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Can Old Vasectomies Be Reversed? A Doctor Weighs In

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Paul Turek, MD, FACS - Blogs
By Paul Turek, MD, FACSBoard-certified urologistMay 16, 2019

You had a vasectomy years ago, and you loved the results…until you changed your mind. Now you want more children, but you’re wondering – is it possible? While vasectomies are intended to be a “permanent” form of contraception, with the technology and surgical skill now available, “permanent” doesn’t have to mean forever.

When it comes to vasectomy reversal surgery, there are two big myths that I’d like to put to rest.

The first is that “vasectomies aren’t really all that reversible” – in the vast majority of cases (and with the help of a skilled surgeon), they are reversible.

The second myth is that you should “completely forget about reversing older vasectomies” (a vasectomy age of 15 years or more). 

The biggest issue with the “older” vasectomy is that, just like a tire that is continually being filled with air, a “blow out” can occur behind the vasectomy, nearer to the testicle. This basically adds another “blockage” to the system, in addition to the vasectomy itself, so now, there are two points of obstruction to getting the sperm flowing again. This means that a more involved procedure, called an epididymovasostomy, is needed during reversal surgery to restore sperm flow and fertility. But we are much more adept at performing these highly technical microsurgical procedures than we have ever been in the past. Connecting two tubes that are 1/100 of an inch in diameter with suture 1/10 as thin as a hair is routine stuff now. It’s medical progress at its best.  

New research now shows that “older” vasectomies can be successfully reversed almost as easily as “younger” ones. In a published series of 1229 men undergoing vasectomy reversal who were grouped into having either younger (1 to 15 years old) or older (16 to 38 years old) vasectomies, the rates of achieving moving ejaculated sperm counts after reversal surgery were statistically close: 88% in younger vasectomies and 65% in older vasectomies. Not only that, the actual sperm counts obtained in these two groups of men after reversal surgery were no different (averaging 55 million sperm).

This suggests two things. The first is that men continue to make as much sperm after a vasectomy as before it, regardless of how long they’ve had the vasectomy. The second is that older vasectomies are more reversible than we ever thought possible. And that means that fatherhood after vasectomy can be a reality.

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About the Author
Paul Turek, MD, FACS

Paul Turek, MD, FACS, is founder of The Turek Clinics, providing state of the art medical treatment to men worldwide. Yale- and Stanford-trained, Dr. Turek has pioneered male fertility techniques including testicular mapping and sperm retrieval and has popularized the no-scalpel vasectomy. To read more from Dr. Turek, visit his award-winning blog.

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