Vasectomy reversal, unlike vasectomy, is a lengthy surgery, and therefore cannot be safely or satisfactorily done in an office setting. Many reversal clinics, however, use the approach of using sedation in conjunction with local anesthesia in an office operating suite in order to keep costs down.
Dr. Finnerty has had extensive experience with this approach, but now only performs vasectomy reversal under general anesthesia. While many men can be done safely under sedation, about 10% will become restless or require large amounts of sedation to be comfortable. Such situations can become hazardous, and can greatly impair the ability to do a precision microsurgical repair. We see several patients a year who have had reversals performed in such a setting which subsequently failed.
Reversal surgery is best performed in an ambulatory surgical center, where you check into the facility in the morning, and by evening are recovering in the comfort of your own home. This way, your safety and comfort can be best assured by providing the latest technology, using highly trained anesthesiologists and nurses in state-of-the-art surgery suites, and Dr. Finnerty can concentrate fully on giving you the best technical repair possible.
Preparing for Your Surgery
In order to have the safest and most comfortable experience with your surgery, certain preparations are important. The following information is provided to help you prepare for your vasectomy reversal surgery.
Please read and follow this advice carefully, and be sure to call us if you have any questions.
- You should avoid taking any aspirin or aspirin-containing products for two weeks before your surgery. Products containing anti-inflammatory medication, such as ibuprofen (Motrin, Advil), Naprosyn, or similar drugs should be avoided for one week prior to surgery. These medications prevent normal blood clotting, and increase the risk of bleeding during and after surgery. (Even a single aspirin tablet will affect blood clotting for over one week!) Tylenol (acetaminophen) is safe to take at any time. If you are required to take aspirin or other similar medications for medical reasons, please contact us prior to surgery to discuss them.
- You should shower or bathe the evening before surgery.
- You will need to shave the scrotal area the night before or morning of surgery. The area to be shaved includes the front and sides of the scrotal sac, the penis, and the area over both groins on either side of the penis. It is not necessary to shave the pubic area (the area above the penis). Shaving should be done within 24 hours of the surgery.
- You must have a completely empty stomach for at least 12 hours before the scheduled time of your surgery. This means absolutely no food or fluids, even water. This is required for your safety by the anesthesia physicians—there can be no exceptions to this requirement; surgery will be canceled and rescheduled if it is not kept. If you are required to take prescription medications daily, please contact us for further instructions.
About Anesthesia
Vasectomy reversal surgery takes a considerable amount of time, generally lasting between 2 and 3 hours. While the extent of the surgery is not a great deal more than a vasectomy, it is nevertheless time-consuming due to the precision placement of microsurgical sutures.
Dr. Finnerty requires general anesthesia in all cases of vasectomy reversal surgery, unless there is a compelling medical reason for not doing so (which is very rare). Using current outpatient anesthesia techniques, general anesthesia is extremely safe, and recovery is typically smooth and comfortable for most patients.
Our anesthesia staff are all board-certified physicians, and are experienced in every aspect of anesthesiology, from outpatient surgery to major heart and trauma surgery. You will be under the care of experienced and highly qualified physicians with state-of-the-art training and equipment, dedicated to making your surgery experience a safe and pleasant one.
After Your Reversal Surgery
For most patients, recovery from reversal surgery is smooth, comfortable, and uneventful. Nevertheless, it is important to follow certain guidelines to minimize your risk of discomfort or complications, and give your surgery the best chance for success.
The following information is provided to help you recovery from your vasectomy reversal surgery. Please read and follow this advice carefully, and call us if you have any questions.
- It is important to remain at bed rest for the first 48 hours after the procedure.
- An ice pack should be applied to the scrotal area during this time, 20 minutes on and 40 minutes off. Avoid direct contact between the ice pack and the skin, however.
- Some swelling of the scrotal area is normal for the first few weeks. Minor bruising of the skin is also common. If the swelling is severe and associated with increased pain or severe bruising, or if there is continued bleeding from the incisions, this should be reported to the doctor.
- You may resume light activities after 48 hours. You should avoid heavy lifting, strenuous exercise, or prolonged standing for 10-14 days.
- You must avoid sexual activity of any kind for 10 days after the surgery. Failure to adhere to this may result in an unsuccessful surgical result.
- Wear a scrotal support or snug-fitting Jockey shorts for 7-10 days.
- The skin stitches dissolve on their own, usually in about 7-10 days. A small amount of drainage is common, especially after 4-5 days. This will stop when the sutures are gone. If there is redness, swelling, or excessive drainage from the incisions, especially after 3-5 days, this should be reported to the doctor.
- You may shower after all bleeding from the incision has stopped. This is generally 48-72 hours.
A sperm count should be performed 3 months after your repair. Counts obtained before this time may be falsely low or even zero due to surgical swelling. The sperm count may be arranged through our office, or by an independent or hospital lab if you live outside of our area. A request form for this test will be provided to you after surgery. If you misplace it, or need additional requests, another may be obtained from our office or downloaded here.
Recovering from Vasectomy Reversal
While vasectomy reversal takes quite a bit longer than a vasectomy (because of the microsurgical technique), the recovery is similar to vasectomy in many cases. Generally, most patients have only mild discomfort, and can return to light activities within a few days of surgery. Risks of the surgery are generally quite low, with a small risk of bleeding and infection, both of which are rare. External stitches will dissolve and do not require removal; they generally come out on their own after about 7-10 days.
Swelling is generally at its greatest about 3-5 days after surgery, during which time intermittent icing is very helpful. Thickening of the surgical incision and scrotal area are normal, and may persist for up to several months after surgery. This is a normal part of the healing process. A scrotal support (”jock strap”) or snug-fitting Jockey briefs are recommended during the first 1-2 weeks for your comfort.
Strenuous physical exertion or vigorous exercise should be avoided for two weeks after surgery. Although the repair is quite sturdy and is unlikely to be damaged by such activity, swelling and discomfort can be greatly increased by overdoing it. Sexual activity may be resumed in 10-14 days.
