Vasectomy reversal

Expert reviewer, Professor Raj Persad, Consultant Urological Surgeon
Next review due March 2023

A vasectomy reversal is a complex operation to reconnect the tubes that carry sperm from your testicles to your penis after a previous vasectomy. You might be thinking about having a reversal if you regret your decision to have a vasectomy.

If successful, it means you’ll have sperm in your semen and be fertile again. However, there’s no guarantee that the operation will restore your fertility or that you’ll be able to get your partner pregnant.

How successful is vasectomy reversal?

The success rate of a vasectomy reversal depends on how long it’s been since your original vasectomy procedure. The longer the gap between having a vasectomy and reversing it, the less likely it is to be successful. So, for instance, around 75 in 100 men who have their vasectomy reversed within three years go on to get their partner pregnant. For men who have their vasectomy reversed after 15 years, this figure falls to 30 in 100 men getting their partner pregnant.

The chance of success may also depend on the type of vasectomy you had originally, and what surgery you have to reverse it. The surgeon’s experience in doing the procedure is also a factor, so be sure to consider this, along with their success rate.

A successful vasectomy reversal doesn't guarantee that your partner will get pregnant. Other factors, such as your partner’s age, play a part along with other causes of female infertility and male infertility. For more information, see Our FAQ: What happens if vasectomy reversal isn’t successful?

How much does a vasectomy reversal cost?

Vasectomy reversal is not usually available on the NHS, and private health insurance companies don’t usually fund it either. You’ll need to pay to have the procedure done privately. Costs for vasectomy reversal vary widely between clinics, but are typically several thousand pounds. It can depend on the experience of the surgeon and how long they take to perform the procedure. You’ll need to contact a clinic directly to get a quote. Make sure you understand exactly what is covered in the fee, including assessments before the procedure, follow-up and aftercare.

What are the alternatives to vasectomy reversal?

An alternative to vasectomy reversal is to use an infertility treatment called intra-cytoplasmic sperm injection (ICSI). This involves surgery to remove sperm directly from your testicle or your epididymis (where sperm are stored inside your scrotum). Your partner will also need a procedure to remove an egg. A single sperm is then injected into your partner’s egg and if the egg is fertilised, it’s transferred to your partner's womb.

As with vasectomy reversal, you’ll usually need to pay for all or some of this treatment. Generally, when possible, vasectomy reversal is thought to be the better approach because it involves only one partner having treatment rather than both. However, this will depend on the length of time since your vasectomy, how old your partner is, the number of children you want, and the costs involved. In some circumstances, ICSI might be a better option. You can talk to your GP to find out more about fertility treatments or book an appointment directly with a fertility clinic.

Preparing for a vasectomy reversal

If you’re considering a vasectomy reversal, your surgeon will go through exactly what to expect including the potential risks and benefits of the procedure. They’ll want to know about your previous vasectomy and any other previous surgery or conditions you may have. They might want to do some tests and examine your genital area too. Do ask your doctor if you have any questions or need any more explanation about the procedure. You’ll be asked to sign a consent form before the procedure, so it’s important that you feel fully informed.

Your surgeon will explain how to prepare for your procedure. For example, if you smoke, it’s a good idea to quit before any operation. Smoking can increase your risk of infection and other complications after surgery, and slow your recovery.

Vasectomy reversal is usually done under general anaesthesia, which means you’ll be asleep during the procedure. A general anaesthetic can make you sick, so you’ll be asked to stop eating and drinking for several hours before your operation. Make sure you follow any instructions given to you by the clinic.

You can often go home on the day of your procedure, but sometimes you may need to stay overnight – so be prepared for this. If you go home the same day, you’ll need someone to drive you and stay with you overnight.

On the day of your operation, your surgeon will check that you’re still happy to go ahead with the procedure. You might also be given compression stockings to wear, and an injection of an anticlotting medicine called heparin. This helps to prevent blood clots developing in the veins in your legs during surgery.

What happens during a vasectomy reversal?

The procedure will take between two and four hours, depending on the exact technique your surgeon uses.

Once the anaesthetic has taken effect, your surgeon will make a small cut (about 2cm long) in each side of your scrotum. These will usually be in the same place as your vasectomy scars.

They’ll locate the tubes that carry sperm from your testicles to your penis (the vas deferens) and cut these above and below where they were previously tied or sealed. They’ll then gently open up the tubes and check the fluid inside to see if there’s sperm in it. This shows whether there’s any blockage in the tubes where your sperm are stored (the epididymis).

The rest of the procedure will be done in one of the following two ways.

