis comprises much smaller tubes than the vas deferens, this type of procedure is more difficult and has a lower success rate than a traditional vasectomy reversal.

Potential Side Effects or Risks

• Although vasectomy reversal is a relatively low-risk procedure, according to Urology Health, there are some dangers and potential side effects or risks associated with the surgery. Common side effects include a potential allergic reaction to local anesthetic, body aches and pains, constipation, nausea and postoperative pain.
  A patient may also experience bleeding at the site of the incision, which makes the penis and scrotum appear bruised or swollen. This is a common side effect and is not normally dangerous. However, occasionally infections, hematomas and painful swelling can be caused by bleeding inside the scrotum. Generally, hematomas resolve themselves without the need for drainage, but patients experiencing this side effect should consult with their physician. Infection, which occurs in less than 5 percent of reverse vasectomies, must be treated with antibiotics.
  Rare side effects include long-term testicular pain (defined as discomfort lasting three months or longer), testicular atrophy (including scarring, fibrosis and diminished sperm and testosterone production in the affected testicle), and sexual difficulties (which doctors agree may be a psychological side effect).

Success Rate

• According to the Oxford Journals, approximately 85 to 97 percent of reverse vasectomies are successful, resulting in at least some sperm being transported through the tubes to the penis. Certain conditions that hinder the success of a vasectomy do exist, including varicocele (enlarged veins within the scrotum), infections, injuries or hormone imbalances. In addition, approximately 10 percent of men experience low sperm counts following successful reverse vasectomies. This lowered sperm count can be caused by leakages in the tubes or the formation of excess scar tissue in the tubes.