Vasectomy reversal is a day surgery, which means the patient comes to the hospital, has the surgery and leaves on the same day.
There are two methods of vasectomy reversal - vasovasostomy and vasoepididymostomy. Both of these procedures are microsurgical techniques done under an operating microscope, and using miniature instruments. First one side of the scrotum is operated on, and then the other side.
After inducing anesthesia, a 1-2 inch incision is made in the skin of the scrotum. The two cut ends of the vas deferens are found and freed from the surrounding scar tissue. A drop of fluid from the testicular end of the vas deferens is placed on a glass slide and examined under the microscope. If the fluid contains sperms, then the two cut ends of the vas deferens are sewn together to re-establish sperm flow. This vasectomy reversal procedure is known as vasovasostomy.
If the fluid from the vas deferens is thick and pasty and contains no sperms, it indicates a blockage in the epididymis. In this case, the operating urologist opens a tubule of the epididymis and examines the fluid there under the microscope for the presence of sperms. If sperms are present in this fluid, then the cut end of the vas deferens is connected to the open tubule of the epididymis. This vasectomy reversal procedure is called a vasoepididymostomy.
The vasovasostomy or vasoepididymostomy is closed with a very thin suture material. Most urologists prefer a two-layered closure. First the mucosa (inner layer) of the vas deferens is closed with 6-8 interrupted sutures and then a second series of sutures are placed on the muscular (outer) layer of the vas deferens. The incision in the skin of the scrotum is then closed.
Epididymis: Epididymis is a tube-like structure which connects the testis and the vas deferens. The sperms are stored and matured in the epididymis.
General anesthesia: Anesthesis where there is unconciousness and loss of sensation all over the body.
Incision:Incision is a cut made in the body to perform surgery.
Local anesthesia: In local anesthesia medicine injected into the site of the operation to temporarily numb that area.The patient remains awake.
Sperms: Sperms are male reproductive cells. They are produced in the testes. They are carried in fluid called semen. Sperms are capable of fertilising an egg cell to form a zygote.
Spinal block: Spinal block is a type of anesthesia. Medicines are injected into the spinal column to numb the lower half of the body.
Vas deferens: Vasa deferentia are thin tubes which carry sperms from the testes to the urethra. Vas deferens is also known as sperm duct. Each vas deferens is about 45 cms long.
Vasovasostomy: Vasovasostomy is a method of vasectomy reversal surgery where the two cut ends of the vas deferens are reconnected.
Vasoepididymostomy: Vasoepididymostomy is a method of vasectomy reversal surgery where the vas deferens is connected to the epididymis.