Sequence of the Op

Since refertilization requires a precise microsurgical procedure, the procedure is performed under general anesthesia. After the patient is asleep, the skin is opened either through the scars of the vasectomy operation or through an incision in the middle fold of skin of the scrotum (testicles). The separate ends of the vas deferens must be exposed and the fused stumps cut open on both sides.

If seminal fluid is already leaking on the side of the testis, it can be assumed that it has already passed through and the vasovasostomy can be started. To do this, the two ends are sutured together again layer by layer under a magnifying glass in an anatomically correct manner. If there is any doubt about the patency of the vas deferens, a tubulovasostomy is performed, in which the vas deferens is sutured directly to a canal of the epididymis. The skin is then closed again and a sterile, firm dressing is applied.

Aftercare

Aftercare of surgical wounds is usually not necessary unless there are signs of complications. In order to check the success of the refertilization, a spermiogram is made, i.e. an examination of the ejaculate for the presence of sperm, their number and motility. The full success can only be predicted after about six months, but a first spermiogram is usually examined after two to three months.

Risks

The risks of a vasovasostomy or tubulovasostomy are the same as for any minor surgical procedure. There may be bleeding or infection at the surgical wounds, but some surgeons use antibiotics prophylactically for a few days around the operation. Due to the small size of the incisions and the highly sterile conditions in the operating room today, these complications are quite rare.

Also relatively rare are wound healing disorders or injuries to other structures, such as nerves in the operating area. A “post-vasovasostomy syndrome” is not known, in contrast to the post-vasectomy pain syndrome. General anesthesia also carries certain risks, which should be explained in advance. Especially patients with previous cardiovascular diseases or high drug consumption should talk in detail with the responsible anaesthesiologist.