Tag Archives: sperm granuloma

Vasectomy Reversal: A “preoperative” predictor of better than average results?


This is the isolated vas deferens at the time of a reversal. You can see the clips and a mass effect of the body’s attempt at healing the vasectomy “trauma.” This is called a sperm granuloma. Note the vas tubes going into the mass of healing and clips. Both sides are normal in appearance and normal caliber.

What a granuloma does is act as a “pop off” valve and releases some degree of pressure on the testicles. This in turn makes for less damage to the testicles and allows them to rebound sooner from a reversal. In many cases it will also improve the character of the fluid at the time of the reversal (which is also a favorable finding for the percentages of success).

So, if you are considering a reversal and in the shower examine yourself and feel a knot along the course of the vas tube above the testicle, this is a favorable sign and that you may have a better than average success rate for both patency  and pregnancy.

Just a small and interesting caveat for the couple thinking about reversing a vasectomy.

Reversal: Does it matter which type of vasectomy was done?


In the big scheme of things nope! However the picture shown above the vasectomy was done with clips. For the reversal surgeon this type of vasectomy is the easiest to find and usually is associated with a smaller segment to remove.

When the vasectomy has been done with fulguration alone (burning the inside of the severed vas) it be hard to find the actual site of the vasectomy. The defect is sometimes so small that the entire vas tube appears as if nothing has been done.

If a sperm granuloma has formed this is very easy to find and is a positive thing as the fluid is much better in this case.

Finally, a vasectomy should only be done if the couple is wanting “permanent” birth control. So a urologist doing a vasectomy in a way to make a reversal easier in my opinion is not the right attitude for either the patient or the doctor.