THE VASECTOMY REVERSAL OPERATION

Before the operation day, you will have had a “pre-assessment” appointment with the nurses to assess your general fitness, screen you for MRSA and do some baseline investigations. You will not need to shave the area, as this can be done in the operating theatre.

You will be admitted into hospital on the operation day itself. We will ask you not to eat or drink for at least 6 hours before surgery. You will see Mr Rees, as well as your anaesthetist and your named ward nurse. You may also see the resident medical officer at the hospital. You will have the chance to ask any more questions you may have, and then we will ask you to sign a consent form. Immediately before the operation, the aneasthetist may also give you a pre-medication.

 

 

You will be given a full general anaesthetic (where you will be asleep).

Mr Rees will make a small incision in the front of the scrotum. Occasionally it is necessary to make two separate incisions – one on either side. The ends of the tubes are then identified, and re- joined with fine stitches using an operating microscope. The whole operation can take up to 2 hours. Very occasionally it is not possible to connect the tubes, particularly if the gap between the two patent ends is too long. It may only be possible to connect one side. Sometimes it may be possible to join the upper ends to the sperm-carrying mechanism (epididymis).

Dissolving sutures (stiches) are put in the skin, (but they can), which can take up to 2 weeks or occasionally longer to dissolve. A loose dressing will also be applied to the scrotal area.

You will wake up in the recovery area, and then be taken back to your room on the ward, where your nurse will look after you. He or she will monitor your pulse and blood pressure, and will also be able to let you know how the procedure went, and what we found during the operation.

You will be given painkillers in theatre and additional pain relief by mouth after the operation if you need it.

You may then want some refreshments, and you will usually be able to get out of bed a few hours after waking up from the surgery. The dressing is then checked, and if all well then it is usually possible to go home on the same day (ie a daycase procedure). The dressing can be removed the next day.

Please wear supportive (but not tight or loose) underwear while recovering form the operation.

If all goes well, then you should be able to return to desk work after one week and not do anything too physical during that period – ie no long walks, running, gym, lifting etc. The tiny ‘joins’ in the vasa need minimal disturbance in order to heal properly and for the procedure to be a success. ‘Pottering’ or desk work is fine. If your job is more manual then you should be off work for two weeks.

You should avoid a bath for the first week, to avoid dissolving the sutures too soon. Showers are fine, but avoid direct rubbing on the site of the wound – pat dry with a towel.

You should not drive for 48 hours after the general anaesthetic, and it is not advisable to drive any long distances for at least a week after the surgery. There will be discomfort in the scrotal area that may impair braking / clutch control etc. You do not normally need to tell the DVLA that you have had surgery, unless you have a medical condition that will last for longer than three months after your surgery and may affect your ability to drive. You should, however, check with your insurance company before returning to driving.

You will need to avoid sexual activity for a month. You may have some involuntary night-time ejaculation during this period which is unavoidable, and there may be some blood in the first few ejaculates. This is normal following this operation.

In case there are any complications, it is inadvisable to arrange any foreign travel for the month following surgery.

It takes approximately 3 months to make new mature sperm. The next step is therefore a sperm count 12 weeks after the operation. You may have been given a request form by the ward when you were discharged from hospital, but if not, Mr Rees’ Secretary will send you one. You should refrain from ejaculation for at least 3 days before doing the test. Mr Rees will then be in touch by letter or telephone to give you the results of the test.

It is however possible to start trying for a baby before these results – and it is possible to fall pregnant any time after the operation. However, as mentioned above, you should avoid sexual activity for the first 4 weeks after the operation.

If you have any concerns or would like a follow up in the clinic after your surgery, please do let Mr Rees’ Secretary know.