of any sperm in the contents of each vas usually is due to “blowouts” in the epididymides. Under these circumstances an operation should be performed only by a micro-surgeon with proven vasoepididymostomy expertise, bypassing the blowouts. Prognosis The prognosis for each patient should be determined by a pre-operative examination of the vasectomy sites and consideration of the time interval since vasectomy. Rate of pregnancy The rate of pregnancy depends on such factors as the method used for the vasectomy and the length of time that has passed since the vasectomy was performed. The reversal procedures are frequently impermanent, with occlusion of the vas recurring two or more years after the operation. The presence of sperm granulomas improves the likelihood of restoring sperm to the semen with a vasovasotomy. A local urologist can easily determine whether a patient has 0, 1, or 2 sperm granuloma by a painless examination of each vasectomy site. If the interval since the vasectomy is less than fifteen years, the prognosis will be 70% or better and this local examination is probably not needed. A sperm granuloma develops from post-vasectomy sperm leakage and somehow it behaves like a safety valve preventing internal pressure build up and ruptures of the delicate epididymis tubules with subsequent obstructive scarring. Statistics Vasovasostomy can be effective regardless of how long it's been since the original vasectomy. However, if more than 15 years have passed since the original vasectomy, one may have a lower chance of having enough healthy sperm in one's own semen to father a child. Also, the longer the obstructive interval, the more likely it is that a vasoepididymostomy will be required. Costs Typical cost of one vasovasostomy is US$5,000–15,000 (one side). See also Tubal reversal, reversal of a tubal ligation Vasectomy reversal Vasitis nodosa References External links Vasovasostomy Pictures Vasectomy Reversal American Urological Association sponsored site. Urologic surgery Male genital surgery Vasectomy reversal de:Vasovasostomie