This is the isolated vas deferens at the time of a reversal. You can see the clips and a mass effect of the body’s attempt at healing the vasectomy “trauma.” This is called a sperm granuloma. Note the vas tubes going into the mass of healing and clips. Both sides are normal in appearance and normal caliber.
What a granuloma does is act as a “pop off” valve and releases some degree of pressure on the testicles. This in turn makes for less damage to the testicles and allows them to rebound sooner from a reversal. In many cases it will also improve the character of the fluid at the time of the reversal (which is also a favorable finding for the percentages of success).
So, if you are considering a reversal and in the shower examine yourself and feel a knot along the course of the vas tube above the testicle, this is a favorable sign and that you may have a better than average success rate for both patency and pregnancy.
Just a small and interesting caveat for the couple thinking about reversing a vasectomy.
Medical aphorism: “The art of getting away with it.”
Patients who are considering a vasectomy reversal usually have a busy life. They to a person don’t like being out of work and even if they did their employer probably won’t view a reversal as medically necessary. So a common question is how soon can I go back to work and how soon to resume working out? Well…this is where “getting away with it” comes in.
Since a reversal is a procedure which usually takes a bit over two hours, the incision on each side is open for about an hour each and this lends itself to bruising and scrotal swelling. A patient can physically go back to work in three to four days but because of the nature of the procedure and the fact that the scrotum is a dependent structure (hangs down) and is potential space (not tight like the skin over your arm) it is prone to bruising and swelling.
So the answer…you can “get away with” three to four days but:
- The longer you are off your feet and elevate the scrotum the less swelling and bruising you’ll have
- The two incision are less than an inch long and closed with absorbable suture and the incisions take about two weeks to heal.
- Being up and about probably won’t hurt the repair of the vasectomy site inside or the healing process on the outside but extra swelling may slow the process and may make you more uncomfortable.
- We recommend no strenuous activity or sex for three weeks.
- Having said all of this I have had patients who told me they planned to go to work “a desk job” the next day
- And I have had a patient he had sex the night of the procedure-of note he came to the office the next day all “swollen up” and yet he and his wife were pregnant in three months. Go figure!
The last guy…he was practicing the art of getting away with it and got away with it. But…not everybody does.
I tell patients the “company policy” is off your feet as long as possible, the more you’re off your feet the less swelling and bruising, and no sex or strenuous activity for three weeks. However just like in companies, the company policy is rarely adhered to or enforced…it is a template of what is desirable.