Can a vasectomy be reversed?
Vasectomy reversal is the most cost-effective way of achieving pregnancy after a vasectomy.
Whether a couples desires more children in a relationship or the desire for children in a new
relationship, vasectomy reversal offers the best chance of pregnancy.
There are over 35,000 vasectomy reversals performed annually in the United States. The most
common reasons for this procedure include divorce/remarriage, desire for more children in a current
relationship or death of a child. Occasionally, a vasectomy reversal will be performed simply
because a man has changed his mind and wishes to restore continuity of his reproductive tract.
Whether a couples desires more children in a relationship or the desire for children in a new
relationship, vasectomy reversal offers the best chance of pregnancy.
There are over 35,000 vasectomy reversals performed annually in the United States. The most
common reasons for this procedure include divorce/remarriage, desire for more children in a current
relationship or death of a child. Occasionally, a vasectomy reversal will be performed simply
because a man has changed his mind and wishes to restore continuity of his reproductive tract.
More information about vasectomy reversal:
 | Vasectomy reversal technique | |
| Financial information for vasectomy reversal | |
| Frequently asked questions | |
| Contacting a vasectomy reversal specialist | |
| 650-962-4663 |
Vasectomy Reversal
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How is a vasectomy reversal performed?
What is the success rate of a vasectomy reversal?
The success rate for vasectomy reversal is greater than 95% when sperm are identified at the time of
surgery. The chances of finding sperm at the time of vasectomy is determined by two important
between the vasectomy and the vasectomy reversal is greater than 15 years, the chances of
developing a secondary epididymal obstruction is approximately 50-60%. Also, when the vasectomy
is performed low on the vas deferens then these chances are compounded. If sperm are not
identified at the time of vasectomy reversal, an epididymovasostomy will be required to reverse your
vasectomy. Vasectomy reversal success with epididymovasostomy is 65-70%.
surgery. The chances of finding sperm at the time of vasectomy is determined by two important
between the vasectomy and the vasectomy reversal is greater than 15 years, the chances of
developing a secondary epididymal obstruction is approximately 50-60%. Also, when the vasectomy
is performed low on the vas deferens then these chances are compounded. If sperm are not
identified at the time of vasectomy reversal, an epididymovasostomy will be required to reverse your
vasectomy. Vasectomy reversal success with epididymovasostomy is 65-70%.
There are two ways to reverse a vasectomy: vasovasostomy and epididymovasostomy. Both
techniques involve bypassing the obstruction in the reproductive tract. Vasovasostomy is the
preferred method of vasectomy reversal when sperm are identified in the vas deferens at the time of
surgery. Epididymovasostomy is the preferred method when sperm are not seen in the vas deferens.
Vasovasostomy
Vasectomy reversal performed by vasovasostomy is done using an operating microscope that
provides magnification 25 times the normal image size. This is important since the size of the vas
deferens is about the same as a piece of spaghetti and should be sewn in two-layers to offer the
highest pregnancy rates. Microscopic suture (10-0 nylon) unseen by the naked eye is used during
the vasectomy reversal. It is important to use this fine a suture to prevent leakage of sperm and to
minimize obstruction of the lumen of the vas deferens by the suture itself. The cost of the suture
itself is over $600 per vasectomy reversal!
techniques involve bypassing the obstruction in the reproductive tract. Vasovasostomy is the
preferred method of vasectomy reversal when sperm are identified in the vas deferens at the time of
surgery. Epididymovasostomy is the preferred method when sperm are not seen in the vas deferens.
Vasovasostomy
Vasectomy reversal performed by vasovasostomy is done using an operating microscope that
provides magnification 25 times the normal image size. This is important since the size of the vas
deferens is about the same as a piece of spaghetti and should be sewn in two-layers to offer the
highest pregnancy rates. Microscopic suture (10-0 nylon) unseen by the naked eye is used during
the vasectomy reversal. It is important to use this fine a suture to prevent leakage of sperm and to
minimize obstruction of the lumen of the vas deferens by the suture itself. The cost of the suture
itself is over $600 per vasectomy reversal!
