"ASK THE EXPERT "
VasReversal's New Beginnings is extremely pleased to introduce a page devoted to and highlighting vasectomy reversal specialists and their answers to the most common and important questions regarding vasectomy reversal. Check back often for new questions and answers from some of the world's best reversal surgeons! This month features Dr. Philip Werthman, MD., the Director of the Center for Male Reproductive
Medicine & Vasectomy Reversall
How Long Should You Abstain From Sexual Activity After a Vasectomy Reversal and Why?
Philip Werthman, MD, FACS
Director, Center for Male Reproductive Medicine & Vasectomy Reversal
Clinical Assistant Professor of Urology
USC School of Medicine
Los Angeles, California
The optimal period to refrain from sexual activity after a vasectomy reversal is somewhat debatable. A period of abstinence is needed following surgery to allow the reconnected ends of the vas to heal and give the procedure a chance for success. Clearly the time period should not be too short as to compromise the surgery, nor should it be oppressively longer than necessary for the patient. The information available on the internet is very varied and confusing. I have read articles saying that a man should abstain for 3 months after surgery and others instructing frequent ejaculation starting 2 days after a reversal and every 2 days there after to push sperm through the connection and keep it open. Clearly there are many misguided and misinformed opinions that can be found but we must look to science, experience and reason to make a sensible and accurate recommendation to patients.
I feel that the optimal period of abstinence following a reversal is three and a half to four weeks. The reason I recommend this time period is based on anatomy of the vas and physiology, plus many years of performing successful reversals and knowing what works best. The vas is a muscular tube with an inside channel about the size of a pen dot. During a reversal, the vas is reconnected using suture half the thickness of a human hair. The sutures make the vas water-tight and should perfectly realign the inner channel. This reconnection is extremely delicate and needs time to heal. During an ejaculation, sperm are forcibly pushed through the vas connection by powerful muscular contractions in the wall of the vas. These contractions are powerful enough to tear apart the sutures and allow sperm to leak out of the connection that can lead to scarring and inflammation and cause the reversal to fail.
During the normal healing process, collagen, the body’s scaffolding material, is laid down in the wall of the vas and seals the connection and gives it strength. Collagen is made at the site of the wound and at the reconnection at about 2 weeks following surgery and is continually laid down in the vas wall for several more weeks. It is at this time that the vas reconnection has gained strength and the vas wall should be sealed and is not at risk of being pulled apart. It has been my experience that this 3 ½ week period is long enough to resume sexual relations safely without posing a risk to the success of the reversal. A longer period of abstinence than a month is overkill and clearly a shorter period of less than 2 weeks makes no sense based on the principles of would healing and an even shorter abstinence period is potentially harmful to the surgery.
The above is not designed as specific medical advice for any particular situation. It is important to discuss this with your surgeon and research all aspects of reversal before proceeding. The "Ask the Expert" page of VasReversal New Beginnings is the combination of experience and opinions of individual reversal surgeons and is not meant as medical advice.
