Post-Vasectomy Reversal: Key Recovery Questions and Concerns

Q: Post-Vasectomy Reversal: Key Recovery Questions and Concerns

Hello： 1) It is advisable to avoid sexual intercourse until the incision site of the vasectomy is fully healed. <br>2) Infection is unlikely, but the impact on the function of the vas deferens after the procedure is uncertain. <br>3) It is common for swelling to occur after this

Vas deferens reconstruction

Hello doctor, my husband underwent a vasectomy reversal surgery a few days ago (he had been previously sterilized), and I have a few questions to ask since there is very little detailed information available online.

1.
How long after the vasectomy reversal surgery should we wait before resuming sexual intercourse?
2.
What are the potential consequences of engaging in sexual activity shortly after the surgery? He had intercourse just four days post-operation, despite my refusal and warning him against it due to concerns about the wound.
I’m worried about any possible complications such as wound infection.
(I apologize for his disobedience; it won’t happen again.)
3.
The day after the surgery, his testicles became significantly swollen, larger than my palm (excluding the fingers), and one side has a hard protrusion at the wound site.
Is this normal? (We went to the emergency room, but the doctor was not very knowledgeable and called in an outpatient physician.
After an ultrasound, they said the hard lump was due to slight bleeding from the surgical site, which formed a small hematoma, and advised us to apply ice.
They mentioned that if it continues to grow, it might indicate ongoing bleeding that could require surgical intervention to remove the hematoma, and that the swelling was due to mild inflammation but within normal limits.) Is this assessment accurate?
4.
Prior to the surgery, one of his testicles was slightly larger.
An ultrasound revealed that this was due to excess semen accumulation after his vasectomy, which his body could not metabolize quickly enough.
However, two different hospitals provided conflicting information: one suggested that the accumulation could lead to blockage after the reversal, while the other did not mention this issue at all, only stating that the success rate of reconnection is about 70% (after three years of vasectomy).
I would like to know if semen accumulation affects the reconnection success rate.

I apologize for the trouble, and I greatly appreciate your help in answering my questions.
Thank you very much.

Anna, 20~29 year old female. Ask Date: 2017/07/16

Dr. Du Shixi reply Urology

Hello: 1) It is advisable to avoid sexual intercourse until the incision site of the vasectomy is fully healed.
2) Infection is unlikely, but the impact on the function of the vas deferens after the procedure is uncertain.
3) It is common for swelling to occur after this type of surgery; the extent of the swelling varies.
If there is minimal bleeding, it will typically be absorbed by the body (the body has self-healing capabilities), but significant bleeding may require the removal of blood clots.
4) Individual circumstances vary, so it is important to discuss your specific situation with your physician.
Wishing you good health.

Reply Date: 2017/07/16

More Info

Post-vasectomy reversal surgery is a significant procedure that can raise various concerns regarding recovery and future fertility. Here are some key points addressing your questions and concerns:
1. Timing for Resuming Sexual Activity: After a vasectomy reversal, it is generally recommended to wait at least 2 to 3 weeks before resuming sexual activity. This waiting period allows the surgical site to heal properly and reduces the risk of complications such as bleeding or infection. Engaging in sexual activity too soon can strain the surgical site and potentially lead to complications.

2. Impact of Early Sexual Activity: Engaging in sexual activity just four days post-surgery can pose risks. The primary concerns include the potential for increased swelling, bleeding, or infection at the surgical site. If the surgical area is not adequately healed, there is a risk of reopening the incision or causing additional trauma to the area. It is crucial to monitor for any signs of complications, such as increased pain, swelling, or discharge from the incision site.

3. Postoperative Swelling and Hardness: It is not uncommon for the scrotum to swell after a vasectomy reversal. The swelling can be due to inflammation and fluid accumulation, which is a normal part of the healing process. However, if one side of the scrotum is significantly larger than the other, or if there is a hard lump at the incision site, it is essential to monitor this closely. The emergency physician's assessment that the hard lump is likely a small hematoma (a localized collection of blood outside of blood vessels) is plausible. Ice packs can help reduce swelling, and if the swelling continues to increase or if there are signs of infection (such as fever, increased redness, or discharge), it is advisable to follow up with the surgeon.

4. Concerns About Sperm Accumulation and Blockage: Regarding the pre-existing condition of sperm accumulation (often referred to as spermatocele or epididymal cysts), it is essential to understand that while these conditions can affect the size of the testicles, they do not necessarily impact the success rate of the vasectomy reversal. The success of the procedure is generally determined by the patency of the vas deferens and the quality of the sperm produced. The claim that sperm accumulation could lead to blockage is not universally accepted; however, it is essential to have open communication with your healthcare provider regarding any concerns about fertility and the potential for blockage post-reversal.

In summary, it is crucial to adhere to postoperative guidelines to ensure proper healing. If there are any concerns about swelling, pain, or the surgical site, do not hesitate to reach out to the surgeon for further evaluation. Additionally, discussing fertility concerns and the implications of previous sperm accumulation with a urologist specializing in male fertility can provide more personalized insights and guidance.

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