Microsurgical Vasectomy Reversal
The gold standard Microdot Multilayer Microsurgical technique — performed by Mr. Manohar Jesuraj, the only UK surgeon endorsed by Dr Sheldon Marks of the International Centre for Vasectomy Reversal, Arizona. Success rates up to 90%+.
Success rate within 3 years of vasectomy
Zeiss operating microscope magnification
Dedicated surgical slot per patient
Fee Pricing
The only vasectomy reversal service in the UK that I would recommend to patients from Europe when they consult me.
THE PROCEDURE
What Is a Vasectomy Reversal?
A vasectomy reversal is a microsurgical procedure that reconnects the vas deferens — the tube that carries sperm from the testicle — allowing sperm to be present in the ejaculate once again, making natural conception possible.
The vas deferens has an inner channel (lumen) of just 0.2–0.4mm in diameter — smaller than a pinhead. Reconnecting it successfully requires the highest level of microsurgical skill, the finest possible sutures, and a powerful operating microscope. At this scale, the difference between an adequate result and a gold standard result is enormous.
At Tees Urology, every reversal is performed using the Microdot Multilayer Microsurgical Vasovasostomy (MMMV) technique — the world gold standard, developed at Cornell University by Professor Goldstein and refined by Dr Sheldon Marks. Mr. Jesuraj has been performing this procedure for over two decades.
New relationship — wanting a family
Around 88% of patients have formed a new relationship and wish to have a child together.
Change of mind — wanting more children
Approximately 10% of patients simply decide they want more children — as circumstances change.
Post-vasectomy pain syndrome
Reversal can resolve chronic scrotal pain caused by back-pressure after vasectomy — even when fertility is not the goal.
Failed reversal elsewhere
Patients who had a reversal at another centre that did not result in pregnancy — a redo reversal with the gold standard technique.
Why Our Technique Is Different
Not all vasectomy reversals are the same. The difference in technique between centres is enormous — and directly affects your chances of success.
| SURGICAL FACTOR | Most UK Clinics | ★ Tees Urology |
|---|---|---|
| Magnification | 4x–6x surgical loupes | 20x–40x Zeiss operating microscope |
| Suture size | 6-0 sutures (standard) | 10-0 / 11-0 — finer than human hair |
| Technique | Single or two-layer repair | Microdot Multilayer — 3 layers |
| Intra-op fluid analysis | Often not performed | Always performed — every case |
| Vasoepididymostomy | Many centres unable to perform | Performed same operation if needed |
| Operating time | 60–90 minutes | 3–4 hours dedicated slot |
| Both sides checked | Variable | Always — 98%+ bilateral completion |
The Microdot Multilayer Method
Developed at Cornell University — the world gold standard for vasectomy reversal, used at the finest centres globally.
Microscopic Examination of Vas Fluid
Before any stitching begins, fluid from the testicular end of the vas is examined under a microscope. This critical step determines whether sperm are present — and identifies any epididymal blockage (blow-out) that would require vasoepididymostomy.
Microdot Mapping of the Vas Lumen
Microdots — tiny ink marks — are placed around the circumference of the vas opening to precisely guide suture placement. This ensures the ultra-fine stitches are perfectly aligned even when the lumen is collapsed or as small as 0.2mm.
Three-Layer Microsurgical Reconstruction
The vas is reconstructed in three separate layers: first the inner mucosal layer (the most technically demanding — this is what most clinics skip), then the muscularis, then the outer adventitial layer. This creates a watertight, aligned, patent connection.
Vasoepididymostomy If Required
If the fluid analysis reveals a blow-out — epididymal blockage caused by back-pressure after vasectomy — Mr. Jesuraj performs vasoepididymostomy in the same operation. This even more delicate bypass procedure connects the vas directly to the epididymis. It is included at no extra charge.
Your Chances of Success
Success rates depend primarily on the time elapsed since vasectomy. The sooner a reversal is performed, the higher the likelihood — but Mr. Jesuraj has achieved successful reversals for men more than 20 years post-vasectomy.
| Time Since Vasectomy | Patency RateSperm in ejaculate | Pregnancy RateNatural conception | Outlook |
|---|---|---|---|
| Under 3 years | Up to 97% | Up to 76% | Excellent |
| 3–8 years | Up to 88% | Up to 53% | Good |
| 9–14 years | Up to 79% | Up to 44% | Reasonable |
| 15+ years | Up to 71% | Up to 30% | Still worthwhile |
| 20+ years | Variable | Variable | Individual assessment |
From First Enquiry to Positive Test
Microscopic Fluid Analysis
During surgery, we examine the vas fluid under high magnification to check for the presence of sperm or clear fluid.
Microdot Mapping
We use the Microdot technique to map the vas lumen, ensuring a perfect 360-degree anatomical alignment of the tubes.
Procedure Day
We perform a multilayer closure using 10-0 and 11-0 sutures, which are significantly finer than a human hair.
Vasoepididymostomy
If a secondary blockage is found, we can perform this complex “blow-out” repair in the same surgical session.
Frequently Asked Questions
Interested in Microsurgical Vasectomy Reversal?
Book a consultation with Mr. Jesuraj to find out if you are a suitable candidate. Appointments available within days.