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For men who have had a vasectomy but now desire to father children, their most effective option is usually vasectomy reversal.   Vasectomy reversal is performed as a “day surgery” or outpatient procedure.  The procedure re-establishes continuity of the vas deferens to allow sperm to reappear in the semen and takes about 3 hours. 
Because of the small size and delicate nature of the involved structures, best results are achieved by using an operating microscope or microsurgical technique.  Using any lower form of magnification generally does not allow the highest success rates.
Reversing the vasectomy is done one of two ways.  The most common method is a vaso-vasostomy where the 2 ends of the vas deferens are re-joined, re-establishing flow of sperm.  In certain instances (such as when a vasectomy is over 10 years old) a different technique may be required.  This technique is known as vaso-epididymostomy and is required when the upstream structure called the epididymis has been “blown out” and scarred shut from long term blockage.  Unfortunately, it is not until the procedure is underway and fluid from the vas deferens can be examined that this decision is made.  Since the vaso-epididymostomy is an even more technically demanding and delicate procedure than vaso-vasostomy, it is important to choose a vasectomy reversal surgeon who is able to perform this procedure, especially if your vasectomy is over ten years old.
Patients go home the same day of their surgery and can resume work in a few days.  Because of the delicate nature of the surgery, it is best not to engage in any strenuous physical activity or sexual activity for 2-3 weeks after the procedure.  A semen analysis is usually done at about 6 weeks after surgery to look for sperm.

Finding a Vasectomy Reversal Surgeon

When searching the internet, finding the right vasectomy reversal surgeon can be confusing.   Rest assured that despite what some would have you believe, there is more than one urologist who can perform your vasectomy reversal successfully.  Important factors to consider are:
• How often does the surgeon do vasectomy reversal?
• Is a microsurgical technique used?
• Can the surgeon convert from a vaso-vasostomy to a vaso-epididymostomy if necessary during the reversal procedure?

What is often overlooked is that you should be comfortable with your choice and have trust in your surgeon.

Dr. Dan French has been fellowship trained in male infertility and microsurgery at the Cleveland Clinic and brings this expertise to the Dallas Center for Pelvic Medicine located in Dallas Texas.  For a consultation regarding vasectomy reversal, please contact our office at (214) 360-1535.