Vasectomy Reversal (also known as Vasovasostomy)
Vasovasostomy (Vasectomy Reversal) involves stitching the cut end s of the vas deferens back together in two layers and is the simpler and more common procedure. Vaseoepididymostomy is performed if the epididymis is inflamed or scarred to the extent that it blocks sperm from reaching the vas deferens. In vaseoepididymostomy, the surgeon bypasses the blockage and stitches the vas deferens directly to the epididymis in two layers.
The surgeon determines which procedure is necessary by removing the scarred ends of the vas deferens resulting from the vasectomy and then examining the fluid coming from the upstream end of the tube for sperm content and fluid quality. The fluid is checked under a separate microscope by the surgeon during the procedure. If the fluid contains sperm or, in rare cases, is clear, a vasovasostomy is performed. If the vas fluid does not contain sperm or is thick and opaque, a vaseoepididymostomy is performed to bypass the blockage and permit sperm to flow directly from the epididymis to the vas deferens.
Vasectomy reversal surgery is performed under general anesthetic in an ambulatory surgery center on a same-day, outpatient basis. The surgery takes approximately 3 hours.
You will be asked to wear a scrotal support and stay home from work at least a week and avoid strenuous activity, including sex, for 2 weeks after surgery, after which you should be released to resume normal activities.
After surgery, it may take several months for sperm to return to the ejaculate and exhibit normal motility, or movement. Semen analysis will be checked in the office after your surgery during the first nine months after surgery.
There are many factors that affect rate of success, including site of the vasectomy, length of the remaining vas deferens, length of time between vasectomy and reversal, whether reversal surgery has already been attempted, epididymal blockage and the fertility of your partner.
The most accurate estimate of success rates is given after a consultation with our doctors and the above factors taken in to account. Our specific success rate for patients with your characteristics will be discussed.
Generally, the biggest predictor of success is the length of time between vasectomy and reversal procedures. The greater the length of time, the greater the chance that epididimyal blockage has occurred necessitating vaseoepididymostomy. Studies reveal that success rates in both fertility and conception decline as the time between vasectomy and reversal increases. In men who had vasovasostomies from less than three to more than 15 years ago, sperm return declined from 97% to 71%, and conception declined from 76% to 30%. These rates, however, do not apply to specific individuals or couples. You should not be discouraged if your vasectomy was some time ago.