  • If there are sperm in the fluid, this shows there’s no blockage. Your surgeon will then join the cut ends of your vas deferens back together using dissolvable stitches. This is called a vasovasostomy.
  • If there aren’t any sperm in the fluid, it means there’s a blockage in your epididymis. Your surgeon will join your vas deferens directly to a section of the epididymis that bypasses the block. This is a more complex operation, called a vasoepididymostomy.

In either case, your surgeon may perform the operation using microsurgery – when a microscope is used to magnify the tubes. At the end of the procedure, your surgeon will close your skin with dissolvable stitches.

What to expect afterwards

You’ll need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

If you’re going home the same day, you’ll need someone to take you home and stay with you overnight while the anaesthetic wears off. Sometimes you may need to stay overnight. It can take a while to get over having a general anaesthetic. You might find that you're not so coordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or make any important decisions.

Before you go home, your nurse will give you some advice about caring for the wounds in your scrotum and what pain relief you can take. They’ll also give you information about follow-up appointments.

Recovering from a vasectomy reversal

You’re likely to have some swelling, bruising and pain around your scrotum after a vasectomy reversal. You’ll probably need a few days off work. If you need something to help with the pain, take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

It’s a good idea to wear close-fitting, supportive underwear such as tight pants, or a scrotal or athletic support for the first few days after your procedure. Your clinic may provide this. It will protect your scrotum and help to ease any discomfort and swelling.

While you can do some gentle exercise a week after your procedure, don't lift anything heavy or do any strenuous exercise for the first few weeks. It’s best to wait about a month before you have sex again. There’s a risk you could harm the healing (and the success of the reversal) if you have sex before this time. There might be blood in your semen the first few times you ejaculate.

It’s best to wait a couple of days until you have a shower, and a couple of weeks before having a bath. Dry your genital area gently and thoroughly afterwards.

If you have stitches, they’ll usually disappear within two to three weeks.

Post-surgery sperm tests

You’ll need to have your semen tested after the procedure to find out if it contains sperm. You’ll usually be asked to do this around three months after your vasectomy reversal. If you’ve had a vasoepididymostomy, it can take longer for sperm to appear in your semen. Your doctor might need to test your semen every three months for a year until they find sperm.

Complications of vasectomy reversal

Complications are when problems occur during or after the operation. Possible complications of a vasectomy reversal include:

  • bleeding inside your scrotum – this is called a haematoma
  • an infection
  • hard lumps in your testicles, called sperm granulomas
  • damage to blood vessels, which can cause your testicles to shrink (testicular atrophy)
  • long-term pain in your testicles
  • scar tissue forming in the join, which re-blocks the tubes (vas deferens) that carry sperm from the testicles to your penis

It's possible that a vasectomy reversal won’t restore your fertility and you may need further fertility treatments to have a baby.

Frequently asked questions

  • No. A vasectomy reversal won't affect your ability to get an erection or your sex drive. The procedure doesn’t affect the nerves or blood flow to your penis, so it won’t affect your ability to get an erection. Nor does it affect the production of testosterone, the male hormone that controls your sex drive.

    Many men have trouble getting or keeping an erection from time to time. This can often be caused by psychological and emotional issues. For example, you might be feeling anxious about your fertility or the emotional pressure of trying for a baby. If you think this might be happening to you, talk to your GP. They may be able to help or recommend a counsellor you can talk to.

  • It can take several months for sperm to re-appear in your semen, particularly if you’ve had a vasoepididymostomy. So, if a test shows no sperm at three months, your surgeon will suggest a repeat test every few months.

    If sperm haven't reappeared by a year and a half after your vasectomy reversal, it's unlikely that the procedure has worked. Your surgeon will talk to you about what your options are next. Sometimes it’s possible to have more surgery to try to reverse the operation again. Other options include infertility treatments, including assisted reproductive techniques such as in vitro fertilisation (IVF) treatment.

  • The quality of sperm doesn't just depend on the count, but also on how healthy they are and how well they can move. Things that can adversely affect quality or amount of sperm include:

    • smoking
    • drinking too much alcohol
    • certain medicines or health conditions
    • being obese
    • increased heat in your scrotum

    Following a healthy lifestyle by eating a healthy balanced diet, keeping active, not smoking and not drinking alcohol to excess will help with both your health and fertility.

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Related information

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  • Reviewed by Pippa Coulter, Freelance Health Editor, March 2020
    Expert reviewer, Expert reviewer, Professor Raj Persad, Consultant Urological Surgeon
    Next review due March 2023