Often this procedure can be performed with purely local anesthetic and gentle sedation. At Men’s Health Clinic Manitoba, we offer men the option of choosing either light sedation or deep sedation (general anesthesia) for their procedure.

During the procedure, the vasectomy site is identified and the vas deferens is cut on the testicular side of the prior vasectomy. Fluid is then sampled from this cut end. If sperm is present, then a simple repair is performed (vasovasostomy – see below). If sperm is not present, then a more complex repair is required (vasoepididymostomy – see below).

It is not possible to know which procedure is required until the time of surgery. However, if a vasectomy was done less than 10 years ago, you are more likely to perform a vasovasostomy (more successful procedure).

Nonetheless, it is recommended that you choose a surgeon that is able to perform the more complex vasoepididymostomy and who performs vasectomy reversals frequently with the use of an operating microscope (improvement in success rate by as much as 30-40%). The ability of your surgeon to perform vaso-epididymostomy is crucial to achieve the best outcomes.

A vasovasostomy involves reconnecting the vas deferens back together. At Men’s Health Clinic Manitoba, this is performed in 2 layers with ultra fine sutures to ensure the highest rate of success.

If no sperm is present, then a epididymovasostomy is necessary. This is a complex reconstruction that involves reconnecting the vas to a tiny tubule on the epididymis.  Very few surgeons have the specific skillset required for this complex surgery. Since no one is able to definitely confirm which procedure (vasovasostomy or vasoepididymostomy) is required until the time of surgery, it is important your surgeon have the ability to perform a vasoepididymostomy when required. A vasoepididymostomy is often needed on either one or both sides in 10-20% of cases.

Given how small the vas deferens is (inner diameter ~1.7 mm), the procedure requires the use of an operating microscope and very fine sutures to bring the tubes together.

The procedures requires significant surgical skill and patience, in addition to real-time intra-operative fluid testing, to ensure the best outcome.

A typical vasectomy reversal usually takes between 2-3 hours. A vasectomy reversal is an outpatient procedure and therefore you do not require an overnight stay. For out-of-province patients, we can help coordinate logging and transportation to and from the airport. 

A vasectomy reversal will be more uncomfortable than your vasectomy as there is more manipulation that is required. However, the majority of men find that the discomfort improves significantly after 7-10 days. Oral pain medications will be provided.

In general, a vasectomy reversal is quite safe with a very low risk of complications following the procedure. Risks of the procedure include the following: 

Bleeding (<5%)

Infection (<5%)

Failed reversal (no sperm in the ejaculate) (~5-15% - varies based on which procedure, vasovasostomy or vasoepididymostomy, is performed)

Unable to get pregnant despite successful vasectomy reversal 

Pain  (1-2%)

The most common question asked is how successful is a vasectomy reversal? This can be challenging to answer as it depends on what success is defined by. In general terms, the chance of returning sperm after a vasovasostomy can be greater than 95% with the chance of sperm returning to the ejaculate after a vasoepididymostomy roughly 60-70%. Many surgeons will quote very high success rates such as the greater than 95% but this does not translate to what actually matters, having a child. During your consultation, Dr. Patel will give you a realistic idea as to your chance of success as this depends on not only the success of the reversal but also your partners age, health and prior fertility status.

However, this can vary substantially as you may perform a direct connection on one side (vasovasostomy) and the more complex procedure (vasoepididymostomy) on the other side.

If sperm is present, the surgeon performs a vasovasostomy (direct connection).

If sperm is not present, the surgeon will perform the more complex vasoepididymostomy which can have lower success rates. There is no cost difference to the patient as this is an intra-operative decision. 

At most vasectomy reversal centres, the surgeon looks for themselves under the microscope whether there is sperm or not. This is often done quickly and can dramatically change the procedure performed if not enough time is spent to see if sperm is present or not, or if the provider lacks the required experience. 

Nothing to eat or drink after midnight the evening prior to your surgery 

If you are taking any blood thinners (aspirin, warfarin, etc...) please check with our office for instructions 

Arrange for someone to drive you home after your procedure 

Shave the scrotum 24 hours before the procedure 

Take a warm shower the morning of the procedure

Apply ice pack to the scrotum for 10 minutes on, then 10 minutes off, for the first 2 hours after the procedure. Repeat as necessary. 

We recommend that you “take it easy” for 24 hours. 

You can shower after 48 hours, no baths for 2 weeks. 

No heavy lifting for 2 weeks. 

No intercourse or masturbation for 2 weeks.

Our office will arrange form a semen analysis to be performed 2-3 months after your procedure.

In In the vast majority of circumstances, a vasectomy reversal tends to be the most cost effective option (IVF can be cost upwards to $15-20,000). However, there are situations where in-vitro fertilization may be recommended (i.e. longer time since vasectomy > 10-15 years, older female partner age (>40), and patient preference).

During your consultation with Dr. Patel, both options will be discussed to ensure you are provided a full understanding of what options are available to you. 

Absolutely. Some couples may choose to freeze sperm at the time of the vasectomy reversal as a back-up in case the vasectomy reversal procedure is not successful or they are unable to get pregnant. The sperm is collected directly from the vas deferens or testicle. 

It is important you select the surgeon that is the right fit for you and your partner. A vasectomy reversal is a life changing decision that should be handled seriously and professionally. The following questions should be considered: 

Should I get a vasectomy reversal or should we proceed with in vitro fertilization? 

How many vasectomy reversals do you perform annually? 

Are you fellowship trained in microsurgery? 

Do you perform your procedures with an operating microscope? 

Do you look for sperm at the time of the vasectomy reversal? 

Do you perform a 1-layer or 2-layer vasovasostomy? 

Do you perform a vasoepididymostomy (VE) in case the vasovasostomy (VV) is unable to be performed?