There are several things about the picture above. First of all, the vas deferens has been isolated and is ready to begin the vasectomy reversal procedure proper. There are basically three parts to a vasectomy reversal.
- First you have to dissect out the vas deferens and identify the vasectomy site. In the case above this was easy. You see in the middle of the picture a conglomeration of clips which were used to do the vasectomy. I like it when clips have been used. The area is much easier to find and there is less damage to the vas deferens.
- Secondly, the vasectomy site is excised and fresh vascularized vas deferens are delineated and prepared to reconnect.
- Finally the actual reversal. The microscope is brought into the operative field and after having approximated the two ends…the reversal is performed under the microscope using microscopic suture, usually 12-14 on each side.
Another interesting finding in the above picture is the sperm granuloma. On the right side of the clips you see a bulge before the vas narrows. This finding is a positive sign of success and that the fluid will be favorable. In this case the vasectomy had been done 5 years previously and the fluid noted upon transection showed a mildly cloudy fluid which with microscopic evaluation showed whole sperm.
So even before the reversal procedure with the microscope even started there where several positive findings the will contribute to a reversal success and pregnancy.
Considering a vasectomy reversal? We do them all the time and the consultation is free. Make an appointment 24/7 by just leaving your number and we’ll contact you.
Just like the Marines…only the strongest, the fastest, the finest “get through.” And this is natures way of assuring the best sperm for the job.
“Cracking the egg” is very competitive!
A link between vasectomy reversals and birth defects has not been convincingly demonstrated.
If you are considering a vasectomy reversal, even if you are unsure who you will choose to perform it, it is a good idea to have a preoperative consultation. You can ask the pressing questions that concern you, you can get a concept of the procedure, the time it will take, the cost, and as a result of the exam of the previous vasectomy site-you will know if there are any contraindications for the procedure pertinent to you. It is also an opportunity to get to know the physician that may be doing the procedure.
The reason it is not unusual for a consultation to be free for reversals is that the visit and the subsequent procedure is usually not covered by insurance. The free consultation is beneficial to both parties and by being at no cost encourages the couple to take that”first step” to the journey of having another baby.
No. All vasectomies involve removing a segment and then closing both ends of the vas defens tube. Whether the vasectomy was no needle, no scalpel, or whether the ends were closed with suture, electrocautery, or staples it doesn’t matter. What is seen at the time of the reversal is a scarred area of vas between the testicle and body side of the tube. This segment is removed, the ends resected to clean and pristine tissue and then prepared for the rejoining process. The operative microscope is useful in examining the “freshened” ends of the vas tubes as success rates depend on no residual scar at the point of the repair.