The initial step during a vasectomy reversal is to
identify whether or not there are sperm in the fluid
from the cut end of the vas deferens. If sperm are
identified then a vasovasostomy can be performed
successfully using microsurgical technique. If
sperm are not identified then a secondary
epididymal obstruction has developed and re-
connecting the vas deferens at the site of vasectomy
will universally be unsuccessful. This occurs 30% of
the time and is dependent on several factors such as
the time since your vasectomy and the site of your
vasectomy. If sperm are not seen then an
epididymovasostomy will be required in order to
reverse the vasectomy. (see below)
identify whether or not there are sperm in the fluid
from the cut end of the vas deferens. If sperm are
identified then a vasovasostomy can be performed
successfully using microsurgical technique. If
sperm are not identified then a secondary
epididymal obstruction has developed and re-
connecting the vas deferens at the site of vasectomy
will universally be unsuccessful. This occurs 30% of
the time and is dependent on several factors such as
the time since your vasectomy and the site of your
vasectomy. If sperm are not seen then an
epididymovasostomy will be required in order to
reverse the vasectomy. (see below)
The next step in a vasectomy reversal is to
re-approximate the ends of the vas deferens in a
tension-free manner. The 10-0 Nylon suture is
placed in the lumen of the vas deferens to provide a
water-tight closure for the sperm to travel. This is
important since leakage of sperm outside the lumen
can cause obstruction itself.
re-approximate the ends of the vas deferens in a
tension-free manner. The 10-0 Nylon suture is
placed in the lumen of the vas deferens to provide a
water-tight closure for the sperm to travel. This is
important since leakage of sperm outside the lumen
can cause obstruction itself.
Epididymovasostomy
Epididymovasostomy is required during vasectomy reversal when there is absent sperm in the vas
deferens. This signifies that a secondary epididymal obstruction has developed upstream from
the vasectomy site. This situattion is encountered in approximately 30% of individuals after a
vasectomy. Epididymovasostomy can only be performed under a powerful operating microscope
and only by specially trained microsurgeons using the finest suture (10-0 nylon).
Epididymovasostomy is required during vasectomy reversal when there is absent sperm in the vas
deferens. This signifies that a secondary epididymal obstruction has developed upstream from
the vasectomy site. This situattion is encountered in approximately 30% of individuals after a
vasectomy. Epididymovasostomy can only be performed under a powerful operating microscope
and only by specially trained microsurgeons using the finest suture (10-0 nylon).
The typical appearance of the vasal lumen after it
has been precisely sewn together using 10-0 nylon
suture. The suture is non-reactive and extremely
fine to prevent any scarring of the lumen after the
surgery.
has been precisely sewn together using 10-0 nylon
suture. The suture is non-reactive and extremely
fine to prevent any scarring of the lumen after the
surgery.
An outer layer of 9-0 nylon suture is placed to
reinforce the inner layer and to relieve tension from
the important inner layer. Numerous interrupted
sutures are placed around the outer layer ensuring a
tension-free closure.
reinforce the inner layer and to relieve tension from
the important inner layer. Numerous interrupted
sutures are placed around the outer layer ensuring a
tension-free closure.
The epididymis is opened and a single tubule is
isolated to bypass the obstruction that has
developed.
isolated to bypass the obstruction that has
developed.
The vas deferens is then attached to the
epididymis using fine sutures (9-0 nylon). This
attachment brings the vas deferens into close
proximity of the single epididymal tubule.
epididymis using fine sutures (9-0 nylon). This
attachment brings the vas deferens into close
proximity of the single epididymal tubule.
The single epididymal tubule is sewn to the
inner lumen of the vas deferens using
microscopic sutures to create a water-tight
closure, similar to vasovasostomy.
inner lumen of the vas deferens using
microscopic sutures to create a water-tight
closure, similar to vasovasostomy.
Additional fine sutures are placed in the outer
layer of the epididymis to secure the vas
deferens in place and to release tension off of
the fine inner sutures.
layer of the epididymis to secure the vas
deferens in place and to release tension off of
the fine inner sutures.
| Financial information for vasectomy reversal | |
| Frequently asked vasectomy reversal questions | |
| Contacting a vasectomy reversal specialist | |
Who should perform my vasectomy reversal?
"Since it is seldom possible to determine pre-operatively if epididymovasostomy will be required in a man
undergoing vasectomy reversal, only surgeons skilled in both epididymovasostomy and vasovasostomy
should perform vasectomy reversal"
It was also stated in the practice committee guidelines that the success and pregnancy rates of men
undergoing micro-surgical (24 times magnfication) vasectomy reversal was much higher than in men
undergoing the macro-surgical technique (2.5 times magnification, Loupe assisted).
