The procedure is performed under sterile conditions to prevent infection after the intervention.  You will be awake and conscious during the surgery.  After being positioned on your back, a local antiseptic and sterile drape will be applied to the genital area.  Unlike a vasectomy, local anesthesia of the entire spermatic cord on either side is necessary. A spermatic cord block is performed by injecting an anesthetic agent in the inguinal area under ultrasound guidance which might cause mild burning that lasts for a few seconds.  The skin on the side of the scrotum is then locally infiltrated with a local anesthetic and a small incision (generally longer than that performed for vasectomy) is made.  Once the area is frozen and numb, you will no longer experience pain but will still feel the urologist touching you.

During this complex intervention performed with a microscope, both ends of the tube are then identified and connected together with microscopic sutures and the incision closed. Although very rare, it is sometimes impossible to join the ends together.  Rapidly resorbable stitches will be used to close the small incision and a transparent liquid bandage applied over them.  The same procedure is applied to either side. The stitches will start to go away in 7 to 10 days. The surgery usually takes between sixty to ninety minutes to complete and there is generally no need for any recovery period at the office. Wearing tight underwear after will help in reducing discomfort. You will be able to leave the office quickly by your own means.  Although you may wish to be accompanied it is not obligatory.  You may take a shower 24hrs after.

There is no special preparation necessary prior to the procedure. Fasting is not necessary.  Shaving of the genital area6 is optional. You should make yourself available for 2 hours at the clinic. You may want to be accompanied but this is not absolutely necessary. Please arrive on time for your appointment. Any anticoagulants (blood thinners) should be discontinued prior to the surgery as per your urologist’s recommendations and any allergies noted. Written consent is mandatory.

It is best to avoid any intense physical activity, lifting heavy objects, or sports during the first week which could cause bleeding or swelling. You should avoid sexual activity for three weeks to allow for adequate healing of the tubes to occur.  Return of sperm cells in the semen can occur almost immediately in some cases but can be much longer in others. Optimal semen parameters may take up to 12-24 months to be achieved and a first semen analysis will be performed approximately three months after the surgery to verify the quality of the sperm.

Note that even if sperm cells are present within the sperm, this does not guarantee a pregnancy.

Many couples have been able to achieve pregnancy after a vasovasostomy, even after more than 10 years after the vasectomy.