Vasectomy Reversal

Maybe you’ve decided to get a vasectomy reversal because you’ve changed your mind about trying to have biological children. Or perhaps you want a reversal to help relieve ongoing testicular pain. Whatever your reason for coming to see us, the first thing we’ll do is ask some questions and listen. Understanding your reasons for wanting a reversal and looking at your overall health can help us decide if the procedure is right for you. Our experts may ask:

• Why do you want a vasectomy reversal?
• When did you have a vasectomy? Vasectomy reversals are generally more successful the sooner they happen after a vasectomy. 
• Have you had any injuries or other surgeries (including hernias) on your groin?
• Do you know of any conditions or injuries you have that may affect your fertility?
• Do you have any health conditions?
• Do you have a history of blood disorders or take blood-thinning medications, like anticoagulants?
• Do you have any allergies to local anesthetics or antibiotics?
• Do you take medications or supplements?

Then, we’ll explain the procedure and what can affect the success of a vasectomy reversal. We’ll also take the time to answer any questions you have. If, together, we feel a vasectomy reversal is a good option, we’ll schedule the procedure and tell you what you need to do to prepare for it.

There are two main ways we do vasectomy reversals. But your urologist won’t know the best one for you until they see the anatomy of your vas deferens and presence of sperm during the procedure.

Once you’re asleep or numb from anesthesia, your urologist will make a small cut in your scrotum, often in the same place as your vasectomy scar. After that, they have two main options to do a reversal:

Vasovasostomy

A vasovasostomy is the go-to way to do a vasectomy reversal. Your urologist will remove scar tissue from both ends of your vas deferens that were cut from your vasectomy. They’ll then align the two ends and sew them together.

Vasoepididymostomy

If you have another sperm blockage in a different place, a vasovasostomy alone won’t restore your fertility. Your urologist will need to do a more complex procedure called a vasoepididymostomy. They’ll sew your vas deferens to your epididymis. This is the tightly coiled tube next to your testicle where sperm cells mature before moving into your vas deferens.

Freezing your sperm

Some men want to freeze their sperm as a backup. Cleveland Clinic surgeons can do this at the same time as your vasectomy reversal. This sperm can be stored for years or even decades and can still be used for in vitro fertilization if needed. Your provider can talk with you about this option.

Recovering from a vasectomy reversal

Recovery from a vasectomy reversal is similar to what you experienced after your vasectomy, so you’ll know the drill. You’ll be able to go home the same day after surgery.

Applying ice to your groin on and off for at least 24 hours after the procedure can help the healing process. Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil^® or Aleve^®, can help provide relief for mild pain.

You can usually get back to your regular activities about two days after a vasectomy reversal. It’s a good idea to wear an athletic supporter for at least a week. You should avoid strenuous activities for at least one week and sexual activity — including masturbation — for two to three weeks after the procedure. If you don’t take time to recover fully, it could lead to potentially serious complications. Be sure to follow your provider’s recovery advice — and listen to your body.

Follow-Up Care

Your care at Cleveland Clinic doesn’t end with the vasectomy reversal. Your urologist will follow up with you to make sure you’re healing well. After six to 12 weeks, they’ll also recommend a test called a semen analysis to check your semen for sperm to see if the reversal was successful.

After a successful vasovasostomy, sperm usually appear in your semen after a month. Following a vasoepididymostomy, sperm usually reappear after three to 15 months. Your provider will let you know when to get a sperm count test. If anything happens along the way, they’ll be by your side to manage any complications.

Success rates

The team at Cleveland Clinic has done hundreds of vasectomy reversals. Depending on your specific situation, your success rates can be above 95% for sperm in your ejaculate.

Taking the Next Step

If you’ve decided that you’d like to reverse your vasectomy, you’ll want experienced, caring healthcare providers on your side. Cleveland Clinic’s highly skilled urologists are ready to guide you through a vasectomy reversal. They’ll tailor the procedure to your needs and give you compassionate care throughout the process.