Men who have had a vasectomy might opt for a reversal. While the procedure is most often successful, there are no absolute guarantees.

If you've made the tough decision to have a vasectomy, why would you want to undergo a vasectomy reversal? Well, some men might want to start a new family or maybe some men might want to have their vasectomy reversed because they have pain in their testicles. Vasectomy reversal surgery is complicated and it's not as easily performed as the vasectomy. Plus, the surgery is more costly.

What happens during a vasectomy reversal procedure and what are the statistics for restoring fertility? We'll answer these questions and more in our discussion of a vasectomy reversal.

How a Vasectomy Reversal is Done

Vasectomy reversal can be performed two ways:

One procedure involves reattaching the ends of the vas deferens (the duct that carries sperm) back together (vasovasostomy). After your surgeon sews the ends together, the vas deferens is then attached to the epididimis — the storage area at the back of the scrotum where sperm matures. If stitching the vas deferens back together won't work, because of damage that might interfere with potency, your doctor may need to directly attach the sperm duct to the epididimis, bypassing the area that is blocked (vasoepididymostomy).

The exact procedure is decided after your surgeon gets a view of your anatomy during the procedure itself. Until then, you won’t know which approach is needed. It’s also possible that one side will result in a vasovasostomy, while the other requires vasoepididymostomy.

What You Should Consider

Vasectomy reversal is not usually covered by insurance. If a medical necessity exists, ask your physician to intervene on your behalf, providing records to your insurance carrier. Post vasectomy pain syndrome has caused some men to experience persistent discomfort. The cause of this discomfort is unknown.

It's important to gather success stories from your surgeon before you choose who will perform the procedure. So, you'll want to know how many vasectomy reversals actually worked, in addition to having all of your questions answered and involving your partner during the consultation.

Prices vary, and can cost as much as $12,000; beginning at around $5,000.

Does Vasectomy Reversal Work?

Over half of vasectomy reversal procedures work. The chances of adequate sperm count decline over time. If it’s been more than 15 years since your vasectomy, the possibility of success is still there, but the chances are reduced. If you’ve fathered a child, your doctor will know that you are a good candidate. Otherwise, it might be necessary for the surgeon to perform a biopsy using a small needle inserted into the testicle. The results can provide information about hormone levels and sperm count.

If the goal is starting a family, your partner’s reproductive health is an important factor as well. Optimal health of both partners increases the chances of a positive outcome.

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What to Expect From a Vasectomy Reversal

You should be able to go home the same day, unless there are unexpected complications. Vasectomy reversal procedures are performed in the hospital or at an outpatient surgery center and they take about four hours.

There is a risk of bleeding, which means that it’s important to refrain from the use of aspirin or pain medication (such as Ibuprofen) that promotes bleeding. Do not take any supplements or herbs. If you do take any, discuss it with your surgeon as garlic capsules, willow bark and gingko biloba can increase the risk of complications from bleeding. Green tea supplements can also contribute.

You can usually decide whether you prefer general anesthesia or a spinal nerve block (epidural). Discuss the pros and cons of each with your physician before you proceed with your vasectomy reversal.

After the procedure, you’ll need someone to drive you home and you'll need an athletic support to wear after surgery. You will also end up with a small scar on the underside of your scrotum.

Nerve damage is possible during a vasectomy reversal, which could result in chronic pain.

If sperm leaks into the scrotum after surgery, a small mass (called a granuloma) can form and reduce your chances of reproducing. A granuloma is a benign mass that forms in the body in response to inflammation, bacteria, fungus or a virus.

It's important to follow your doctor's instructions to ensure a good response to the surgery.

No Guarantees, So Why Do It?

To avoid disappointment, many men have their sperm frozen during a vasectomy reversal. Your surgeon can identify healthy sperm by looking under a microscope. Later, the sperm can be directly injected into your partner’s egg, via a procedure called ICSI (intracytoplasmic sperm injection).

It may take up to two years for your partner to become pregnant if you decide to go the natural route. Depending on the type of procedure performed, sperm production usually occurs within three to 15 months.

Your decision can be made easier through a good rapport and open communication with your doctor. If you decide to have your vasectomy reversed, make sure you write down all of your questions. Speak with other men who have had the procedure — internet forums can be very useful for this, but be wary. Check out your physician’s health grade at healthgrades.com.

Regardless of the unknown, it’s important to approach any decision with a positive and open mind. Fear and stress are known hindrances to healing.