A vasectomy reversal is a surgical procedure that reconnects the previously cut or blocked tubes (vas deferens) from a vasectomy, allowing sperm to flow again and potentially restore fertility. This is often called a vasovasostomy.

Advanced techniques using an operating microscope handled by a urological surgeon can lead to higher precision and success rates.

A single incision is made in the middle part of the scrotum. This incision allows the surgeon to carefully dissect and expose both vas deferens tubes. It also enables the option of performing a vasoepididymostomy, if necessary.

Any scar tissue from the previous vasectomy is removed. The ends of the vas tubes are probed to ensure they are open and gently dilated if needed. Using a specially designed clamp, the cut ends are brought together and meticulously joined with very fine suture material, which is barely visible to the naked eye.

To strengthen the connection, a second layer of sutures may be added. Throughout the procedure, a high-powered operating microscope is utilized to enhance visualization. Finally, the skin is closed with dissolvable sutures.

In more complex cases where the vas deferens is extensively scarred or the vasectomy was performed near the testicle, a vasoepididymostomy procedure may be necessary. This involves directly connecting the vas tubes to the epididymis, which is where sperm is stored near the surface of each testicle. The decision to perform vasoepididymostomy is typically made during the surgery based on the specific conditions observed.

Success rates vary based on factors such as the time since the vasectomy, the surgeon's skill, and the presence of anti-sperm antibodies. Success rates range from 40% to 90%, with higher success rates within a few years after the vasectomy.

Whilst there are surgeons who are highly skilled in this procedure, it is important to know that there are no guarantees that the procedure may work. Hence why it is all the more important you are well informed and certain about undertaking a vasectomy.

The procedure typically takes around 2 to 4 hours, depending on the complexity of the case. An overnight hospital stay is often recommended.

The procedure is performed under anesthesia, so you won't experience pain during the surgery. However, some discomfort and swelling may be experienced during the recovery period.

The recovery time varies for each individual, but typically you can expect to take it easy for a few days and avoid strenuous activities for about 2 to 3 weeks. It's important to follow your surgeon's post-operative instructions for optimal healing.

Like any surgery, there are potential risks and complications, although they are generally rare. These may include infection, bleeding, scarring, chronic pain, and a reduced success rate if complications or blockages are encountered during the surgery.

It usually takes a few months for sperm to appear in the semen following a vasectomy reversal. Once sperm is detected, you can begin trying to conceive. It's important to note that successful sperm presence doesn't guarantee pregnancy, and it may take several months or longer to achieve a pregnancy.

In some cases, a repeat vasectomy reversal procedure may be an option if the initial surgery fails or if subsequent blockages develop. However, the success rate may be lower with repeat procedures due to increased scarring and other factors.

Yes, if desired, a vasectomy can be performed again after a vasectomy reversal. However, it's important to carefully consider this decision as a vasectomy reversal is considered a more complex procedure than a vasectomy.

If the vasectomy reversal is not feasible or unsuccessful, alternative options for achieving pregnancy include using donor sperm, adoption, or exploring assisted reproductive technologies such as in vitro fertilization (IVF) with sperm retrieval techniques.

In some cases, a vasectomy reversal may alleviate post-vasectomy pain syndrome, a condition characterized by chronic testicular pain following a vasectomy. However, relief is not guaranteed for everyone, and the success rate may vary.