Yes, in some cases. Vasectomy reversal (vasovasostomy) restores sperm flow in many men, particularly within the first 10 years of vasectomy. Success rates decline with time: up to 75% within 3 years, falling to around 30% after 15 years. Reversal is not available on the NHS in most areas and costs between £2,000–4,000 privately. Success is not guaranteed and depends on the surgeon's experience, time elapsed since vasectomy, and female partner’s fertility.

You should use additional contraception until a post-vasectomy semen analysis confirms the complete absence of sperm. This test is typically performed 8–12 weeks after the procedure and after a minimum of 20 ejaculations. Until you receive written confirmation that the semen is sperm-free (or contains only non-motile sperm), you are not reliably sterile. Do not assume the vasectomy is effective before this confirmation.

Post-vasectomy pain syndrome (PVPS) is persistent scrotal discomfort or pain after vasectomy, lasting more than 3 months, and affects approximately 1–2% of men. It is caused by congestion of the epididymis (build-up of sperm), sperm granuloma formation, or nerve damage during the procedure. Most cases are mild and respond to NSAIDs and supportive underwear. Severe cases may require corticosteroid injections, epididymectomy, or even vasectomy reversal. PVPS is more common in men with a history of scrotal pain or orchalgia before vasectomy. It should be discussed as a complication risk before the procedure.

After vasectomy, some men notice small firm lumps in the scrotal area — often sperm granulomas. These are formed when sperm leak from the vas deferens and provoke a local immune and inflammatory reaction, creating a small nodule. Sperm granulomas are benign, affect around 15–40% of men post-vasectomy, and usually resolve spontaneously without treatment. They can occasionally cause tenderness. If a lump is painful or growing, or if you have any concern about a testicular lump, always have it assessed by a clinician to exclude the extremely small but important possibility of testicular cancer.

Yes. Two male fertility investigations that are often overlooked but important are: (1) Anti-sperm antibody (ASA) testing — in men with poor motility and no other cause, antibodies can coat the sperm surface and impair penetration of the egg. ASA affects 5–10% of infertile men. (2) DNA fragmentation testing — high levels of DNA damage within sperm (measured by the sperm DNA fragmentation index, DFI) can cause recurrent IVF failure or miscarriage even when conventional semen analysis is normal. Antioxidant therapy and varicocele repair may reduce DNA fragmentation. These tests are typically performed at specialist andrology clinics.

Yes. Stopping anabolic steroids allows natural testosterone production to recover, but this can take 12–24 months or longer, and may be incomplete in some men. During this period, semen analysis is typically severely abnormal or showing azoospermia. Recovery can be accelerated with hCG injections and FSH therapy under specialist supervision. Men who wish to have children after steroid use should be assessed by a reproductive endocrinologist. The longer and higher the dose of steroids used, the longer recovery takes. Men considering fertility treatment should stop steroids at least 12 months before any ART cycle.

Post-thrombotic syndrome (PTS) is a complication affecting 20–50% of people after DVT, causing chronic pain, swelling, skin changes, and — in severe cases — venous ulceration in the affected leg. It results from valve damage in the deep veins caused by the clot. The most effective prevention is wearing correctly fitted class 2 graduated compression stockings for at least 2 years after DVT. Early ambulation after DVT (walking is safe and beneficial), adequate anticoagulation, and compression therapy all reduce the risk. Severe PTS may require specialist vascular assessment.

Lymphoedema is chronic, progressive swelling caused by damage to the lymphatic system. Unlike pitting oedema from venous causes, lymphoedema is typically non-pitting, affects the foot and toes (not just the ankle), and does not improve with overnight elevation. Common causes include cancer treatment (lymph node removal or radiotherapy), infection (particularly recurrent cellulitis), and primary lymphatic abnormalities. It is managed — not cured — with complex decongestive therapy (manual lymphatic drainage, compression garments, skin care, and exercise). Early specialist referral to a lymphoedema clinic is important.