OHSU

vasectomy reversal

A vasectomy reversal is the surgical removal of the vasectomy site and reconnection of sperm drainage to semen, ideally to regain male fertility.

The introduction of microsurgery has greatly improved the success of vasectomy reversal. In the experience of our surgeons, who have performed more than 3,300 procedures, is that about 70 percent of couples will be able to have a child after vasectomy reversal if the surgery is done within 6 to 7 years of the vasectomy. After 7 years, the pregnancy expectation gradually declines to about 40 percent after 15 years. We have determined that spousal age is also an important factor predicting success. Pregnancies can occur as quickly as a few weeks, or it may take more than a year. The average time to pregnancy is about eight months.

The surgery is done through a small mini-incision on each side of the scrotum. The vasectomy site is removed and the ends of the vas inspected to be sure they are open. In most cases sperm is found to drip from the end draining the testicle. If no sperm is found, it may mean that the portion of the vas closer to the testicle has been so badly damaged that it will no longer conduct sperm. When no sperm is found, the vas closer to the testicle must be explored to find sperm. The reversal will be done at the spot where sperm is located, bypassing the damaged portion. The probability of the bypass increases as time from the vasectomy increases. In rare cases, the vasectomy can cause such extensive damage that sperm are not found. In that situation, the repair will be done at the site that appears best in the judgment of the surgeon.

Complications are unusual. As with all surgery, there is always the risk of bleeding and infection. Expect bruising, swelling and pain at the surgical site. Within 10-14 days the swelling usually subsides but may be present for several weeks. Plan for 1 week off work after surgery. A few men will require some additional days off work if the swelling and pain have not subsided.