Our Services

Vasectomy Reversal

Approximately 5-8% of men will desire having another child following vasectomy.   Thankfully there are options to ensure this is possible.  Vasectomy reversal is the process of bypassing the blocked area of the vas to allow sperm to travel through the genital tract normally.  The testicle continues to make sperm normally following prior vasectomy, so the process is to allow the sperm to get out.  

 

Vasectomy reversal is a very specialized procedure.  Few urologists have specific training in this procedure and outcomes following the procedure are better with physicians performing this procedure routinely.  Vasectomy reversal can typically be performed through a small scrotal incision.  The vas is identified and the area of blockage exposed.  The healthy end of the vas closer to the testicle is then evaluated.   Once a healthy segment is isolated, the planned location of repair is opened.  Once the testicle end of the vas is opened, fluid should be seen.  This fluid is evaluated under a bedside microscope to ensure sperm or portions of sperm are present.  Evaluation for sperm is the critical part of the vasectomy reversal that improves outcomes regardless of how long ago the patient had the vasectomy.  Once sperm are seen, this is a healthy segment to use.  The other end of the vas is then prepared and the two ends are sewn together using suture that is smaller than a human hair.  No matter how well one side is performed, the other side is then done in a similar manner.  

 

If sperm are not seen in the fluid of the testicle end, a new segment will need to be identified moving closer to the testicle.  At times, it is necessary to attach the vas to the epididymis.  This is only found out at the time of surgery.  Performing a vasoepididymostomy (vas attached to the epididymis) instead of a vasovasostomy (vas attached to vas) will lower success rates following surgery.   

 

Surgeons performing vasectomy reversal should be able to provide an idea of the success rate based on the patient factors.  Success is typically very good when care is taken to evaluate and ensure sperm are present in the region being attached.  Success can be defined as sperm returning to the ejaculate or achieving a pregnancy.  It is important to ask your surgeon how they are defining success, because rates of returning sperm to the ejaculate are higher than pregnancy rates.  Vasectomy reversal is not 100% effective.  There are cases when sperm are not returned to the ejaculate or return in lower concentration.  Other risks of the procedure include hematoma formation, bruising, infection, or delayed re-stenosis.

 

Alternatives to vasectomy reversal include sperm aspiration with IVF or donor sperm use.  Donor sperm tend to be the cheapest alternative for most couples and can be used with intrauterine insemination (IUI).  However to use a patient’s own sperm, only sperm aspiration or vasectomy reversal are options.  Sperm aspiration is often performed in the office.  After completely numbing the testicle, sperm can be aspirated from the epididymis.    The number of sperm attained makes it so assisted reproduction is necessary afterwards.  

 

Cost is an issue for many reproductive treatments.  Please make an appointment to discuss this further.  I attempt to ensure all patients are able to pursue the reproductive option they desire and understand cost is an issue that needs to be discussed.  

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We will attempt to make the appointment as close to your desired date as possible, but this submission is not a guarantee of an appointment at that time. If an urgent visit is needed to discuss sperm cryopreservation prior to cancer treatment, please call the office directly and be sure to notify the staff of this need.

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OhioHealth Urology Physicians
OhioHealth Riverside Methodist Hospital
Bing Cancer Center
500 Thomas Lane, Suite 3G
Columbus, Ohio 43214

Phone: (614) 788-2870
Fax: (614) 533-0177
 
 

OhioHealth Urology Physicians
OhioHealth Riverside Methodist Hospital
Bing Cancer Center

500 Thomas Lane, Suite 3G
Columbus, Ohio 43214

Phone: (614) 788-2870
Fax: (614) 533-0177