A vasectomy reversal is a surgical procedure that restores the flow of sperm through the vas deferens. It is usually performed by an experienced microsurgeon using specialized instruments, including an operating microscope. The sutures used in vasectomy reversal are finer than human hair.

There are two types of vasectomy reversals: vasovasostomy and vasoepididymostomy.

A vasovasostomy is the operation most frequently performed for vasectomy reversal. It entails stitching the cut ends of the vas deferens together, and is the surgery of choice for vasectomy reversal. However, if excessive inflammation or scarring has occurred in the epididymis, sperm may be blocked from getting to the vas deferens.

If a blockage has occurred in the epididymis, merely connecting the two cut ends of the vas deferens (as is done in a vasovasostomy) will not solve the vasectomy reversal problem. To bypass the blockage in the epididymis, a vasoepididymostomy must be performed.

A vasoepididymostomy vasectomy reversal procedure is performed by connecting the vas deferens directly to the epididymis. One end of the vas deferens is stitched directly to the epididymis.

From a surgical standpoint, it is rare that a vasectomy cannot be reversed.

In the past, if the epididymis was blocked or a large segment of the vas deferens was removed during the vasectomy, a vasectomy reversal procedure was considered to be too complicated and was unlikely to be successful.

Today, however, the development of new microsurgical techniques has provided a way to bypass an epididymal blockage and correct a shortened vas deferens. These new techniques have led to improved pregnancy rates following vasectomy reversal even in the most extreme cases.

Before the advent of microsurgical techniques, vasectomy reversal procedures were only occasionally successful. With the relatively recent advances in microsurgical techniques, instruments and suture materials, success rates have greatly increased.

Results of recent studies indicate that following microsurgical vasovasostomy (vasectomy reversal) sperm appears in the semen in approximately 85 to 97% of men. Approximately 50 percent of couples subsequently achieve a pregnancy.

Following microsurgical vasoepididymostomy (vasectomy reversal), sperm appears in the semen in approximately 65% of men. Approximately 20 percent of couples subsequently achieve a pregnancy.