Vasectomy Reversal

A common procedure

Doctors have estimated that 10 percent of men who have a vasectomy change their minds and want their vasectomy reversed.  The most common reason for a vasectomy reversal is a divorce and remarriage, but sometimes a couple simply has a change of mind.  Another reason – a rare occurrence, fortunately – is the tragic death of a child.

The success rate for a vasectomy reversal varies depending on the time interval from the vasectomy to the reversal, and how the vasectomy was done.  The success rate can be as high as 98 percent in very favorable situations, or as low as 25 percent in less favorable circumstances.

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The first step is an exam by a urologist. Following the exam, the urologist will discuss the patient’s individual situation and chances of a successful vasectomy reversal, as well as the costs involved. He may discuss alternatives which might carry a better chance of success.

Often, a vasectomy reversal is successful in getting sperm back into the semen (known clinically as “technical success”), but there is still no pregnancy. The shorter the time interval from the vasectomy to the vasectomy reversal, the higher the pregnancy rates, as illustrated in the chart below.

Vasectomy reversals and related success rates

Years Between Vasectomy and Reversal Sperm Present in Semen Pregnancy Rate
Less than 3 98% 76%
3-8 88% 53%
9-14 79% 44%
>15 71% 30%

 

Other factors (beside a short time interval between the vasectomy and reversal) which are associated with success are 1) presence of a Sperm Granuloma (small bump) at the vasectomy site, and 2) Vasectomy performed as far from the testicle as possible.

Microsurgical vasectomy reversals

A microsurgical vasectomy reversal is performed as an outpatient in an outpatient surgery center.  The procedure can take three to five hours, depending on the complexity of the reversal.  It is usually performed under general anesthesia, but in some cases it can be performed under local anesthesia.  The risks are quite small, but include bleeding or infection in less than 1 percent of patients.