What should men prepare before undergoing a vasectomy?

Some couples choose to have a vasectomy for contraception, but after a few years they want to have another child. In this case, the man needs to undergo a vasectomy reversal. What should be done before this operation?

Preparations for male vasectomy reversal

1. Explain the success rate of anastomosis to the patient and his/her family, including the recanalization rate, re-pregnancy rate, re-fertility rate and possible complications. Both the husband and wife are informed and sign a consent form.

2. Ask about the patient’s medical history in detail to understand what type of vasectomy the patient has undergone, whether he has undergone male vasectomy reversal, and the conditions during and after the operation.

3. Perform a full-body physical examination. Check blood and urine routine, blood clotting time, and do related auxiliary examinations if necessary. Focus on checking the urinary and reproductive system and semen routine to understand whether surgery is suitable and decide on the surgery and anesthesia method.

4. For local skin preparation, wash the perineum once a day 2 days before the operation. After the genital skin is prepared, wash the lower abdomen, penis, scrotum and perineum with warm water and soap.

5. Local infiltration anesthesia with procaine should be performed and a skin test should be performed.

Male vasectomy reversal surgery steps

1. The surgeon wears surgical clothes, a hat, and a mask, washes his hands routinely, and then wears sterile gloves.

2. Lie on your back with your lower limbs slightly apart.

3. Lay a sterile towel and cover it with a sterile drape to expose the surgical field.

4. Incision and separation of the vas deferens. Remove the skin scar of vasectomy, enlarge the incision to 2-3 cm, separate the distal and proximal ends of the vas deferens clearly, and lift the two ends with sutures. Then separate along the vas deferens to the two ends until there is no tension on the anastomosis after the residual end is removed. It is not advisable to separate too much to avoid affecting the blood flow of the vas deferens. Remove the distal and proximal residual scars.

⑴Separation of vas deferens and removal of scar

5.Introduce the stent wire into one end of the vas deferens and use a 7-8 needle to insert it into the lumen from the proximal end of the vas deferens until it passes through the wall 1.5 cm from the distal end and out through the scrotal skin. Introduce the nylon thread into the needle lumen and withdraw the needle so that the nylon thread remains in the lumen with the end exposed outside the skin. Suture the skin end with silk thread to fix it to the skin.

⑵Introduce the support wire

6. Insert the stent wire into the lumen of the other end of the vas deferens. Insert the other end of the nylon wire upward into the distal lumen of the vas deferens 4 to 5 cm to serve as a lumen stent.

⑶Insert the stent wire into the other end of the vas deferens

7. Anastomosis of the vas deferens: Use 7-0 nylon thread or 5-0 silk thread to suture the vas deferens intermittently with 3 to 4 stitches for end-to-end anastomosis.

8. To reduce the tension of the vas deferens, intermittent sutures are made with silk thread to suture the tissues around the vas deferens. Generally, only 2 to 3 stitches are needed to cover the vas deferens, and then the skin incision is sutured.

⑷ Vasectomy and suture of skin incision