Urology - NOSC Northern Ontario Surgical Centre

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Urology

Vasectomy Reversal

A vasectomy is a surgical procedure used as a form of permanent contraception and involves cutting the tubes that deliver sperm from the testes into the ejaculate. Many men undertake this procedure once they are done having children.  Some men find that their circumstances may change, however, and they wish to have the ability to conceive once again.

Common reasons for patients to pursue vasectomy reversal include changing their mind on having more children, remarrying or beginning a new relationship that is accompanied by the desire to conceive children with their new partner. Sometimes tragic circumstances such as the loss of a child may precipitate the desire to have more children.

Whatever the reason, patients looking to reverse the effects of their vasectomy have the option to do so through a vasectomy reversal procedure. Vasectomy reversal restores fertility either by reconnecting the ends of the severed vas deferens, located on each side of the scrotum (known as a vasovasostomy) or by connecting the vas deferens to the epididymis, a small organ located on the back of the testes (known as an epididymovasostomy).

Educate Yourself on Your Procedure

If you are considering a vasectomy reversal procedure, please explore the links provided for further information on this procedure and what you can expect. If you have any questions about vasectomy reversal surgery or any of the other procedures available at the Northern Ontario Surgical Centre, please contact us at 705-674-4300 to set up a consultation.

What are the Benefits of a Vasectomy Reversal Procedure?

Vasectomy Reversal patients often pursue surgery for a number of reasons including:

  • Restore flow of sperm to ejaculate
  • Regain fertility
  • Improve chances of conception and pregnancy
  • Increase family size

Preparing for Your Vasectomy Reversal Procedure

What is the first step in my Vasectomy Reversal procedure?

The first step when considering a vasectomy reversal procedure is to schedule a consultation with your surgeon.  The consultation process provides an opportunity for you to obtain important information about the procedure and to have all of your questions answered prior to proceeding with surgery.  It also enables your surgeon to properly assess you and determine whether you are a suitable candidate for a vasectomy reversal procedure.

You should be prepared to discuss your medical history, including any medical conditions, drug allergies, medical treatments you have received, previous paternity, previous surgeries, and all current medications.

You will also be asked for information regarding your female partner. Specifically, her age, past pregnancy history, medical history and menstrual cycle. It is important to consider your female partner’s fertility as well as your own when considering increasing the size of your family.

During your consultation, your surgeon will also perform a physical examination and assess your general health. Different surgical approaches and options will be discussed with you, along with recovery and success rates.

The benefits, risks and potential complications associated with vasectomy reversal surgery will be thoroughly explained during this consultation. The information provided at the initial consultation will be comprehensive and thorough, and should enable you to make an informed decision as to whether or not the vasectomy reversal procedure is the right choice for you.A comprehensive instruction package will be provided to you at the time of consultation, and includes instructions for both before and after surgery.

Am I a candidate for a vasectomy reversal procedure?

The ideal candidates for a vasectomy reversal procedure are healthy men who have realistic expectations of surgical outcomes.

What is the success rate for vasectomy reversal procedures?

There are two definitions of success following a vasectomy reversal procedure. The first is the return of sperm to the semen (patency rate), and the second is pregnancy.  Patients see a great deal of success in terms of return of sperm to the semen. The patency rate tends to be higher for patients who have a vasovasostomy procedure and lower for patients who have an epididymovasostomy.

Pregnancy rates are lower than patency rates, because pregnancy rates depend not only on patency rates but also a number of other factors, including the female partner’s reproductive health and age. 

How long will it take before my sperm are motile?

The length of time that it may take before you have sperm in your semen again depends on a number of factors include the nature of your vasectomy, how long it has been since your vasectomy and whether your vasectomy reversal procedure was a vasovasostomy or an epididymovasostomy.

The Procedure

What will I need to do prior to surgery?

Prior to surgery you will be scheduled for a pre-op session with a Registered Nurse to review your medical history and your post-operative instructions. She will review all of the information you will need to know to prepare yourself for surgery.

Where will my vasectomy reversal procedure be performed?

Your vasectomy reversal procedure will be performed in the state-of-the-art facilities of the Northern Ontario Surgical Centre. The Northern Ontario Surgical Centre has been awarded accreditation by the CAAASF (Canadian Association for Accreditation of Ambulatory Surgery Facilities) for meeting the standards of a hospital in regards to monitoring,emergency and resuscitation equipment. With two levels and entrances that conceal the actual size of the facility, the centre itself spans 8000 square feet and incorporates fully equipped major and minor operating rooms, amonitored multi-bed recovery area, 10 laser and treatment rooms, spacious consultation areas, private offices to discuss financing options, elegant waiting areas and a private waiting and secure rear entrance/exit for additional privacy when desired.

Do I need to stay overnight?

The vasectomy reversal is performed as an outpatient procedure and you will not be required to stay overnight at the Northern Ontario Surgical Centre.

Who will be performing my procedure?

