Vasovasostomy

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Vasovasostomy (literally connection of the vas to the vas) is the surgery by which vasectomies are reversed in males.

In the majority of cases the vas deferens can be reattached but, in some cases fertility is not achieved. There are several reasons for this, including blockages in the vas deferens, and the presence of autoantibodies which disrupt normal sperm activity. If blockage at the level of the epididymis is suspected, a vaso-epidymostomy (connecting the vas to the epididymis) can be performed.

Fertility success, defined as return of sperm to the ejaculate, ranges from roughly 30 to 90 percent, and depends greatly on the length of time from a patient's vasectomy. The shorter the interval, the higher the chance of success. The likelihood of pregnancy is somewhat lower (30 to 60 percent), and can depend on female partner factors.

About 60 percent of men who had undergone a vasectomy develop anti-sperm antibodies. Many of these go on to successfully father children after vasovasostomy. The effects of anti-sperm antibodies continue to be debated in the medical literature but, there is agreement that antibodies reduce sperm motility.

The procedure is performed by urologists. Almost all urologists specializing in the field of male infertility perform vasovasostomies using an operative microscope for magnification, under general or regional anesthesia. The use of loupe magnification, or no magnification at all, is an older technique that is falling out of favor.

Vasovasostomy is typically an out-patient procedure (patient goes home the same day).