Vasovasostomy

The procedure involves joining the segments severed during the vasectomy, allowing sperm to pass through once again. This is a microsurgery performed with a surgical microscope, in which the specialist sections the blocked ends, applying serial cuts to locate the exit of the seminal fluid. This fluid must be analysed to determine its quality (presence of sperm) and, if it is optimal, saline solution is injected into the abdominal segment to ensure its permeability (that there is free passage to the prostate). At this point, surgery is performed to join the segments.

This procedure is performed in most cases under local anaesthetic, which allows for a quicker recovery and does not require hospitalisation. In some specific cases, sedation will be administered, requiring the patient to remain in hospital for a few hours to ensure proper recovery. The surgery usually lasts between 2 and 4 hours.

The success rate varies depending on several factors, such as how the previous vasectomy was performed, the time elapsed since the vasectomy, any complications that may have arisen during the first procedure, and the experience of the microsurgeon andrologist. In general, the success rate is between 80% and 90% if the interval between vasectomies is 10 years or less, decreasing thereafter.

In any case, before the procedure, the specialist will explain the possible outcomes of the procedure based on your case and the vasectomy technique used. A preliminary examination will also be made to determine the distance between the segments and assess the possibility of reversibility. The use of magnifying glasses or microscopes allows for more precise surgery, resulting in higher success rates.

Following the procedure, the length of pregnancy may vary depending on each individual case. Sometimes, pregnancy is achieved within three months, and other times, it takes two years. This will depend on the results of the sperm analysis, which does not recover at the same rate in all cases.

In cases where patients have previously undergone unsuccessful revascularisation, the possibility of undergoing this procedure again may be considered, as there are different surgical techniques available. In some cases, the specialist may not recommend a second procedure, either because the defect is too large or because of the age of the patients (over 35 years of age without children).

Following a vasovasostomy procedure, it is important for patients to bear in mind the following instructions:

• The patient should wear a testicular suspensory and tight-fitting underpants 24 hours a day to prevent movement of the scrotum for approximately 2 weeks. After the intervention, there may be bruising on the scrotum and in the groin area, which will gradually disappear.
• The wound may bleed. In this case, the patient should replace the gauze pads with fresh ones. The dressing must be kept dry for 48 hours after the procedure; after that, the patient may shower (but not bathe), removing the bandage beforehand and replacing it afterwards.
• It is important to follow the medication guidelines provided by the specialist.
• Subsequent job reincorporation will depend on the tasks carried out. When the job entails office work, the patient can return to work after 3-4 days. When the job entails physical movements, the patient should wait between 2-3 weeks.
• During the first week after the operation, the patient should not drive, and for up to three weeks, refrain from riding a motorbike or bicycle.
• Sports and strenuous activities should be avoided until at least 3 weeks after the procedure.

It is possible to freeze sperm during vasovasostomy. Thus, in cases where the procedure does not achieve the desired results, the couple may undergo in vitro fertilisation using frozen sperm from the testicle (TESE). You should consult and discuss this possibility with your specialist.

At the Assisted Reproduction Unit at Centro Médico Teknon, we use sperm freezing techniques that ensure subsequent fertilisation, employing precise technology during treatment.