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.
Date of Vasectomy Reversal by Dr. McHugh – May 2021
Date of post reversal semen analysis- December 2021
Number of sperm seen-98 million
Number of sperm necessary for pregnancy-20 million
Motility-65%
Assessment-A good start!
The road to a successful pregnancy after a vasectomy reversal is convoluted journey. The above semen analysis is a wonderful start and confirms that the procedure was successful and that the patient’s testicles adapted to being obstructed for the 11 years. Now the normal impediments to pregnancy common to all couples becomes a factor. Considering all the factors, this is very favorable in culminating in a successful pregnancy. We wish the couple a happy outcome and appreciate the opportunity in participating by way of a microscopic vasectomy reversal.
A common question after a vasectomy and as well microscopic vasectomy reversals is “What is the significance of skin bruising around the vasectomy site?” More importantly to the patient inquiring about this is, “Is anything wrong or does anything need to be done?”
Most casual observers will think of the North Star as the brightest star, in fact it is Sirius. (The North Star is known for its dependable location in the sky, not its brightness.)
According to Greek mythology, Sirius was the dog of the hunter Orion, and the ancient Romans placed the star in the constellation Canis Major (Latin for “Greater Dog”). The Romans thus referred to the sweltering period when the rising of the sun and Sirius converged as the “dies caniculares” or “days of the dog star.”
By the 1500s, the English world began to call the same summertime point on the astronomical calendar as the “dog days.”
A common question asked is whether the reversal will be harder if clips were used or if the patient was told by the urologist “I took out a section and burned it.”
In the vast majority of cases this has no influence on the microscopic vasectomy procedure.
The procedure is harder if both sides of the vasectomy were done in the vas deferens closest to the testicle-the convoluted vas. This area is smaller in diameter and not straight (convoluted) and this makes the repair a little harder.
Whether clips or burned, there is not difference in how difficult the reversal will be. Having had clips makes the area of the vasectomy easier to locate.
The amount of vas tube removed is usually not an issue unless there is a very large segment removed and this is customarily not done.
Of note, if you have had two vasectomies done, this could be an issue. If you had a complication after the vasectomy, say a large hematoma or infection that had to resolve or be operated on, these may affect the repair. On all unusual issues, be sure to make the reversal doctor aware.
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