What Women Want to Know About Vasectomy Reversals

I see a lot of couples for vasectomy reversal procedures. As they gather information before proceeding, typically the partner, not the patient, fires off most of the questions. These queries come in two forms: questions directed at me and those having to do with the procedure.

The Dirty Dozen

Thank goodness that I’m a data-driven-doctor, because my patients are similarly inclined. Here are a dozen of the most common questions women ask me about their partners’ reversal procedure:

1. How long does it take?
   It depends on whether a straight connection (vasovasostomy) or bypass procedure (epididymovasostomy) is needed. Typically, 2 to 3.5 hours of surgery on a come-and-go basis.
2. How risky is it?
   I believe that paying attention to risk is essential to keeping a healthy man healthy. Performed under intravenous and local anesthesia, complications from anesthesia (heart or lung issues) or the procedure itself (bleeding, infection, chronic pain) occur in <1% of cases.
3. How painful is it?
   Men take an average 3-4 pain pills (total) after surgery, typically over the first 48 hours. Back to work at a desk job as soon as the pills stop. And, we’re studying a traditional Chinese herbal supplement to replace opiate pain pills after surgery.
4. How can we reach you after surgery?
   Uniquely, I keep in touch with patients using GetWellLoop, which connects us daily for 3 weeks after the procedure.
5. What technique do you use?
   I’m a big fan of studying the masters who preceded me and taking their techniques to the next level. I apply whatever technique works best for each patient. Some keywords are: microscopic, modified 1-layer, formal 2-layer, invagination.
6. How much experience do you have performing these procedures?
   It’s my favorite thing to do, and I publish my results in peer-reviewed literature. Can’t get much more “authentic” and “valid” than that!
7. How many vasectomy reversals do you do?
   One to three cases weekly. As a measure of procedural complexity, the average age of vasectomies that I reverse is 15 years, and 17% of my cases have already failed vasectomy reversals with other surgeons. Call me “clean up.”
8. When can we have sex again?
   I like to keep things moving to keep them open. Two weeks until sex with straight connections and 3 weeks after a bypass procedure.
9. What’s the chance he’ll have a sperm count?
   Short answer: it depends, but it’s high. For vasectomies that were performed fewer than 15 years ago, return of motile sperm occurs in 90-100% of cases. For vasectomies that were performed greater than 16 years ago, 75-90% of cases.
10. What’s the chance I’ll get pregnant?
    Hard to accurately judge surgeon success using this metric because there’s another party involved here (the partner). However, 55-65% in the average case.
11. How quickly will I get pregnant?
    Great question. This depends as much on the female partner’s fertility potential as it does on the quality of the vasectomy reversal. With vasectomies performed <15 years ago, typically <1 year, but with reversals performed >16 years ago, typically 1-2 years.
12. Can he get another vasectomy afterwards?
    Tapping into the idea that men really love their vasectomies, I now offer a “One & Done” package that includes both a reversal and a subsequent vasectomy. Short answer: absolutely possible.

There are also less common but equally interesting questions I get asked. Two of them come to mind: “Do you cut yourself shaving?” (never!) and “How much sleep do you get before surgery?” (I love sleep). Both questions stem from real concern about the well-being of the partner having surgery. As Winnie the Pooh once said: “Some people care too much; I think it’s called love.”