Vasectomy Reversal
What is a vasectomy?
A vasectomy is surgery men have to prevent pregnancy when having sex with female partners. In the surgery, the vas deferens, the two tubes that carry sperm from the testicles to the penis, are cut and blocked. After the surgery, the semen that is ejaculated during sex no longer contains sperm.
What is vasectomy reversal?
In a vasectomy reversal, surgery is performed to reconnect the vas deferens after a previous vasectomy. Up to 6 percent of men (approximately 30,000 men each year), change their minds after vasectomy and wish to father children again.
One common misconception is that after a period of time, a vasectomy reversal is no longer possible. While the age of the vasectomy (or the obstructive interval) is a factor, there is no time cutoff where a vasectomy reversal will not work. Very high success rates can still be expected decades after vasectomy. Our experts have performed successful reversals with vasectomies performed over 30 years prior.
What happens during the vasectomy reversal?
The surgery is an outpatient procedure. This means that patients do not need to stay in the hospital for this type of surgery. The surgery itself typically takes 3-4 hours depending on the level of complexity of the repair.
The goal of a vasectomy reversal is to bypass the point of obstruction. While the initial vasectomy causes blockage in the vas deferens, additional blockage points can occur elsewhere in the vas deferens or epididymis after the vasectomy. In order to identify the level of blockage, during the vasectomy reversal procedure fluid from the vas deferens is examined under the microscope. Based on the inspected fluid’s color, consistency, and contents, the indicated procedure can be determined.
Vasectomy reversal may involve two types of procedures: In a vasovasotomy (or VV), the surgeon stitches the cut ends of the vas deferens together.
In the other type of procedure, a vasoepididymostomy (or VE), the surgeon creates a bypass around a blockage found in the epididymis to reconnect the vas to the unblocked epididymis.
How effective is vasectomy reversal?
The effectiveness of a vasectomy reversal is up to 90-95 percent. Vasovasotomy procedures (90-95 percent) generally have higher success rates than vasoepididymostomy procedures (65-70 percent). In either type of surgery, the vasectomy reversal is often more successful with microsurgery as this allows precise reapproximation of the cut ends of the genital tract. Microsurgery is a type of surgery that requires an operating microscope to perform the procedure. Fellowship trained in microsurgery, our experts are able to delivery state-of-the-art care with superior success rates.
What is recovery like?
Patients undergoing vasectomy reversal will be given specific recovery instructions by their surgeon based on the specific procedures performed and the specifics of their case. In general, patients are advised to stay off their feet for a few days. Pain is manageable and similar to the original vasectomy procedure. Applying ice packs to the scrotum is suggested to reduce swelling and pain. Prescribed pain medication may be necessary for a few days after the procedure. After that, over-the-counter pain medications such as acetaminophen or ibuprofen may be used to reduce pain if necessary. Patients routinely return to sitting, office jobs within 3 days and jobs that are physically strenuous in about 4 weeks. Ejaculation and strenuous activity should be avoided for 2 weeks.
A follow up visit will occur at 2 weeks to assess healing and recovery. At 6 weeks, the first semen analysis will be checked. Depending upon the type of repair and time from vasectomy, sperm can take 1 month to 1 year to return to the ejaculate.