How a Vasectomy Reversal is Performed

vasectomy reversalIf you have had a vasectomy and have now made the decision to start a new family, you may wish to have a vasectomy reversal. Although not always successful, this procedure could restore your fertility, meaning you may be able to father a child.

Unlike a vasectomy, a reversal is only done under a general anaesthetic with Mr Harriss (as the results are better and he has better access to all the anatomy required), which means that you will be asleep throughout the procedure. A micro-surgical vasectomy reversal is significantly more challenging to perform than a vasectomy, requiring specialised skills and expertise.

In most cases, your vasectomy reversal will take the form of a vasovasostomy. During this procedure, Mr. Harriss will make a small cut on the underside of your scrotum. This will expose the vas deferens (the tube that carries sperm) and release it from the surrounding tissues. He will then cut open the vas deferens and look at the fluid inside. If sperm are present in the fluid, he will sew the ends of the vas deferens back together to re-establish the passageway for sperm.

If it appears that there is a blockage , Mr Harriss will continue to seek fluid and this can mean that a vaso-epididymostomy is required. A vasoepididymostomy is the microsurgical procedure where the vas deferens is joined to the epididymis. It is the most difficult and technically challenging microsurgical procedure for the treatment of male infertility. Surgeons must have excellent microsurgical skills and extensive experience to be able to perform this anastomosic procedure between the vas deferens and epididymis. The epididymis is a tightly coiled (15 foot long if uncoiled) tube behind the testis where sperm go after leaving the testicle. It is basically a swimming school for sperm. Testicular sperm are unable to swim or fertilize an egg naturally, and acquire these abilities as they pass through the epididymis. The diameter of the epididymal tubules is only 200 microns (twice the diameter of a human hair) which is how 15 feet of length can fit into this. After leaving the epididymis, sperm empty into the vas deferens, which transports the sperm to the ejaculation ducts, which empty into the urethra in the penis. The aim is to bypass the blockage to enable sperm to pass in ejaculation.

A vasoepididymostomy is more complicated than a vasovasostomy, but may be the only option if a vasovasostomy cannot be done or is unlikely to work.

Mr. Harriss will decide on the most suitable technique to use during the vasectomy reversal surgery itself.