The Vasectomy Reversal Experience, What to Expect
This article, written by Dr. Sheldon Marks, will explain what each patient can expect with the vasectomy reversal at our full time, vas reversal only “Center-of-Excellence in 2023.”
Of course, men are naturally worried about potential pain during and after the vas reversal. The good news is that most men tell us how surprisingly easy and pain-free the vas reversal was here at ICVR. When the doctor does the “house call” the next morning at the hotel, almost all patients tell us that they didn’t even ask for a single Tylenol. In fact, many tell us that this was the most positive medical experience that they have ever had. Those that come to us after a failed vasectomy reversal elsewhere let us how wonderful our care was as compared to their experience by the first doctor.
Before we start
After we answer any questions and review the steps of the procedure, each patient is given a medication to relax him and another pill that blocks excessive inflammation (meloxicam or celecoxib). The goal is to be proactive and prevent issues rather than the usual medical approach of waiting until problems develop and then try to treat. Within minutes the patient feels relaxed as we walk with him back to the private operating suite.
In the OR
The patient is then connected to all the safety monitoring devices by the senior RN to closely watch the oxygen and carbon dioxide levels, blood pressure, respiratory rate and depth, heart rate, etc. Over the next 20 to 30 minutes he is then given very small pulses of the intravenous sedatives at minimal doses to reach that level of sedation where the patient becomes so relaxed and comfortable that he easily falls asleep. We do not use general anesthesia because of concerns over rare but serious and avoidable risks (1,2). While he is sleeping, the surgeon instills the numbing medicine (both instant onset lidocaine mixed with long acting bupivicaine) so that almost all men feel nothing during and after the vas reversal, even later that night and over the next several days.
Patient’s wife/partner
If any family members accompany the patient, we make the time waiting at ICVR both interactive and educational. We have a private family room (no-one else uses it) with Wi-Fi and cable where she can rest, watch TV or work while being kept up-to-date with regular phone calls from the OR. Plus, our andrologist will bring her into the lab to show her the sperm that we see and teach her about sperm – the counts, motility and how to improve results and fertility (3).
When he wakes up
When the vas reversal is over in about 2 to 2.5 hours, he will have felt to him like only 3 to 4 minutes have passed by. The patient is then walked to the adjacent recovery where he will be joined by his wife and slowly wake up over the next 60 to 90 minutes. Once he has had something to eat and drink, Dr. Marks or Burrows will review the customized 25-page bound discharge instruction book as well as the digital photographs of the sperm seen and key portions of the microsurgical reconstruction.
Going home
The patient can then leave to go directly home if they live in the region or to a nearby hotel to rest with ice. That night every patient is asked to call the doctor on his cell phone. The following morning for those from out of town, the doctor will do a “house call” and come by the hotel and visit and see how the patient is doing, review the customized discharge instruction book and the key highlights of what was found and answer any questions about continued care the next few weeks and months.
Our ICVR staff is available to answer any questions about vasectomy reversals or to schedule a free, no obligation consultation with one of the two microsurgeons in person, by phone, Zoom, in-office, Skype or Face Time. Contact us at (888) 722-2929 .
This page was reviewed, edited and updated January 4, 2023 by Sheldon H. F. Marks, MD.
References:
1. Harris M, Chung F. Complications of general anesthesia. Clin Plast Surg. 2013 Oct;40(4):503-13.
2. Devereaux, P.J., Xavier, D., Pogue, J. et al, Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011;154:523–528.
3. Participating Centres of Chaps-UK. Modifiable and non-modifiable risk factors for poor sperm morphology. Pacey AA, Povey AC, Clyma JA, McNamee R, Moore HD, Baillie H, Cherry NM. Hum Reprod. 2014 Aug;29(8):1629-36.