Vasectomy Reversal

vasovasostomy

Vasectomy reversal is the reconnecting of the two ends of the vas deferens that were cut and blocked during the vasectomy procedure. The sperm are still being made in the testicle, but after a vasectomy they are not able to be released into the ejaculate fluid. The vasectomy reversal restores continuity to the original anatomical configuration to restore sperm to the ejaculate.

The procedure is performed in the operating room, under a general anesthetic to maximize comfort and minimize movement. The operation is performed using an operative microscope, with 20 times the magnification of the human eye. An operative microscope has been shown to improve outcomes, as the inner lumen of the vas deferens is approximately 1/100th of an inch in diameter.

There are two types of connections that may be performed. This determination is made at the time of surgery, based on where sperm are found. Vaso-vasostomy, is when the two vas ends are sewn back together, in their original configuration. Sometimes this is not possible due to scarring, and an alternative operation, the Vaso-epididymostomy, is necessary. The Vaso-epididymostomy is a similar microsurgical procedure that involves the connection of the vas to the epididymis, a collection of small tubules that sperm pass through prior to entering the vas. Both types of connections have excellent patency rates when performed by someone fellowship-trained in these operations, and performed under the surgical microscope.

Here are the answers to some common questions about vasectomy reversal:

  • When can I go home?

After surgery, men go home the same day. They are encouraged to restrict activities to light duties for 2 weeks to allow for healing of these delicate connections.

  • When can I have sexual intercourse after a Vasectomy Reversal?

Men can return to intercourse after 3 weeks.

  • When will I be able to conceive again?

We check for the presence of sperm in the ejaculate at 3 months after the surgery. Couples are encouraged to “try” to achieve a pregnancy even before we have checked for sperm at 3 months.