Clips do the least damage, followed by rings and tying methods. Electrocoagulation does the most damage and is the least reversible. Although sterilization methods that destroy the most tissue are the least reversible, they are believed to be the most effective means of sterilization. This is why electrocoagulation has been widely used in the United States as a method of blocking the tubes. Successful reversal of vasectomy also depends upon the amount of undamaged tube left after sterilization.
Ligation damages less tissue than electrocoagulation.
In addition, the chance of reversal success is greater if the vasectomy was done on the straight sections of the vas, and if the pieces to be joined are of equal size. Unfortunately, the surgeon can judge whether the conditions are good for successful male reversal only at the time of the reversal surgery. The use of an operating microscope or surgical loupe to magnify the surgical area during the operation is important. It is even more important in male reversal procedures than in female procedures, since the thin vas deferens is more difficult to reconnect than the larger fallopian tube. The reports of greater success using microsurgical techniques may also be due to the increased training and experience of most microsurgeons.