A vasectomy reversal is typically performed as an outpatient procedure under general anesthesia. The surgeon makes small incisions on either side of the scrotum to access the vas deferens. The ends of the vas deferens are then carefully cut and examined under a microscope. If healthy sperm are present, the surgeon will reconnect the vas deferens using tiny stitches. This type of surgery is often referred to as microsurgery.

There are two main types of vasectomy reversal procedures: vasovasostomy and epididymovasostomy. Vasovasostomy is the more common procedure and involves reconnecting the two cut ends of the vas deferens.

Epididymovasostomy is a more complex procedure performed when there is a blockage in the epididymis, the structure that stores and matures sperm before they enter the vas deferens. During epididymovasostomy, the surgeon creates a new connection between the vas deferens and the epididymis to allow the sperm to bypass the blockage.