Vasectomy Reversal

The number of men coming to the urologist and requesting surgical reversal of a vasectomy has grown dramatically. In the United States remarriage and the desire to initiate a pregnancy is by far the most common reason given for requesting the vasectomy reversal. However, couples who have merely “changed their minds” as well as couples who have lost a child and are attempting to initiate another pregnancy also request them. The refinement of microsurgical techniques and technological advancements has resulted in a significant improvement in post-operative pregnancy rates.

Prior to a vasectomy, sperm are produced in the testicles and leave the testicles by entering a small coiled tube called the epididymis. The epididyimis travels next to the testicle and then leads to the vas deferens which carries sperm into the urethra. During a vasectomy, the vas deferens is divided and the ends sealed. Sperm are still produced in the testicle but cannot travel past the vasectomy site. A vasectomy reversal is an operation that reconnects the two ends of the vas deferens that were separated and sealed at the time of the vasectomy. At times the vas deferens is reconnected to the epididymis (epididymovasostomy) due to a secondary blockage in the epididymis. This operation is performed entirely under the microscope.

We use a microsurgical three-layer technique utilizing microscopic sutures and the latest microsurgical equipment and reconstructive techniques facilitating precision suture placement. The vasectomy reversal is an outpatient procedure and operating time for a vasovasostomy or epididymovasostomy is approximately 3 hours. Post-operative follow-up includes an initial evaluation of wound healing around 10 to 14 days and a semen analysis at 6 to 8 weeks.

The success of a vasectomy reversal is dependent on the skill of your surgeon as well as intra-operative findings. During the procedure, fluid from the vas deferens will be examined and determine if sperm is present. The quality of the fluid (clear and watery vs. thick and pasty) and the presence of sperm will dictate the expected success.