Vasectomy and Vasectomy Reversal
Can a vasectomy be reversed? How is a reversal performed?
A vasectomy is intended to be a permanent form of birth control. However, a wide range of life events – including the death
of a child, divorce and remarriage and changes in financial status, among other things – lead men with vasectomies to seek
reversals.
Although vasectomy reversal is an outpatient procedure, it is an extremely complicated surgery requiring great skill and experience
in microsurgery.
A reversal requires the surgeon to stitch together the vas deferens – which is about the diameter of a strand of spaghetti
– and to ensure alignment of its inner channel – which is one-third of a millimeter in diameter. What’s more, the surgical thread that is used to knit the two ends together is finer than a human hair and nearly
invisible to the naked eye. The procedure, therefore, requires the use of an operative microscope.
A “basic” reversal called a vavovasotomy involves reconnecting the vas deferens that was cut during a vasectomy. When there’s
a blockage between the vas deferens and the epidydymis, a more complicated procedure called a vasoepididymostomy is required.
The type of procedure required is often identified during the reversal:
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When surgeons find fluid with sperm cells coming from the vas, they can generally reconstruct the open channel by reconnecting
the vas ends in more than 90 percent of patients.
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If only fluid without sperm can be seen coming from the vas, surgeons can build an open channel through the vasectomy site
in somewhat greater than 70 percent of patients. (The actual pregnancy rate is closer to 40 percent.)
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Finally, if the fluid is poor and sperm are absent, the vas can be directly connected to the epididymis; however, there’s
a further reduction in the potential success rate.
Summary: Vasectomy reversal
A vasectomy is intended to be a permanent procedure. Even so, due to unforeseeable life events, vasectomy reversals are technically
possible – and increasingly common. In fact, over 50,000 men have reversals each year.
The success of a reversal is contingent upon the skill of the surgeon, the condition of the tissue, as well as the time that
has passed since the original vasectomy. A major study has found that the chances of rebuilding a vas channel range from 71
to 97 percent, depending on the numbers of years since vasectomy. The same study found that the chance of pregnancy ranges
from 30 to 76 percent.
Because individual cases vary, it’s important to discuss your personal success factors with a urologist formally trained in
microsurgical technique and who frequently performs this procedure.
