Vasovasostomy refers to the surgical procedure that involves reversing the effects of male sterilization or vasectomy. For vasectomy, the sperm ducts or vasa deferentia, which transport sperm to the seminal vesicles, are seared after cutting and tying them. This interrupts the pathway through which sperm travels to prevent sperm from entering the semen during the ejaculation process.
Effectiveness of Vasectomy Reversal
The two main methods of reversing a vasectomy are vasovasostomy & vasoepididymostomy. They aim to bring back the fertility of a man instead of a vasectomy that works to serve as an effective birth control method. It is a certified contraception option that poses a lesser complication risk combined with a much quicker recovery period than other forms of contraception (1).
In most cases, the effects of a vasectomy are reversible, although that doesn’t guarantee a successful conception. It is heavily dependent on the time that has passed since performing the procedure. In simpler terms, the longer the period, the more difficult it is to have a successful pregnancy.
However, other factors at play in the delay of pregnancy, such as the female partner’s age, type of reversal method, fertility potential of the female partner, and the expertise of the performing practitioner.
Types of Reverse Vasectomy Procedures
As mentioned earlier, there are two types of vasectomy reversal procedures; vasovasostomy & vasoepididymostomy. For vasovasostomy, the surgeon puts back the ends of the sperm ducts and reconnects them together.
As a result, sperm can find a way through to the outside of the penis during ejaculation. Vasoepididymostomy works to stitch back the outer and inner sections of the vas deferens to connect them to the epididymis. As such, vasoepididymostomy is classified as a bypass procedure (2).
The most common method of vasectomy reversal is known as vasovasostomy. In this procedure, the vas deferens section under blockage during vasectomy is restructured with the ends close to the upper and lower part of the region being sutured back. Men whose vasectomies were done much earlier, usually longer than 15 years, a vasovasostomy may not be the way to go.
Another group of men who are not liable for a vasovasostomy is those whose vas deferens blockage is exceptionally close to their testes. In both cases, getting a vasoepididymostomy is the only other way to reverse a vasectomy.
This procedure is a highly technical and intense procedure that requires it to be performed by a highly qualified health professional. These professionals are usually highly trained urologists who have tremendous expertise in microsurgical operations (3). Vasoepididymostomy is a microsurgical operation that involves connecting the upper section of the vas deferens to an epididymal tubule as opposed to the connection of both ends of the vas deferens in a vasovasostomy.
The epididymis is the dangling structure near the testicles that runs from the testes to the vas deferens through which sperm is stored before dispensation during ejaculation. The opening made in a vasoepididymostomy procedure is much smaller than that on a vasovasostomy. That is where microsurgery comes in owing to the delicate level of the whole process.
Vasovasostomy & Vasoepididymostomy
Both these procedures are performed as outpatient procedures where the patient is placed under general anesthesia to numb the targeted region. Monitoring is necessary to ensure that there is no blockage on the vas deferens or epididymis from scar tissue.
Links to Sources Used:
- Vasectomy reversal https://health.ucdavis.edu/urology/specialties/male_infertility_and_sexual_dysfunction/Male-Reproductive-Sexual-Health/Vasectomy_Reversal.html
- Microsurgical vasovasostomy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739128/
- Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194271/