Sperm production occurs in the testis. After passage through the efferent ducts, sperm are stored and undergo maturation in the epididymis. The epididymis is a continuous, tightly coiled tube approximately 15-18 feet in length, which leads into the vas deferens. Sperm that have not passed through the epididymis are generally not able to fertilize eggs under normal conditions. The vas deferens is responsible for directed and propelling sperm into the urethra.
The decision of whether to perform a vasovasostomy or an epididymovasostomy depends upon the quality of the fluid from the testicular side of the vas deferens. The fluid is expressed and examined under a microscope at the time of surgery.
If sperm are present in this fluid, then a reconnection between the two vas ends can be performed - vasovasostomy. When sperm are present in this fluid, we expect >95% or more patients to demonstrate a return of sperm to their ejaculate postoperatively, with an associated 75% pregnancy rate. If no sperm are present, but the vasectomy fluid looks abundant and appropriate for ultimate sperm production (clear, watery), then a vasovasostomy is performed with a successful outcome of 75%. If poor-quality fluid is present (e.g., thick, pasty) and sperm are absent, or no fluid at all is found, then an epididymovasostomy (connection of the vas to the epididymis) is performed with a successful outcome of approximately 60%.
Microsurgical advances result in significant pregnancy rates, and it is essential that the surgeon be skillful with microsurgical technique, as precise suture placement is critical to the success of the procedure. The surgeon must also have the ability to perform the more difficult epididymovasostomy procedure.
The success of a vasectomy reversal depends on:
- The skill of the surgeon
- The findings at the time of surgery
Contact Us
Please contact one of
the vasectomy reversal specialists at the Chesapeake Urology Male
Fertility and Sexuality Group, for an appointment:
Karen Elizabeth Boyle, M.D.
David M. Fenig, M.D.
Brad D. Lerner, M.D.
Chesapeake
Urology's premier vasectomy reversal specialists serve patients in Maryland and in the Mid-Atlantic Region
including Virginia, West Virginia, Pennsylvania, Delaware, and
Washington, DC.
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« Microsurgical Vasectomy Reversal
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Success Rate
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Choosing Your Surgeon Wisely
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Why Choose Chesapeake Urology for Your Vasectomy Reversal
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Sperm Production
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Vasovastomy
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Epididymavasostomy
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Vasectomy Reversal Post-Operative Instructions
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Karen E Boyle M.D.
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David M Fenig M.D.
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Brad D Lerner M.D.
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