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Male Infertility: Vasectomy Reversal
Microsurgical Vasectomy Reversal Offers High Treatment Success in an Outpatient Surgery Setting
by Eric K. Seaman, M.D.

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 Reversal?
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 main factors:

  1. The skill of the surgeon (preferably a surgeon with extensive microsurgical experience).
  2. 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

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