Vasectomy reversal

You can undo a previous vasectomy by having vasectomy reversal surgery. This procedure reconnects the tubes that carry sperm from the testicles, allowing the sperm to mix with semen and be released during ejaculation. It’s typically done to restore fertility options in people assigned male at birth. However, some people turn to this procedure to relieve lingering testicular pain resulting from earlier vasectomy surgery.

When considering this procedure, it’s important to find skilled urologists with a track record of successful vasectomy reversals. Penn Medicine’s male urology program features specialists highly skilled in microsurgical vasectomy reversal—the gold standard for achieving optimal surgical outcomes. They can review your health background, talk through any concerns, and discuss the best treatment plan to meet your needs.

Your surgeon will use specialized tools to reattach the tubes that were previously cut during your vasectomy. This includes a surgical microscope that magnifies and illuminates this delicate area in detail, making it easier for surgeons to work with precision.

Your care team won’t know which of the following techniques will work best until they begin surgery. So, you’ll want to be sure that your surgical team has experience with each method. 

• Vasovasostomy: Two separate cut ends of the sperm-carrying tube (called vas deferens) are reattached to form a single tube that can transport sperm again as part of a normal flow. 
• Vasoepididymostomy: If the two cut ends of the sperm-carrying tube cannot be directly attached to one another, the vas deferens is connected to the epididymis, a part of the reproductive system at the back of each testicle that stores sperm.

It may take a few months or up to a year for sperm to return to the semen and for fertility to be restored.

Your doctor will assess your general health and do a physical exam to determine whether you’re a good candidate for vasectomy reversal. They may also suggest you take tests to ensure your sperm is healthy. Most people can proceed with surgery, though your doctor will discuss any risks if you have certain blood disorders, groin injuries or surgeries, or sensitivities to medications or anesthesia.

It’s important to talk with your doctor about your goals for vasectomy reversal surgery to be sure it’s a good option for you. The vasectomy reversal success rate for the surgery itself is very good, often 85 percent or higher. However, pregnancy rates after a vasectomy reversal can vary, with averages typically around 50 percent. This is because several factors can influence reproduction rates, including your sperm health and the reproductive health of your partner. The elapsed time since your vasectomy also plays a role. A lower pregnancy rate is found among those who have a vasectomy reversal many years after their vasectomy.

If you’re seeking to relieve pain in the testicles caused by a previous vasectomy, you’ll want to discuss whether the procedure is likely to bring you long-term relief. While most people find significant pain reduction, a frank talk with your care team about what matters most to you will help set reasonable expectations.

Vasectomy reversal surgery is typically an outpatient procedure that lasts up to four hours. Your doctor will give you preparation guidelines to follow, including any restrictions on food, drink, and medications. You may be asked to shave the groin area before your procedure and to bring tight-fitting, supportive underwear to wear home.

You’ll receive general anesthesia to put you to sleep or local anesthesia with sedation. An anesthesiologist will monitor you throughout the procedure to keep you pain-free and comfortable. 

The procedure itself involves making two small cuts on either side of the scrotum, probably close to where you have vasectomy scars. The surgeon will pull the vas deferens out through each cut to assess any scar tissue and blockages and to check for the presence of sperm. Based on their findings, they’ll choose the best surgical method (vasovasostomy or vasoepididymostomy) to reconnect tissues and allow sperm to flow. 

After the procedure is complete, your doctor will close the area with stitches and wrap it with bandages. You’ll be moved to a recovery area for monitoring until you’re ready to go home. Occasionally, people stay in the hospital overnight for observation.

In the days immediately after surgery, you’ll probably experience some pain similar to what you felt after your vasectomy. This can be controlled with icing and over-the-counter pain medications.  

It’s common to take a week or two off from school or work to promote healing. You’ll also have limits on some activities, like heavy lifting, sex, and other physical movements, like running. You’ll have a follow-up appointment with your care team shortly after surgery to check your recovery and remove stitches if needed. Ongoing follow-up appointments may be scheduled to check your sperm count and flow. 

Be sure to follow the guidelines that your doctor provides after surgery to ensure the fastest, most complete recovery.

Experts in male urology at Penn Medicine deliver comprehensive care to support your urological and reproductive health. Our sub-specialists have deep experience in focus areas that include sexual health, fertility, prostate conditions, and urinary function. With advanced, specialized training, our care teams help you access a wide range of treatments.

Whenever possible, we use robotic and microsurgical techniques that allow for smaller incisions, quicker recovery, and improved results. As an academic research hospital, we’re also connected with clinical trials and groundbreaking treatments that may not be widely available at other health centers. We’ll work with you to find the most appropriate methods to achieve your health and family planning goals and answer any questions you have about whether you can reverse a vasectomy.