What Is a Vasectomy Reversal Like?

While more than 500,000 American men undergo a vasectomy as a permanent sterilization method each year, some 6-10% end up undergoing reversal procedures. Their motivating factors may vary, but the steps to restore their fertility are similar.

If you’re considering a vasectomy reversal, our team at Urology Associates of Southeastern North Carolina in Wilmington, North Carolina, can help guide you through the process.

Understanding a vasectomy

To explain how to reverse a vasectomy, it helps to revisit what your initial procedure involved.

A vasectomy prevents pregnancy by keeping you from ejaculating sperm during sexual activity. We accomplish this by making a tiny incision or puncture to access each of your vas deferens so we can block or cut them. These thin tubes carry the sperm made in your testicles to your urethra. 

When you have a vasectomy, your testicles still make sperm. However, it can’t pass from your body when you ejaculate during sexual activity. Instead, your body absorbs it. 

This form of pregnancy prevention is better than anything except abstinence, and only 1-2 women in 1,000 still become pregnant after their partner undergoes the procedure.

Reversing a vasectomy

Since your testicles continue to make sperm after a vasectomy, the main purpose of a reversal procedure is to restore the connection to your urethra. We use two different microsurgery procedures to achieve this, depending on whether sperm is present.

To check for sperm, we make a tiny incision on each side of your scrotum to access your vas deferens. After trimming the scarred ends of tissue from your first procedure, we collect vasal fluid near your testicle to check for sperm.

If we find sperm in your vasal fluid, we perform a vasovasostomy. If not, we use vasoepididymostomy. Sometimes, you need one of each to reverse your vasectomy.


When you have sperm in your vessel fluid, this indicates you have a clear path between your testicles and the cut (or blocked) vas deferens. During a vasovasostomy, we simply rejoin your vas deferens to restore flow from your testicle to your urethra.


Not having sperm in your vessel fluid can indicate a blockage. To restore your fertility, we have to move around this blockage and connect the upper portion of your vas deferens to the epididymis instead. The epididymis is a long, coiled tube behind your testicle that stores and carries sperm.

What to expect during your vasectomy reversal procedure

We perform both vasovasostomy and vasoepididymostomy as outpatient procedures while you’re asleep, so you can go home the same day. 

The healing process is relatively quick, and 50% of men say the pain is similar to having a vasectomy, but 25% say it’s less. You can usually resume regular activity within a week, but you should take it easy and avoid sexual activity for 2-3 weeks. 

Undergoing a vasectomy reversal usually provides good success rates, and vasovasostomy restores fertility in 85 in 100 men. While a vasoepididymostomy is a more complicated procedure, it also provides results nearly as good. 

However, it can take 4-12 months for pregnancy to occur after a vasectomy reversal, and pregnancy rates often depend on the amount of time between your vasectomy and its reversal.

For more information on vasectomy reversal, call our office in Wilmington, North Carolina, at 910-421-2505 to schedule an evaluation, or send us a message online today.

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