Microsurgical Vasectomy Reversal Offers Higher Success Rates

For those men who decide they would like to have more children, a microsurgical procedure offered by UH urologist Nannan Thirumavalavan, MD, offers a greater chance of success than traditional vasectomy reversal surgery. In fact, when a microsurgical reversal procedure is performed within 10 years after vasectomy by a highly skilled surgeon with advanced training, success rates are well over 90 percent. Dr. Thirumavalavan is fellowship trained in microsurgery and vasectomy reversals.

The procedure for reversing a vasectomy uses an operative microscope and tiny sutures to remove or bypass the blockage that was created during the vasectomy, allowing sperm to once again move through the vas deferens and become a live component of the semen. The vasectomy reversal may be accomplished using one of the following procedures:

1. Vaso-vasostomy. The two ends of the vas deferens that were separated at the time of vasectomy are reconnected.
2. Epididymovasostomy. The vas deferens is connected directly to the epididymis because of a secondary blockage in the epididymis. A secondary blockage is more common when vasectomy was done ten or more years ago.

The optimal procedure for each patient will be determined once the surgery is underway and the surgeon can examine the original vasectomy site. A microsurgical vasectomy reversal takes approximately five hours in the operating room and requires general anesthesia.

Understanding Male Reproductive Anatomy Helps Explain Vasectomy Reversal

To better explain vasectomy reversal, it is helpful to understand the male reproductive anatomy and how it is altered during a vasectomy.

Sperm production takes place in the testicles (testes) which are contained within the scrotum at the base of the penis. The sperm then pass through the efferent ducts to the epididymis where they are stored until mature. The mature sperm then travel through a long tube called the vas deferens until it reaches the seminal vesicle. There, the sperm combine with fluid produced by the prostate gland to form semen. During ejaculation, the semen flows through the urethra and comes out of the end of the penis.

During a vasectomy, a small section of the vas deferens is cut out and the ends permanently sealed with heat and/or stitches, blocking the sperm from reaching the seminal vesicle. Vasectomy does not affect sperm production – it just creates a roadblock that prevents delivery. The testicles continue to produce healthy sperm throughout most of a man’s lifetime.