Bullet points/instructions for the post vasectomy reversal operative period:
You can shower but for the first two to three days, don’t let water hit the operative site directly.
A thin layer of Neosporin over the suture sites daily is recommended.
A formal dressing is not required but one 4×4 gauze between underwear and the sutures may be more comfortable.
The sutures dissolve-but not all at the same time. Some separation of the skin in areas is not uncommon and resolves.
The feeling of a “lump” under the skin above either testicle is not uncommon, this is where the body is reacting to the surgical procedure. (It is not uncommon to have this on one side but not the other.)
Compression underwear for three weeks. (This is preferred to the traditional “jock strap.”)
No sexual activity for three weeks. Slowly returning to your normal exercise at that time can resume as well.
The more you can be off your feet the first week following the procedure the less swelling you will have. Some bruising of the skin around the suture sites is common.
Patients can walk and even drive if necessary after 5 days if wearing compression underwear and being careful. Again, the more you are off your feet the better.
The testicles begin producing normal sperm again in 4-6 months, depending on the length of time from the vasectomy. (The longer the interval from the vasectomy, the slower return to sperm production.)
If you desire to have an evaluation of a semen specimen to check for the presence of sperm, one would wait until the 4-6 month period after the reversal. The presence of sperm is a very good sign, however it is not unusual for a longer interval is required for the return of sperm. A specimen can be given to our office and can be quickly evaluated for the presence of sperm. If a formal semen analysis is desired which provides an actual count of sperm, an order can be placed to your local hospital negating having to travel to Gainesville.
If pregnancy occurs, it is usually in the 6-18 month time frame.
If pregnancy occurs…we’d appreciate a picture.
Finally…we appreciate the opportunity to participate in your care.
Georgia’s most experienced No Scalpel Vasectomy and Microscopic Vasectomy Reversal urologist.
Browse our site…particularly reversal cost, success rates and the various blog posts. Then arrange for a free consultation for additional information by using the contact form or by calling our office. Dr. McHugh will give you a call an afternoon that suits you.
Before the vasectomy patient can be released by the urologist to have unprotected sex, there must be two consecutive semen specimens with no sperm. It takes about 25 ejaculations to achieve this. We customarily give two specimen containers at the time of the vasectomy and recommend dropping off the specimens at approximately six and eight weeks. Dr. McHugh personally examines all of the specimens with a microscope.
After the initial clearance to proceed with unprotected sex, the chances of the the vasectomy “growing back together” is 1/2000.
In the diagram above you can see why. When Dr. McHugh performs a vasectomy a section of the vas is removed (red), both ends are cauterized (green) and then an absorbable suture (yellow) is placed on both ends as well.
The diagram above also answers another very common question about vasectomies: Does it affect the patient’s sex life?
The answer there is no. As you see, the only thing “tied off” is the vas deferens and this is where the sperm travels. Testosterone, which is responsible for the male’s sex drive, is produced in the testicle, but leaves the testicle in the blood stream not the vas deferens.
So there is a vas deferens between where the sperm exits and how the testosterone exits the testicle!
The above picture shows the vas deferens isolated and one can see the clips and a small area of swelling of the vasectomy site. If there is swelling here, a sperm granuloma, then the potential for success is higher. A sperm granuloma is a “pop-off” valve of sorts and protects the sperm producing process of the testicle.
The presence of a sperm granuloma explains why a patient 10 years out from a vasectomy might have a better chance than a patient 5 years out who doesn’t have one. This is a random occurrence and can’t be predicted who or who will not have a sperm granuloma. They are only beneficial for the vasectomy patient who is to have a reversal.