Sometimes, for various reasons, men who have undergone a vasectomy decide they have made a mistake and wish to be able to have children again. In some cases, vasectomy reversal may be an option for these patients.

What Are The Indications of Vasectomy Reversal?

Vasectomy reversal may be indicated when a man remarries following a divorce, loses a wife or child, and desires to start a new family. In fact, any time a man wishes to regain fertility after a vasectomy is an indication for vasectomy reversal.

Am I a Candidate for Vasectomy Reversal?

The site of the vasectomy is a factor in the outcome of reversal surgery. A vasectomy can be performed close to the testicle and epididymis or farther away. A disruption of the vas deferens farther away from the testicle will leave a long length of vas deferens (vas remnant) and increase the chance of a successful reversal. The shorter the vas remnant ,the greater the chance of scarring and obstruction in the epididymis necessitating a more difficult vasoepididymostomy.

What Does the Procedure Involve?

Your doctor will examine you before surgery by physically palpating your scrotum to determine the firmness and size of the testicles. If you have one or more shrunken testicles, this may indicate irreversible testicular failure; therefore surgery may not be able to restore fertility. If your doctor encounters an engorged and perhaps firm epididymis, this indicates that an epididymal blockage may be present.

Once the patient is anesthetized, the urologist will make small incisions on each side of the scrotum and first remove the scarred ends of the vas at the point of blockage created by the vasectomy. The urologist will then extract a fluid sample from the end closest to the testicle to examine the fluid to see if it contains sperm.

The presence of sperm in the fluid is an indication that there is no obstruction between the testicle and the location in the tube from which the fluid was obtained, and particularly that there is no blockage in the tube in the epididymis. When sperm are present in the fluid, the passage can be reestablished by reconnecting the ends of the vas. The medical term for reconnecting the ends of the vas is vasovasostomy. This may be accomplished with one of several methods.

If the urologist uses a "modified one-layer" method (figure 2), he/she actually places a series of tiny stitches through the entire thickness of the vas (from the exterior into the central canal) to join the ends. Once these full thickness stitches (the first "layer") are tied, a second set, or "layer," of stitches that only pierce the outer portion of the vas is placed between each adjacent pair of full thickness stitches. The modified one-layer method is used by surgeons who reconnect the ends of the vas without microsurgery, as well as by some surgeons who use microsurgery.

Urologists use microsurgery to produce better results using high-powered microscopes that magnify structures from five to 20 times their actual size. An operating microscope allows the urologist to manipulate stitches smaller in diameter than an eyelash to join the ends of the vas. The "two-layer" vasovasostomy method (figure 3), preferred by many urologists who use microsurgical techniques, involves placing six to eight tiny stitches to join the edges of the inner lining of the vas. This series of stitches is the first "layer." Then, another series of stitches (the second "layer") is placed to connect the outer portion of the two cut ends of the vas.

What Are the Advantages of Vasectomy Reversal?

• You can regain fertility that was previously lost due to a vasectomy

How Many Treatments Are Required?

Usually one treatment obtains the desired result.

Will I Have Pain?

There may be mild to moderate pain after anesthesia wears off. However, it is easily controlled using oral over-the-counter or prescription medications.

When Can I Go Back To Work Or School?

Usually you may return to work after 2-3 days to one week following surgery.

Who Will Perform My Treatment?

All treatments are performed by our expert infertility specialists

How Much Does Vasectomy Reversal Cost?

The cost for this procedure may vary from patient to patient depending on various factors; however, we guarantee that our pricing will always be competitive with that of other local providers furnishing equivalent services.

We provide excellent financing options, and discounts for multiple procedures are available.

For Further Information

If you have been wondering about how to restore your fertility, call TopSurgeons at 800-506-8084 and arrange a private consultation. We can answer any questions you might have about vasectomy reversal or anything else!