Choosing a doctor who is a fellowship trained microsurgeon will guarantee that your surgeon meets the
guidelines established by the leading reproductive society in this country. Many urologists offer
vasectomy reversal services, but only 1-2% of urologists hold the distinction of being fellowship trained
and capable of assuring their patients that they meet the guidelines set forth by the leading reproductive
society in this country.
Some urologists will try to compensate for the lack of this advanced training by offering their patients
seasonal specials, vacation packages or even a money back guarantee along with their vasectomy
reversal. These are gimmicks! Most respectable physicians do not ethically participate in such business
practices. These specials are designed to lure unsuspecting patients into a sub-optimal situation for a
vasectomy reversal. It is important to remember that the ultimate goal of your process and journey is to
have a natural pregnancy after your vasectomy and not receive a free vacation or cut-rate procedure.
Additionally, most of these money back guarantees are designed to only give you back a small portion of
your investment and not the entire amount. Read the fine print and you will see that it really isn't a true
money back guarantee!
Instead of offering gimmicks or vacation packages, we provide the highest quality service. We are so
proud of our technique and quality of vasectomy reversal that every patient receives high resolution
photographs of the critical steps of their reverse vasectomy procedure. We stand behind the quality of
our work by providing you proof of the high quality of the procedure with actual photos from the surgery.
Without these photos, patients are left wondering what happened on the inside and oftentimes only can
evaluate the quality of the incision, which has no relevance to the success of the reverse vasectomy
procedure.
This is why the California Vasectomy and Reversal Center is the leading vasectomy and vasectomy
reversal center in Northern California. We provide our patients with the latest techniques and most
sophisticated equipment when it comes to their vasectomy or reverse vasectomy procedure. We are
conveniently located to all major metropolitan areas of San Jose, San Francisco, Oakland, Sacramento,
Santa Cruz, Monterey, Fresno, Stockton, Santa Rosa, and Modesto. Our patients come from virtually
every corner of California, Nevada, Oregon and Hawaii. Patients from Reno, Las Vegas, Portland,
Bakersfield, Los Angeles, San Diego, Orange County, Riverside, Palm Springs, San Luis Obispo, Visalia
and Santa Barbara have all had successful reverse vasectomy procedures performed at our center.
Last updated 11/24/2007
| California Vasectomy & Reversal Center |
Additional resources to learn
about Vasectomy Reversal
and IVF:
about Vasectomy Reversal
and IVF:
Related Articles:
More Photos of Actual Vasectomy Reversal and Reverse Vasectomy Procedures performed at the
California Vasectomy & Reversal Center
California Vasectomy & Reversal Center
Microdot Technique Vasovasostomy
The Microdot method for performing vasectomy reversal is a variation of the
standard multi-layer reverse vasectomy procedure. Eight evenly spaced
microdots are placed on the face of the cut ends of the vas deferens using a
fine micro-tip pen. Similar 10-0 Nylon and 9-0 Nylon sutures to microsurgical
vasovasostomy are used to re-approximate both layers of the vas deferens.
standard multi-layer reverse vasectomy procedure. Eight evenly spaced
microdots are placed on the face of the cut ends of the vas deferens using a
fine micro-tip pen. Similar 10-0 Nylon and 9-0 Nylon sutures to microsurgical
vasovasostomy are used to re-approximate both layers of the vas deferens.
The microdot technique allows for easy placement of the mucosal 10-0
Nylon sutures. The microdots guarantee even placement of the mucosal
sutures. Re-alignment of the vas deferens is performed during the reverse
vasectomy procedure to ensure patency of the lumen of the vas deferens and
to prevent long-term scarring of the vasectomy reversal procedure.
Nylon sutures. The microdots guarantee even placement of the mucosal
sutures. Re-alignment of the vas deferens is performed during the reverse
vasectomy procedure to ensure patency of the lumen of the vas deferens and
to prevent long-term scarring of the vasectomy reversal procedure.
