What is a VAS
VAS is the tube that transports sperms from the testicles. During the operation of vasectomy a small section of vas is removed and the ends are tied off.

How is reversal of vasectomy performed
The operation is performed under a general anaesthetic, usually as a day case. Through one or two small incisions (these incisions are longer than the one you had for the vasectomy operation) in the scrotum, the ends of the vas are exposed and the scar tissue around the ends is removed. Healthy ends of the vas are joined together using very fine (as fine as hair) non-absorbable suture using a microscope or some other type of magnification.

How long does the operation take?
The operation is a delicate procedure as the vas is a small tube and the channel inside is even smaller. It usually takes 60 to 90 minutes to perform the operation.

What are the complications?
Complications are uncommon but may occur as with any surgical operation. Scrotum is a very accommodating organ. Sometimes blood may collect inside the scrotum. If the collection becomes large it may need to be evacuated. This is however a rare event. Infection of the wound or inside the scrotum may occur and may need a course of antibiotics.

What should I expect after the operation?
Normally you should be able to go home the same day of the operation. You may experience some pain in the scrotum for about 48 hours but this is usually controlled with mild painkillers such as paracetamol. You should be able to resume normal duties and work after 7 to 10 days. You may resume sexual intercourse after 2 weeks. You should be able drive your car with out pain or causing any damage after 10 days.The stitches will dissolve or drop off between 2 to 3 weeks.

What should I avoid?
You should avoid riding a bicycle and sport for at least 6 weeks. Avoid wearing tight under wear or trousers for a few days as they may produce discomfort in the scrotum.

What is the success rate of the operation?
Success of the operation is judged in two ways:

The appearance of sperms in the ejaculate: This is a measure of the technical success of the operation and is approximately 70%

Pregnancy rate: This is between 20 to 30%. Pregnancy rate is lower because, following vasectomy the function of the testis is diminished. As a result the quality and quantity of the sperms produced by the testes are not as good as before the vasectomy operation. In general, the pregnancy rates are better if the reversal operation is performed within 5 years of vasectomy.

Can anything additional be performed to improve the chance of pregnancy?
Yes. Sperms can be obtained from the testis at the time of reversal operation and frozen for future use if the operation does not succeed. The stored sperms can be used to fertilise the egg by a technique called ICSI (Intra-Cytoplasmic Sperm Injection). The fertilised egg is then implanted into the womb.

When will I know if the operation has been successful?
Analysis of seminal fluid is usually performed 3 months after the operation. That test will tell if the operation has been technically successful. Sometimes the sperm count and the quality of sperms improves with time. Equally, sometimes the operation may be successful initially but the scar tissue may block the tubes after a few months.