The reality star opened up about having the surgery on Sunday's episode of Total Bellas.

By Jessica Fecteau
June 20, 2018 09:47 AM
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On the most recent episode of Total Bellas, John Cena told Nikki Bella he will reverse his vasectomy in order for them to have children together. The couple had briefly broken off their engagement in May, with sources telling PEOPLE that Bella couldn’t get past Cena’s refusal to have kids. But on Sundays’ dramatic episode, Cena revealed that he physically couldn’t because of a vasectomy — but was ready to reverse it for Bella.

According to Dr. Joseph Alukal, MD, the director of male reproductive health at NYU Langone Health, about 50,000 people nationwide have vasectomies reversed each year.

While a vasectomy may take only 20 minutes to complete and patients can remain awake with local anesthesia (similar to what you’d receive at the dentist), Alukal says reversing it is a longer process. The procedure, which is done through the same “tiny opening where the patient had the vasectomy,” jumps to a lengthier 2 to 2 1/2 hours. Many patients opt to use a stronger form of anesthesia to go fully under, which Alukal says is the only risk factor going into the surgery.

“Other than that, there’s no risk associated with the reversal,” he tells PEOPLE. “There’s just getting through the procedure and getting through a quick recovery.”

The recovery process is similar to when the patient initially had the vasectomy — a couple days of icing, rest in bed and then two weeks of no strenuous exercise, no heavy lifting and no sex.

Alukal says if the patient had a vasectomy within of 15 years of having the reversal, there’s a better than 95 percent chance that it’s going to work.

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“It depends on the patient, and it depends upon what things feel like when you examine them,” he says. “It’s not something where I’m ever going to tell somebody, ‘Look, this has no chance of working,’ unless there’s really something fundamentally wrong with them when I examine them in, which case we should try and fix that first. That’s really pretty rare.”

Alukal says once the two weeks is over and the patient comes back in for his sperm count, he is able to try having a child without his fertility affected at all from the surgery. While people opt to reverse their vasectomy to try and naturally have children with their partner, Alukal says it’s best if the woman in the relationship is first evaluated for fertility issues before making the decision to do the reversal.

“If somebody were to tell her that she’s really got some fertility issues and that she might ultimately need to do IVF (in vitro fertilisation) anyway, I might tell them let’s stop thinking about doing the reversal,” he says. “You can take sperm directly of the testicle with a different surgical procedure then the guy and his partner can move forward with IVF. That’s a different road for couples to go down.”

He adds: “This is a process that can always be navigated somehow. I always want them to understand this is a solvable problem.”