Vasectomy reversal

You may consider a vasectomy reversal if you had a vasectomy and now wish to father children — whether because of a change of heart, a new partner, or other life circumstances. It is important to know that a return of fertility cannot be assured: the time elapsed since your vasectomy, your partner's age and reproductive health, and the type of repair needed all play a role.

During your consultation, Dr. Bricio, urologist (Endolapv), performs a personalized evaluation: he reviews your medical and surgical history, performs a physical exam, and talks with you about your fertility history and your partner's, to help you decide, based on your case, whether a reversal is a good option for you.

A vasectomy reversal is performed under anesthesia — general, or regional with sedation, depending on your case and the team's recommendation; the goal is for you to stay comfortable and still during this delicate microsurgery.

Through a small incision in the scrotum, the surgeon locates the ends of the vas deferens and examines the fluid inside. If sperm are present, the ends are reconnected directly (vasovasostomy); if they are not, the vas may need to be attached directly to the epididymis (vasoepididymostomy). The exact technique is decided during the surgery itself and is performed with very fine sutures under a surgical microscope.

Afterward, you rest in a recovery room under close observation by the medical team. As an outpatient procedure, most patients return home the same day, with clear instructions and the attentive support of our team.

Before surgery you will have an evaluation visit: your medical history and your previous vasectomy are reviewed, a physical exam is performed, and in some cases tests are ordered to confirm that you produce healthy sperm; a fertility evaluation may also be suggested for your partner.

Only if your doctor instructs you to, stop medications that increase bleeding — such as aspirin, ibuprofen, or blood thinners — as well as certain supplements, as far in advance as directed. If you smoke, it is best to stop, since tobacco can slow healing.

Bring snug underwear or an athletic supporter to wear after surgery, and arrange for someone to drive you home. Our team in Puerto Vallarta can help you coordinate these details — especially if you are traveling from another city or from the U.S. or Canada.

After surgery, it is normal to have mild to moderate pain, swelling, and tenderness in the scrotum; in many cases these symptoms improve over one to two weeks. You will usually be advised to apply cold packs, keep the incision clean, and wear an athletic supporter or snug underwear for several weeks for support.

In many cases you can return to light daily activities within a few days, though you should avoid heavy lifting, strenuous exercise, and sexual activity for two to three weeks, as directed by your doctor. Over the following months, periodic semen analyses check for the return of sperm, which can take anywhere from a few weeks to several months depending on the type of repair.

Go to the emergency room right away if you develop a high fever, bleeding that soaks through the bandage, pus draining from the incision, or pain and swelling that get worse instead of better, and notify the doctor who performed your procedure as soon as possible.

Medical reference source: Mayo Clinic.