Baylor Medicine’s male infertility specialists are renowned for their expertise in vasectomy and vasectomy reversal procedures. Patients from around the globe seek our surgeons’ care due to our outstanding reputation, high-quality outcomes, and exceptional patient satisfaction. Our surgeons have performed over 5,000 vasectomy reversals, helping thousands of men restore their fertility, confidence, and sense of self.
What is Vasectomy Reversal?
A vasectomy reversal is a surgical procedure that reconnects the two ends of the vas deferens that were separated during a prior vasectomy. In some cases, the vas deferens is reconnected to the epididymis (epididymovasostomy) due to a secondary obstruction in the epididymis.
Many men seek vasectomy reversals for various reasons, including remarriage and the desire to start a family, changing their minds, or attempting to have another child after a loss. Advances in microsurgery have significantly improved pregnancy rates following these procedures.
Micro-surgical Vasectomy Reversal Techniques
Vasovasectomy
The most common technique for vasectomy reversal is the microsurgical vasovasostomy. During this procedure, a small incision is made in the scrotum to access the vas deferens, which is then reconnected using microscopic sutures. This minimally invasive procedure is suitable for patients with fluid and sperm present in their vas deferens at the time of surgery. The bilateral version of this procedure has a 95% success rate.
Epididymovasostomy
For patients without sperm and fluid in their vas deferens, an epididymovasostomy may be performed. This procedure involves connecting the vas deferens directly to the epididymis, a duct that transmits sperm from the testis to the vas. As with microsurgical vasovasostomy, this procedure can be performed unilaterally or bilaterally. When both testes require an epididymovasostomy, patients typically experience a 50 to 60 percent success rate, as the epididymis is smaller and more challenging to modify. Patients are advised to freeze their sperm as a precaution.
Operation and Post-operative Information
The operating time for both vasovasostomy and epididymovasostomy is approximately three hours, typically under general anesthesia, though regional anesthesia is an option. Out-of-town patients should plan to stay in Houston for at least one day post-surgery.
Postoperative follow-up includes wound healing evaluation at 10 days to 2 weeks and semen analysis at 6-8 weeks. Monthly semen analyses are conducted for about four to six months or until stabilization. Anti-inflammatory medication may be prescribed if semen quality is less than expected.
Cryopreservation
Cryopreservation of sperm (sperm banking) is routinely performed at the time of vasectomy reversal if whole, motile sperm are present. This serves as a backup in case of inadequate sperm counts post-surgery. Sperm may also be cryopreserved early in recovery when semen quality is high. Sperm are stored at the Scott Department of Urology's Sperm Bank.
