Reverse Vasectomy

Vasectomy Reversal

Vasectomy Reversal or Reverse Vasectomy surgery reconnects the ducts that carry sperm from the testicles into the semen. After successful vasectomy reversal, sperm are present in your semen again and you may be able to get your partner pregnant.

This guide has been written to assist men who want to restore their fertility through vasectomy reversal surgery. The purpose of this guide is to familiarize men with the procedures that are involved, from the initial examination through surgery and the post-operative period, to help lessen the apprehension that can accompany the decision process.

What is a vasectomy?

A vasectomy is a safe, simple, quick and effective method of contraception.

To understand what a vasectomy is, a little knowledge of normal male anatomy is needed. The testicles are continually producing sperm even after a vasectomy. The sperm is stored in the epididymis, located directly above the testicles. Sperm moves from the epididymis through each vas deferens to the prostate, located in front of the bladder. When ejaculation occurs, sperm is expelled from the penis.

A vasectomy is a surgical procedure that disrupts the flow of sperm through the vas deferens. The surgeon actually cuts through the vas deferens and then places a clip or suture.

What is a vasectomy reversal?

A vasectomy reversal is, a surgical procedure that restores the flow of sperm through the vas deferens. It is usually performed by an experienced microsurgeon using specialized instruments, including an operating microscope. The sutures used in vasectomy reversal are finer than humanhair.

There are two types of vasectomy reversals: vasovasostomy and vasoepididymostomy.

A vasovasostomy is the operation most frequently performed for vasectomy reversal. It entails stitching the cut ends of the vas deferens together.

A vasovasostomy is the surgery of choice for vasectomy reversal. However, if excessive inflammation or scarring has occurred in the epididymis, sperm may be blocked from getting to the vas deferens. If a blockage has occurred in the epididymis, merely connecting the two cut ends of the vas deferens (as is done in a vasovasostomy) will not solve the problem. To bypass the blockage in the epididymis, a vasoepididymostomy must be performed.

A vasoepididymostomy is performed by connecting the vas deferens directly to the epididymis. One end of the vas deferens is stitched directly to the epididymis.

What are the success rates associated with vasectomy reversal?

Before the advent of microsurgical techniques, vasectomy reversal procedures were only occasionally successful. With the relatively recent advances in microsurgical techniques, instruments and suture materials, success rates have greatly increased.

Results of recent studies indicate that following microsurgical vasovasostomy sperm appears in the semen in approximately 85 to 97% of men. Approximately 50 percent of couples subsequently achieve a pregnancy.

Following microsurgical vasoepididymostomy, sperm appears in the semen in approximately 65% of men. Approximately 20 percent of couples subsequently achieve a pregnancy.

Is vasectomy reversal a common procedure?

Current estimates are that about one percent of men who have undergone a vasectomy will eventually want reversal surgery.

About 500,000 men have vasectomies each year in the United States. While the number of men requesting vasectomy has remained approximately the same, the number of men requesting vasectomy reversal has increased.

Why do men want vasectomy reversals?

The leading reason that men elect to have vasectomy reversal is to father a child after remarriage following divorce or death of a spouse.

Others seek vasectomy reversal after the death of a child. A small percentage of men seek reversal for relief of scrotal pain attributed to the vasectomy, a desire to restore fertility independent of any change in marital status, or because of religious beliefs.

Can all vasectomies be reversed?

From a surgical standpoint, it is rare that a vasectomy cannot be reversed. In the past, if the epididymis was blocked or a large segment of the vas deferens was removed during the vasectomy, a vasectomy reversal procedure was considered to be too complicated and was unlikely to be successful. Today, however, the development of new microsurgical techniques has provided a way to bypass an epididymal blockage and correct a shortened vas deferens. These new techniques have led to improved pregnancy rates following vasectomy reversal even in the most extreme cases.