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Vasectomy Reversal Questions and Answers

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4- How do time (vasectomy age) and other factors impact the vasectomy reversal success rate?

Time (vasectomy age) and other factors have been found to correlate with vasectomy reversal success rate. Your surgeon will make the decision to perform one of two techniques when reconnecting the vas, during the vasectomy reversal vasovasostomy or vasoepididymostomy. Vasovasostomy is a vasectomy reversal technique that is simpler and offers a higher success rate. If it is necessary to perform the vasectomy reversal using the vasoepididymostomy technique the surgery will be more complicated, not all surgeons can perform this technique and success rate is lower.

Which technique is performed is correlated with how much time has passed since the vasectomy. The vas tube, which was obstructed as a result of the vasectomy, is prone to back pressure in the epidiymus. During the vasectomy reversal surgery, the surgeon looks to identify sperm in the vasal fluid. If sperm are identified the vasectomy reversal surgeon can perform the vasovasostomy technique (a direct vas to vas connection). The more time since a vasectomy, the greater the odds the vasectomy reversal surgeon will see a "secondary epidimal obstruction". This means no sperm are identified in the vasal fluid from the cut end of the testicular vas. In such cases, the vasectomy reversal surgeon must perform a vasoepididymostomy (a re-connection of the vas to the epididymis). Vasoepididymostomy is a more involved vasectomy reversal surgery and means reconnection of the vas tube will be more difficult.

There is a high chance that the vasovasostomy can be performed if the vasectomy reversal is performed within 10 years of the vasectomy. However, research tells us that performing a vasectomy reversal ten years after a vasectomy, has about a 40% chance that a vasoepididymostomy will need to be performed on at least one side.

Other factors that can contribute to the technique performed during the vasectomy reversal surgery include a vasectomy with a large segment of the vas removed, cauterization or ligation (tying off) of both ends of the cut vas instead of just one (i.e. doing a closed ended vasectomy instead of open ended).

Learn more:
Pre and post operative considerations
Types of reconnection: Two Methods
Success rates and their determinants
Vasectomy Reversal Alternatives.
Vasectomy Reversal and Sperm Banking.

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