The first step of a microscopic vasectomy reversal.

You’d think that finding the area of a vasectomy done years ago would always be easy. Well…not always. If the urologist used clips to facilitate the vasectomy, this makes finding the area very easy. However, if he removed only a small portion of the vas deferens and cauterized a small segment on either side of the the transection…this can be difficult to find.

In the picture above you can see on the left side the vas tube is slightly smaller than the right and that the right seems to have groves in it as well increased vascularity. The groove indicated that this is the portion closest to the testicle and is called the convoluted portion of the vas. In the middle of the two yellow things (penrose drains) is the scar from the vasectomy.

This scar will be removed, the fresh ends unaffected by the vasectomy scar isolated and approximated, and then the microscope will be brought into the surgical field to accomplish the microscopic repair with microscopic suture the size of hair.

Often times, whether this step is easy or difficult will predict the how easy or difficult the rest of the procedure will be.

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