Vasovasostomy is a surgical procedure used to restore male fertility after a vasectomy (surgical sterilization in men). This procedure involves reconnecting the cut ends of the vas deferens, which are the channels through which sperm travel from the testicles to the urethra. The goal of vasovasostomy is to allow sperm to again pass through the vas deferens, thereby restoring the possibility of natural conception.
Before deciding on vasovasostomy, a detailed medical and urological examination is conducted. The urologist will assess the history of the vasectomy, the duration since the surgery, the patient’s general health, and the reasons for restoring fertility. It is also important to test the sperm (if present in the ejaculate) or testicular tissue (to see the presence of sperm) to evaluate the likelihood of the operation’s success.

Vasovasostomy is performed under a microscope using very precise surgical techniques. The surgery usually lasts several hours and is performed under general or spinal anesthesia. The procedure requires a high degree of precision because the vas deferens has a very small diameter, and the surgeon must accurately connect the ends of the channels to enable the passage of sperm.
Recovery after surgery typically takes several weeks, during which it is recommended to avoid heavy physical activities and sexual abstinence. The effectiveness of the procedure can be assessed by sperm analysis several months after the surgery, with the first analysis usually recommended after 3 months.
The success rate of vasovasostomy varies and depends on many factors, including the duration of the period from vasectomy to vasovasostomy. Generally, the chances of sperm returning to the ejaculate and the possibility of conception are higher if the surgery is performed within a few years of the vasectomy. The procedure can have a high success rate, but restoration of fertility is not always guaranteed, so couples are sometimes advised to consider other assisted reproduction options.