Reversals are most often done on a come-and-go basis by a urologist. Reversals can be done in an outpatient part of a hospital or at a surgery center. If a surgical microscope is used, the surgery is done while you're asleep under anesthesia. Your urologist and anesthesiologist will talk with you about your choices.
Using microsurgery is the best way to do this surgery. A high-powered microscope used during your surgery magnifies the small tubes 5 to 40 times their size. Your urologist can use stitches much thinner than an eyelash or even a hair to join the ends of the vas.
After you're asleep, your urologist will make a small cut on each side of the scrotum. Your urologist will trim the scarred ends of the vas where they were closed by the vasectomy. Your urologist will take fluid, ("vasal fluid") from the vasal end closest to the testis. Your doctor will check to see if it has sperm in it. At this point, there are 2 types of reversal procedures you can have:
If there is sperm in the vasal fluid it shows that the path is clear between the testis and where the vas was cut. This means the ends of the vas can then be joined. The term for reconnecting the ends of the vas is "vasovasostomy." When microsurgery is used, vasovasostomy works in about 85 out of 100 men. Pregnancy occurs in about 55 out of 100 partners.
If there is no sperm in the vasal fluid, it may mean back pressure from the vasectomy caused a form of "blowout" in the epididymal tube. This "blowout" can lead to a block. Your urologist will need to go around the block and join the upper end of the vas to the epididymis instead. This is called a "vasoepididymostomy" and it serves the same purpose as the vasovasostomy.
Vasoepididymostomy is more complex than vasovasostomy, but the results are nearly as good. Sometimes vasovasostomy is done on one side and vasoepididymostomy on the other.