Male Infertility: Vasectomy Reversal
Microsurgical Vasectomy Reversal Offers High Treatment Success in an Outpatient Surgery Setting
What is a Vasectomy?
A Vasectomy is a surgical procedure which prevents sperm from entering
the ejaculatory system. Sperm is produced in the testis.
It passes from the testis though small channels into the epididymis,
a delicate and long tubule (coiled on itself) where the sperm mature.
The sperm are stored in the end part of the epididymis and beginning
part of the vas also known as the convoluted vas. During ejaculation,
the sperm are propelled through the straight vas into the ejaculatory
ducts and penile urethra. During a vasectomy, the surgeon
actually cuts through the straight vas and then places a clip or
suture around the cut ends.
What is a Vasectomy
A Vasectomy Reversal is an operation which uses microsurgery to
establish a reconnection of the ejaculatory system. It is usually
performed by an experienced microsurgeon with specialized training.
Special equipment is required including an operating microscope,
microsurgical instruments and microsurgical sutures which are finer
than human hair. Two procedures are commonly used to perform vasectomy
reversal: Vasovasostomy (Vas to vas reconnection) and Epididymovasostomy
(epididymis to vas reconnection). Epididymovasostomy: is only required
when there is a secondary blockage in the epididymis and therefore
simply reconnecting the ends of the vas wouldn't accomplish the
goal of the return of sperm to the ejaculate. The presence of this
secondary epididymal blockage or ``blowout" can only be determined
at the time of surgery when the vas is examined for the presence
or absence of sperm.
Why a vasectomy reversal?
More and more patients are seeking vasectomy reversals. The most
common situation occurs when a man who has had a vasectomy decides
to remarry and have children. Sometimes couples merely change their
minds, and sometimes a couple may have lost a child or children
and wish to have more. Fortunately, new techniques and advances
in microsurgery are now resulting in significant pregnancy rates.
Success depends on two
- The skill of the
surgeon (preferably a surgeon with extensive microsurgical experience).
- The operative findings.
What about the Operation Itself?
The operation is performed through two small scrotal incisions. These incisions
are closed with absorbable suture which do not require removal.
Updated March 3, 2007