Every year approximately 500,000 men elect to have a vasectomy as a means of birth control. Due to changed circumstances 2-6% of these men elect to have a vasectomy reversal.
What happens to the sperm after a vasectomy?
After a vasectomy the testis never stops making sperm, but the production decreases as the normal path for the sperm to travel is obstructed. The maturation process, which involves the travel through the epididymis, the tubular network which leads to the vas, is delayed and these sperms never reach the ejaculate.
What happens during a vasovasostomy?
The vasectomy reversal reestablishes the continuity of the tube, the vas deferens to allow the sperm to travel through this tubular network and reach the ejaculate. This procedure is called a vasovasostomy and requires a microsurgical anastomosis (reattachment) by an urologist experienced in this art. This procedure can take between 3-4 hrs.
What is the vasovasostomy recovery process?
The procedure is done on an outpatient basis, and return to work is expected after 5-7 days. Normal activities after 2-3 weeks. Full healing time can take up to 6 weeks.
What is the success rate?
Recent developments using fibrin glue to assist the microsurgical technique can decrease operating room time without affecting the patency rates. Large studies after vasectomy reversal (combined total of 6,600 patients) show patency rates of 89%. Actual pregnancy rates is lower around 73%. The length of time form the time of the vasectomy also affects success rates:
| Patency | Pregnancy | |
| < 3 years | 97% | 76% |
| 3-8 years | 88% | 53% |
| 9-14 years | 79% | 44% |
| > 15 years | 71% | 30% |
| After a repeat procedure | 75% | 43% |
When do you check for success after vasectomy reversal?
Semen analyses are checked 3 months after surgery. Then every 3 months until the sperm count stabilizes. It can take up to 6-12 months for sperm to return to the ejaculate.
