Vasectomy Reversal

Vasectomy reversal at a glance

• A vasectomy reversal reconnects the vas deferens, the duct that moves sperm from the testes to the penis, that was cut during a vasectomy.
• A typical vasectomy reversal is done as an outpatient surgery under general anesthesia with no hospital stay required.
• Occasionally, a urologist must perform a more complex procedure, known as a vasoepididymostomy, to bypass a blockage.
• Vasectomy reversals can be done 20 years or even longer after the vasectomy. However, the longer the time between the initial surgery and the reversal, the lower the chances of fertility success.
• The vasectomy reversal’s effects may not be immediate and can require months to a year for the patient’s partner to get pregnant. But the reversal is usually effective for decades.

Helpful terms

• Epididymis – this is the first tube that leaves the testicle and is also where sperm is stored and undergoes maturation in preparation for ejaculation.
• Vas deferens – this is the tube that carries sperm from the epididymis to the prostate gland.
• Semen – this is the fluid produced by the prostate gland and seminal vesicles and protects the sperm. The semen is the majority of what is ejaculated. This is why men with a vasectomy still produce what looks like a normal ejaculation.

What is a vasectomy reversal?

A vasectomy reversal is the surgical undoing of a previous vasectomy, a form of sterilization that is one of the most effective forms of birth control available. According to the American Urological Association (AUA), only 1 to 2 women out of 1,000 will become pregnant in the year after their male partner has had a vasectomy.

A man may choose to reverse a vasectomy for many reasons. These include remarriage, loss of a loved one spurring the desire for the man to have children with another woman, having more financial stability to support a family, or simply a change of heart.

During a vasectomy, a surgeon cuts the vas deferens, the tube that connects the testicles to the penis. This severing of the vas deferens prohibits sperm from being ejaculated. A vasectomy reversal can be done using one or both of the following procedures.

Vasovasostomy

A vasovasostomy is the most common form of vasectomy reversal. During this procedure, a urologist will make a small incision on each side of the scrotum and test a sample of fluid from the vas deferens near the testicle to check for sperm.

If there is sperm, with the aid of a high-powered microscope the urologist will sew the ends of the previously severed vas deferens back together using stitches that are much thinner than a human hair. This is an outpatient procedure, which can take two to three and a half hours and is typically done under general anesthesia.

Vasoepididymostomy

A vasoepididymostomy is performed if there is no sperm in the test sample from the vas deferens, or if the fluid is abnormally thick. This may be caused by a blockage in the epididymal tube that connects the vas deferens to the testicle.

A vasoepididymostomy is a more complex procedure during which a urologist stitches the vas deferens to the epididymis. The results of a vasoepididymostomy are comparable to that of a vasovasostomy.
Related Reading: Treatments for Male Infertility

It can take four months to a year for a vasectomy reversal to become fully effective. The amount of time between the initial vasectomy and the reversal surgery can impact fertility. According to the AUA, pregnancy rates are higher when the vasectomy reversal is performed sooner after the vasectomy.

Other than a successful pregnancy by the man and his partner, a urologist will determine if the reversal was successful by testing the man’s sperm count every two to three months. The effects of a vasectomy reversal will last for many years to come.

Recovery after a vasectomy reversal

The recovery after a vasectomy reversal is generally easy. Most men consider the pain of the reversal similar to the pain experienced during the vasectomy. Pain is typically managed with medication and lasts roughly a week.

Patients often return to a normal routine within a week of the vasectomy reversal. It is typically recommended that a man wear a jockstrap for support for a few weeks after the procedure. Refraining from strenuous activity and sex for two to three weeks is also recommended.

As with any surgery, there is a chance of side effects or complications. Side effects are rare and include bleeding from the incision, blood in the scrotum known as a hematoma, fever over 100º F or loss of feeling around the scrotum.