How is a vasectomy performed?
In general, a vasectomy will be performed in your urologist's office or at an outpatient surgical center while you are awake. There are two types of procedures: conventional vasectomy and no-scalpel vasectomy. During a conventional vasectomy, the urologist makes one or two small cuts in the skin of the scrotum. The vas is cut, and a small piece may be removed, leaving a short gap between the two remaining ends. The doctor then clips or ties the cut ends and closes the scrotal incision with dissolvable stitches. The entire process is then repeated on the other side. During a no-scalpel vasectomy, the urologist feels for the vas under the skin of the scrotum and holds it in place with a small clamp. A special instrument is used to make a tiny puncture in the skin and stretch the opening so the vas can be gently lifted out, cut, then tied or cauterized and put back in place. During a vasectomy, local anesthesia will be injected to numb the area and eliminate pain, but you will be aware of touch, tension and movement during the procedure.
[Before & After Drawing]

Are there any risks associated with a vasectomy?
Most patients can expect to recover completely in less than a week, and many are able to return to work as early as a day or two after the vasectomy. Sexual activity can usually be resumed within a few days. However, it is important to realize that a vasectomy, even though successful, is not effective immediately. In general, discomfort after a vasectomy is usually minimal and should respond to mild analgesics. More severe pain may indicate infection or other complications. If you notice a significant increase in the size of your scrotum or experience any discomfort, you should contact your urologist immediately. It is very important not to engage in any physical activity for three to four days after the vasectomy. By avoiding activity, you may be able to prevent discomfort. If you experience fever, scrotal redness or tenderness, you should also be evaluated by your urologist because you may have an infection.

What is a vasectomy reversal?
A vasectomy reversal re-establishes fertility by reconnecting the severed sperm duct (or vas deferens), which is located in each side of the scrotum. The procedure restores the passage for sperm to reach a female egg.

What are the different types of vasectomy reversals?
Vasectomy reversals are generally performed in an outpatient area of a hospital or in an ambulatory surgery center. The operation may be performed with local, epidural, spinal or general anesthesia. Once you are anesthetized, your urologist will make small incisions on each side of your scrotum in order to remove the scarred ends of the vas deferens (or vas) at the point of blockage created by the vasectomy. Then, the urologist will extract a fluid sample from the end closest to the testicle to see if it contains sperm. When sperm are present in the fluid, the passage can be reestablished by reconnecting the ends of the vas. Urologists may choose to use a “modified one-layer” method or microsurgery to perform the reversal. During a “modified one-layer” method, a series of tiny stitches is placed through the entire thickness of the vas to join the ends. Once these stitches (the first “layer”) are tied, a second set (or “layer”) of stitches that only pierces the outer portion of the vas is placed between each adjacent pair of stitches. Urologists use microsurgery to produce better results using high-powered microscopes that can magnify structures from five to 20 times their actual size. An operating microscope allows the urologist to manipulate stitches smaller in diameter than an eyelash to join the ends of the vas.

What can be expected after a vasectomy reversal?
Recovery from a vasectomy reversal should be relatively quick. Any pain that you might experience after surgery can be controlled with oral medications. You can usually resume your normal routine and light work within a week. Your urologist will probably advise you to refrain from heavy physical activity for about four weeks. You will also be advised to wear a jockstrap for support for several weeks, and you must refrain from sex for at least two weeks. On average, it takes one year to achieve a pregnancy after a vasectomy reversal. However, some pregnancies occur in the first few months after the reversal procedure, while others do not occur at all.