Vasectomy Reversal Overview

The testicle continually makes sperm that is stored in the epididymis. During ejaculation (expulsion of semen from the penis), sperm are transported from the epididymis and travel down the vas deferens then into the prostate. Fluids from the prostate and seminal vesicles mix with the sperm in the ejaculatory duct to make up the ejaculate (semen).

What is Vasectomy?

A vasectomy is a surgical procedure that blocks the vas deferens thus preventing sperm from flowing to the prostate, as illustrated in Figure 2. Obstruction of the vas is usually accomplished by removing a small segment of the vas deferens and placing a suture or small metal clip on the end of the vas.

Vasectomy Reversal

A vasectomy reversal is a surgical procedure that re-approximates the cut ends of the vas deferens, restoring the flow of sperm from the testicle to the prostate. This procedure generally requires an experienced microsurgeon using an operating microscope to achieve the best success rates. A vasectomy reversal can be accomplished in two ways: a vasovasostomy or vasoepididymostomy.

A vasovasostomy, Figure 3a, is the most common way to re-approximate the cut ends of the vas deferens. The ends of the vas are sewn together using sutures that are finer than human hair. For some men, 20 – 30%, scarring in the epididymis after vasectomy prevents sperm from getting to the vas deferens. In this setting, reconnecting the two ends of the vas will not be adequate to restore fertility. A vasoepididymostomy, Figure 3b, is then performed to bypass the blockage in the epididymis.

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