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The Vasectomy Reversal Procedure and Success Rates

A vasectomy reversal, also known as Vasovasostomy, is a procedure where the cut ends of the vas deferens are reconnected to reestablish flow of sperm from the testicles to the urethra. Reasons to have this procedure performed include the desire to have more children or in rare instances, to attempt to remedy chronic pain from a prior vasectomy. Typically, the sooner a patient decides to have his vasectomy reversed, the better the results. Historically, patients that had their vasectomy reversed within 7 years had higher success rates.

The procedure is performed in an outpatient surgery center under general anesthesia. The reversal procedure usually takes 2-1/2 to 3 hours to perform, and a high-powered microscope is used for visualization. A modified 2-layer closure is performed which means that four full-thickness sutures are placed at the 12 o’clock, 3 o’clock, 6 o’clock and 9 o’clock positions using a 9-0 nylon suture that is smaller than a human hair. An additional four partial thickness sutures are then placed in between the full-thickness stitches. Prior to reconnecting the ends of the vas deferens, the scar tissue from the previous vasectomy procedure must be removed and the patency of the two ends of the vas deferens must be confirmed. Patency of the two ends of the tubes are confirmed by seeing free flow of fluid from the testicular end of the vas deferens and by passing a small nylon suture into the lumen of the other segment of the vas deferens to make sure that there is no obstruction present.

After the procedure, the patient should not perform any strenuous activities for approximately 2 weeks and must not ejaculate for 1 month. We typically see the patient back 7-10 days after the procedure to make sure there is no evidence of wound infection or scrotal hematoma. If the patient is doing well, we will then see him back one-month post procedure to examine a semen sample. Hopefully, sperm will be seen on this initial sample, but it may take up to a year for sperm to be detected in the semen sample. Overall, approximately 85-90% of patients will eventually have viable sperm present on a semen analysis, but this does not translate into pregnancy rates since they are many other factors involved with conception (most of which are female factors).

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