Vasectomy Reversal

An Increasingly Common Procedure

If you’ve made it to this page, you’re probably thinking about reversing a past vasectomy and trying for children, or perhaps you’re experiencing discomfort after having a vasectomy. You’re not alone: In the United States, about 500,000 men have vasectomies each year and approximately three to six percent of those men later seek a vasectomy reversal.

As you probably also know, a vasectomy reversal is a surgical procedure that reverses a previous vasectomy. The goal is to restore the flow of sperm through a tube called the vas deferens. The procedure is usually performed by an experienced microsurgeon using specialized instruments, including an operating microscope. The sutures used in vasectomy reversal are finer than human hair.

Can a Vasectomy be Reversed?

From a surgical perspective, most vasectomies can be reversed. This was not always the case. In the past, if there was an epididymal blockage or if 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, the new microsurgical techniques provide 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.

What are the Two Types of Vasectomy Reversals?

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 vasoepididymostomy is performed by connecting the vas deferens directly to the epididymis.

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A vasovasostomy entails stitching the cut ends of the vas deferens together, as illustrated in Figure 1a and 1b.

vas deferens epididymis

Figure 1a

Figure 1b

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, as illustrated in Figure 2a and 2b. One end of the vas deferens is stitched directly to the epididymis.

Figure 2a

Figure 2b

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