Will a Vasectomy Reversal Work after 10, 15, 20 or 25 Years After Vasectomy? – The Truth About the Number of Years Since the Vasectomy and Vas Reversal Success Rates in 2023

Yes, men can have very high vas reversal success rates, as high as 99.5% in the hands of a skilled and experienced urologic microsurgeon, as far out as 42 years from vasectomy!

This high success rate after vasectomy reversals is based on the published literature, including a paper we recently published in the leading male fertility journal Andrology (1) and a presentation at American Society of Andrology (2).<

The goal of this page, by vasectomy reversal authority, microsurgeon and authorSheldon Marks MD, is to provide accurate, up-to-date information regarding the facts about the number of years since vasectomy (also known as the obstructive interval) and the potential impact on vas reversal success rates.

We hear too often:“But my doctor said a vasectomy reversal could not work because I am 10 years out from vasectomy!” This is so wrong on many levels. This incorrect information is not supported by the world’s expert opinions, what is published in specialty journals, what we teach every year at international fertility and vasectomy reversal courses and what is in the leading (and only) textbook for doctors about vasectomy reversals.

Too many doctors still don’t realize this and mistakenly tell their patients that a vas reversal can’t work because they are too far out from the vasectomy. This is not true! They don’t realize that they are quoting success in 2023 from old 1970’s data and publications – they are telling men today what can be expected based on 40-year-old information from old, abandoned techniques and outdated decision-making (3).

Here at our full time, vas reversal only center we have a proven, published very high success rate as high as 99.5% for vas-to-vas connections in most men, even those who are 10, 15, 20 and 25 years or more from the vasectomy (4)!

The doctors of ICVR even have the world record, a successful vas reversal 42 years from vasectomy, with a 19-year-old vas reversal daughter who now has a one year old baby herself!

In our published paper in the male fertility journal Andrology, we showed that as the years go by, the chances can increase slowly to develop internal blockage and so need an epididymal bypass surgery (VE, vasoepididymostomy), but that this bypass connection can still be very successful at 70 to 90% vasectomy reversal success. The only way to know what technique is correct for that patient is for the surgeon to microscopically analyze the fluid from the vas during the vas reversal – something that many doctors still don’t perform (5).

What our doctors found in a review of 2660 vasectomy reversals at our reversal only center (see graph) is that the longer the obstructive interval from the vasectomy, the higher the likelihood that there will have developed deeper epididymal blockage and so the patient will need a vas-to-epididymal bypass on one or both sides. The need for a vas-to-epididymal bypass starts at 2 years after vasectomy, gradually increasing until it levels off and plateaus at about 20 years from vasectomy. This means that the chances for vas reversal success stay the same whether the man is 20 or 42 years out.

There is no way to determine whether the man will need the straightforward vas-to-vas connection or the epididymal bypass before the vas reversal. No one can accurately say what technique will be needed beforehand based only on the number of years from vasectomy, yet many still do.

Another question we often hear,“is it true that men who are less than 9 or 10 years from vasectomy would be fine most often to go to a doctor that only does vas-to-vas connections?” Absolutely not! Here’s why.

As seen on this graph, the need for a bypass is significant starting at about 7 years, where 1/3 of all men will need a bypass on one or both sides. Even at just 3 to 4 years, there are times when we find deeper blockage and so have to perform VE’s. Every paper that looks at this, and at every course or lecture, the experts say the same thing – if the doctor can’t or won’t perform a vas-to-epididymal bypass, then it not in the patient’s interest for the surgeon to only perform the vas-to-vas reversal on every patient, even for men less than 10 years from vasectomy (6). We just had several patients that needed a VE bypass that were less than 5 years from vasectomy.

The doctor limiting what they do to just the straight forward vas-to-vas connection on every patient is like hiring a taxi Uber or Lyft driver that will only turn right and will not make any left-hand turns to get you to your destination. It will work for many, but not for all.

Experts agree that prospective patients should ask these questions and consider the issues and concerns about doctors that proudly announce that they only perform vas-to-vas connections on every patient, no matter what the microscopic analysis of the vasal fluid shows should be done. Just as bad, top leaders will caution men about the surgeons that decide what technique each vas reversal patient will get ahead of time, only based on the number of years from vasectomy or only how the vasal fluid appears without performing a microscopic analysis to look for the presence or absence of sperm.

Of course, it’s up to each patient and his partner to do their own research so that they can make their own informed, shared decision about which doctor best fits their specific needs.

For answers to any questions or for more information on how to become part of our family where we are “Making Men Dads Again TM,” please call (888) 722-2929 .

This page was reviewed, edited and updated January 4, 2023 by Sheldon H. F. Marks, MD.

References:

1. Mui P, Perkins A, Burrows PJ, Marks SF, Turek PJ. The need for epididymostomy at vasectomy reversal plateaus in older vasectomies: a study of 1229 cases. Andrology 2014;2(1):25-9.
2. Marks SHF, Burrows PJ, Cropp AR, Ax RL, McCauley TC. Obstructive interval should not be a deterrent in vasectomy reversal.. Androl 2008;March/April(Suppl):21.
3. Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the vasovasostomy study group. J Urol. 1991;145:505‐511.
4. Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Angled vas cutter for vasovasostomy: technique and results. Fertility and Sterility 2014;101(3):636-639.
5. Chawla A, O’Brien J, Lisi M, Zini A, Jarvi K.Should all urologist performing vasectomy reversal be able to perform vasoepididymostomies if required? J Urol 2004;172(3):1048- 50.
6. Silber SJ, Grotjan HE. Microscopic vasectomy reversal 30 years later: a summary of 4010 cases by the same surgeon. J Androl 2004;25(6):845-859.