Page 14 - Urological Health

• Pregnancy (failure of the vasectomy) (uncommon), except in rare cases when the surgeon
fails to identify the vas deferens. A semen sample obtained three months after the
procedure will check to see if any sperm remains. A large number of sperm are “upstream”
from the testicle in the seminal vesicles, and these can cause pregnancy in the early
period after vasectomy. You should use contraception until a semen sample is clear of
sperm.
• Pain is expected in the very short term after vasectomy, as with any surgical procedure.
This is usually easily managed. Longer-term pain syndromes can happen, but these are
very rare and should not be anticipated.

11. Can I have my vasectomy reversed? What is involved?

Will it work?

You must think of a vasectomy as a permanent form of contraception. There are circumstances,
however, that may cause a man to wish to have the procedure reversed.

Surgical procedures have been developed that can re-establish contact and patency of the vas
deferens, to attempt to allow sperm to pass again. The testicles retain the ability to make sperm after
vasectomy. These procedures, known as vasovasostomy and vasoepididymostomy,are complex
UNDER REVIEW
procedures performed by experts using microsurgical techniques. They are longer and more involved
surgeries than the vasectomy itself and are generally done under a general anaesthetic, and are not
typically covered by provincial health insurance plans.
They can be successful, and the chances of success will depend on the techniques used, evidence
from the operating room that sperm expression is possible, and the time that has passed since the
initial vasectomy.

12. Why do I have pain in my testicles?

Scrotal or testicular pain is common and unfortunately poorly understood. Getting to a specific
diagnosis and finding the right management plan can be hard and frustrating for you and for your
urologist. Usually, testicular or scrotal pain is not life-threatening.
Your doctor will first try to uncover specific causes of your pain, such as infectious causes, hernias,
injuries, or, more ominous diagnoses, testicular masses or torsion (twisting of the testicle on its own
blood supply). This will be followed by a careful physical exam that assesses the anatomic elements
of the scrotum: the testicles themselves and the structures around them, including the epididymis,
which stores and transports sperm; the spermatic cord, a set of structures which bring blood, nerves
and sperm to and from the testicles; and the inguinal areas (the groin) where hernias develop.

A common diagnosis of scrotal pain is known as epididymo-orchitis, or epididymitis. This is an
inflammation or infection of the epididymis or testicle. In some people, for reasons poorly understood,
a chronic epididymitis can develop. This can be particularly difficult and frustrating to treat, and can
result in impairment of social or occupational function.
Often your doctor will also recommend an ultrasound,whichwill provide amore detailed look at
the structures in the scrotum, and the blood flow to them.

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