The surgery is performed by a urologist who is specially trained in the vasectomy reversal procedure.

How long will the procedure take?

The length of the procedure may vary depending on whether you require a vasovasostomy or an epididymovasostomy. Your procedure may take anywhere from 2 to 4 hours.

How is a vasectomy reversal procedure performed?

Vasectomy Reversal is a microsurgery performed by a qualified urologist under general anaesthetic. During surgery it must be determined whether the blockage of sperm is at the location where the vas deferens were blocked during the vasectomy or whether the blockage is further back in the epididymis. This will influence the type of procedure that is performed.

During the procedure, the surgeon will make a small incision on each side of the scrotum from which the blocked ends of the vas deferens are removed. The surgeon will then obtain a small sample of fluid from the part of the vas deferens closest to the testicle. This sample is analyzed in order to determine if the fluid contains sperm. If it does, it is concluded that there is no further blockage in the epididymis and the two ends of the vas deferens are opened up and reconnected in a procedure called vasovasostomy.

If the fluid sample obtained from the vas deferens does not contain any sperm, then it may be that the original vasectomy caused back pressure and an additional blockage in the epididymis. In this situation the surgeon must bypass the blockage in the epididymis and connect the upper end of the vas deferens to the epididymis above the point of the blockage.  This procedure is known as an epididymovasostomy. Your procedure will take approximately 2-4 hours based on the type of procedure that you require.

Who will administer the anaesthetic?

A board-certified anesthesiologist will administer your anaesthetic, stay with you during the entire operation, and will be there as you wake up.

Who can I contact if I have any questions or concerns?

Patient Coordinators and medical staff are available to answer any questions or concerns following your surgery.

Pricing

How much does a vasectomy reversal procedure cost?

Many patients express concern about the cost of surgery. This is a valid concern as the cost of fertility treatments can provide additional stress to the sensitive issue of fertility.

Therefore, it is important to know the state of your fertility as well as your partner’s fertility and to evaluate the options available to you prior to proceeding with a procedure. Another factor to consider is the number of attempts you will have to conceive with each procedure. With a vasectomy reversal, you have limitless attempts to try to achieve conception whereas with alternative treatments patients must pay for each attempt. Having all the facts necessary will help you determine whether a vasectomy reversal is the best option for you.

Once you decide that a vasectomy reversal is the best choice for you, our knowledgeable Patient Coordinators will be happy to discuss with you pricing as well as payment options.

Is full payment required or do you offer a financing plan?

Payment can be made by cash, certified cheques, Mastercard, Visa, E-transfers or a financing plan. Many patients find that affording their procedure can be made simpler by using a medical/dental financing company which enables you to pay for your surgery with monthly payments. You may follow the links below to learn more. Please note that these companies are not affiliated in any way with the Northern Ontario Surgical Centre.
For more information on how financing companies can help you afford your procedure, visit:

Crelogix: www.crelogix.com
Medicard: www.medicard.com

Is my procedure tax deductible or covered by insurance?

Vasectomy reversal is not usually covered by private or provincial insurance such as OHIP. More information about the coverage eligibility of your surgery can be obtained during the consultation process.

What is included in the surgical fee?

The facility fee, surgeon, nurses, anaesthesia and anaesthetist, surgical supplies, and equipment used are all covered in the fees.

You will also be provided with prescriptions for medications to be taken after surgery. These prescriptions are subject to the same coverage you would receive from your medical insurance. If you do not have personal insurance, these medications will pose an additional cost to you.

Recovery 

Will I need to stay overnight during my surgery?

Vasectomy reversal surgery is an outpatient procedure and does not require an overnight stay at the Northern Ontario Surgical Centre. Following your surgery you will need a friend or family member to pick you up and care for you for 24-48 hours. This person should be familiar with your prescriptions and post-surgery instructions.

What kind of recovery time can I expect from my vasectomy reversal procedure?

After your procedure and a rest period, you will be discharged with dressings and a scrotal support sling in place. You may experience some swelling of the scrotum as well as some bruising or discolouration of the scrotum and the base of the penis which may persist for up to a week. You may apply ice packs to the scrotum beginning the evening of your procedure as needed for the first 24 hours. You may experience some fluid seeping from your incisions for a few days following your procedure. The area should be kept clean and dry, and the seeping should reside shortly. You will be provided with prescription medications should you feel any discomfort from the procedure.

You may remove the dressings and shower, but should continue wearing the scrotal support sling and avoid hot tubs or baths for one week. The sutures used in your procedure are dissolving so there is no need to have your sutures removed.

Light activity can be resumed after 48 hours, or as soon as you feel up to it. You should refrain from participating in any heavy physical activity for 2 to 3 weeks following your procedure. Sexual intercourse should be avoided for up to 4 weeks following your procedure, based on the recommendations of your surgeon.

The Northern Ontario Surgical Centre’s medical team will monitor your progress with follow up visits, and any changes to your physical activity levels will depend on your recovery.