Once the inner luminal sutures are tied, the knots are cut precisely so as to
ensure that none of the suture material extends into the lumen of the vas
deferens. Because of the very small size of the vas deferens lumen, any
redundant suture material can actually obstruct the flow of sperm along the
vas deferens. Likewise, the finest (10-0 Nylon) non reactive micro-suture must
be used to ensure that the lumen is not partially blocked by the suture
material. A water tight closure of the vas deferens mucosa prevents sperm
from leaking out of the vas deferens after the procedure.
ensure that none of the suture material extends into the lumen of the vas
deferens. Because of the very small size of the vas deferens lumen, any
redundant suture material can actually obstruct the flow of sperm along the
vas deferens. Likewise, the finest (10-0 Nylon) non reactive micro-suture must
be used to ensure that the lumen is not partially blocked by the suture
material. A water tight closure of the vas deferens mucosa prevents sperm
from leaking out of the vas deferens after the procedure.
The outer serosal sutures are equally important in the reverse vasectomy
procedure. These sutures relieve tension off of the finer inner luminal
sutures and prevent the ends of the vas deferens from separating after the
reverse vasectomy procedure. Liberal placement of these outer serosal
micro-sutures needs to done under a microscope as well to ensure that the
ends of the vas deferens are precisely approximated.
procedure. These sutures relieve tension off of the finer inner luminal
sutures and prevent the ends of the vas deferens from separating after the
reverse vasectomy procedure. Liberal placement of these outer serosal
micro-sutures needs to done under a microscope as well to ensure that the
ends of the vas deferens are precisely approximated.
Epididymovasostomy (LIVE - Longitudinal Intussuception VasoEpididymostomy Technique)
In those cases where sperm are NOT identified in the testicular vas deferens
a epididymovasostomy or "bypass" operation is required. The typical
appearance of the epididymis many years after the vasectomy procedure.
a epididymovasostomy or "bypass" operation is required. The typical
appearance of the epididymis many years after the vasectomy procedure.
A single tubule from the epididymis is isolated for the reverse vasectomy
procedure. This procedure can only be accomplished under the highest
magnification and the patient laying completely still under a general
anesthetic. Two microsurgical 10-0 Nylon sutures are passed through the
single epididymal tubule prior to opening the tubule with a microsurgical
knife. The sutures are placed along the longitudinal axis of the epididymal
tubule.
procedure. This procedure can only be accomplished under the highest
magnification and the patient laying completely still under a general
anesthetic. Two microsurgical 10-0 Nylon sutures are passed through the
single epididymal tubule prior to opening the tubule with a microsurgical
knife. The sutures are placed along the longitudinal axis of the epididymal
tubule.
The abdominal end of the vas deferens is re-approximated to the serosal
edge of the tunic of the epididymis. The attachment of the vas deferens to
the tunic of the epididymis secures the vas deferens and allows for accurate
placement of the inner mucosal sutures.
edge of the tunic of the epididymis. The attachment of the vas deferens to
the tunic of the epididymis secures the vas deferens and allows for accurate
placement of the inner mucosal sutures.
The microsurgical 10-0 Nylon sutures are passed through the mucosa of the
vas deferens in their corresponding locations on the mucosa of the vas
deferens.
vas deferens in their corresponding locations on the mucosa of the vas
deferens.
The 10-0 Nylon sutures are tied creating a water-tight closure between the
epididymal tubule and the mucosa of the vas deferens. The single
epididymal tubule is pulled (intussucepted) into the lumen of the vas deferens.
epididymal tubule and the mucosa of the vas deferens. The single
epididymal tubule is pulled (intussucepted) into the lumen of the vas deferens.
Additional microsurgical sutures are placed between the tunic of the
epididymis and the outer (serosal) edge of the vas deferens. The additional
microsutures on the outer layer of the vas deferens relieve the tension off of
the important inner luminal sutures.
epididymis and the outer (serosal) edge of the vas deferens. The additional
microsutures on the outer layer of the vas deferens relieve the tension off of
the important inner luminal sutures.
The final appearance of the vas deferens attached to the epididymis at
slightly lower magnification. The "bypass" procedure restores continuity of
sperm flowing through the vas deferens when an obstruction or "blockage" is
identified at some part of the epididymis.
slightly lower magnification. The "bypass" procedure restores continuity of
sperm flowing through the vas deferens when an obstruction or "blockage" is
identified at some part of the epididymis.
Dr Karpman's article on
Vasectomy Reversal from
M.D. News
Vasectomy Reversal from
M.D. News