I am often asked if a vasectomy can be reversed. Most often a man divorces, has a new wife and they wish to have children in their new marriage. Can the vasectomy be reversed?
Normally, sperm – the male reproductive cells that fertilize a woman’s egg – are made in the testicle. Sperm travel away from the testicle through a tube called the vas deferens. There is one vas deferens for each testicle. The vas deferens connect with a reservoir where the sperm is held, ready to be leave the reservoir during sex. The sperm also mixes with secretions from the prostate gland that keep the sperm alive. When the sperm is ejaculated, it travels through another tube, the urethra, inside the penis and is deposited in the woman’s vagina at the cervix or the “gatekeeper” to the uterus.
A vasectomy cuts or blocks the vas deferens. Once the vas deferens is blocked, sperm cannot pass from the testicle to the reservoir where semen and secretions from the prostate gland are stored.
After a vasectomy, a man continues to have normal ejaculations of semen, but the ejaculate no longer contains sperm. This can only be discerned if the ejaculate is examined under a microscope.
In a traditional vasectomy, the surgeon uses a scalpel to make small incisions in the skin of the scrotum near the base of the penis to reach both vas deferens. (The scrotum is the fleshy sac that contains the testicles.) The vas deferens are cut or blocked to prevent sperm from traveling. The incisions in the scrotum are then closed with two or three small stitches.
In my practice, I perform the no-scalpel, no-needle vasectomy, which is less painful, has less bleeding and fewer complications. The surgeon makes one or two tine openings about the size of an eraser to access the vas deferens.
The puncture is widened slightly, then the surgeon cuts or blocks each vas deferens.
The puncture site can be covered with a tiny dressing. No stitches are needed.
A vasectomy is intended to produce permanent sterilization. Special microsurgery can reverse a vasectomy and restore fertility in some cases. Vasectomy reversal is a delicate, expensive procedure. And it is only successful in about 60 to 70 percent of cases.