Can a Vasectomy Be Reversed After 15 Years?
The short answer to whether a vasectomy can be reversed after 15 years is YES. However, there are several factors that influence the success of the outcome. To better understand why, it’s important to appreciate that reversing a vasectomy is far more complicated than performing a vasectomy.
Thousands of vasectomies are performed every day by general urologists, usually in their office under local anesthesia. Vasectomy reversal, on the other hand, is a much more complicated procedure. This procedure is most successful when performed by a skilled micro-surgeon, under general anesthesia, in an operating room, using a state-of-the-art Zeiss OPMI microscope.
There are two types of vasectomy reversal. The relatively ‘simpler’ of the two is referred to as a vasovasostomy. In this procedure, the original blockage created by the vasectomy is removed. A drop of fluid at the bottom end of the vas deferens is examined under a microscope to check for sperm. Swimming, active sperm in this drop will confirm that the route from the testicle to the end of the vas is open. Using the Zeiss microscope to magnify viewing of these structures being operated on, the surgeon reconnects the vas deferens back together to restore the flow of sperm. As wasy as it may sound, reconnecting this tiny tubule is a matter of aligning a diameter that is the size of pen dot back together. No easy feat! When sperm are found in the vas fluid, the surgeon is able to re-connect the ends of the vas. The inner layer is brought together with special micro-sutures half the thickness of a human hair, and the muscle layer is closed over it with a heavier suture to add strength. Sperm can then flow through the new connection and in time pregnancy can be achieved the natural way.
After a vasectomy, some men may develop a secondary blockage that needs to be bypassed. This requires the more technically challenging vasectomy reversal procedure referred to as a vasoepididymostomy. As in the vasovasostomy procedure, the original blockage created by the vasectomy is removed and again, a drop of fluid at the end of the vas is examined. If sperm is not present, it means that a blow-out or rupture has occurred. This can happen with older vasectomies when pressure builds up over time and the body has tried to repair the situation by creating scar tissue and a new blockage in the epididymis. If this second blockage is present and is not recognized and corrected at the time of surgery, the reversal is doomed to fail.
Realizing the need to address this common problem at the time of surgery, we pioneered the Mini-Incision Microsurgical Vasoepididymostomy. When a vasoepididymostomy is called for, we access and examine the epididymis, open a tubule and check the fluid for the presence of sperm. If sperm are found in the epididymal tubule then we know we are at a spot that is upstream from the second blockage. We will then need to bring the open end of the vas to meet the epididymis, and sew it to the open epididymal tubule.
To accomplish the above task, most surgeons will make a large opening in the scrotum and remove the testicle and epididymis from it in order to gain access to the epididymis and vas. But our team has pioneered a way of accessing both the vas and epididymis without having to open up the entire scrotum – leading to better outcomes for our patients fewer complications and less downtime for recovery.
So you see, while a vasectomy can technically be reversed successfully after 15 years, the real answer is… IF you have the right surgeon! Dr. Werthman holds the esteemed record of successfully reversing a vasectomy on a man who’s vasectomy was FIFTY SEVEN years old!
