It is important to realize that a man’s situation can change beyond their control. Men who have had a vasectomy are no exception to this and Dr. Avila knows that they may change their mind after their vasectomy.
In fact, over 500,000 vasectomies are performed each year in the United States. About three per 1,000 of these men request a vasectomy reversal. A vasectomy reversal is a generic term used to describe how the vasectomy edges are reconnected. A reversal can consist of a vas-to-vas reconstruction, or vasovasostomy, and the more challenging vas-to-testicle bypass surgery, or vasoepididymostomy.
The vasectomy reversal is an outpatient surgery. During the procedure, Dr. Avila evaluates the position of the vasectomy site, health of the epididymis, and most importantly the fluid from the vas deferens. The characteristics of the fluid, as well as whether sperm is present allows him to determine whether a vas-to-vas reconstruction or vasovasostomy is appropriate. If not then he proceeds with the vas to testicle bypass procedure, or vasoepididymostomy
The vasovasostomy is performed under an operating microscope. Dr. Avila reconstructs the vas tube in two layers. Small sutures are placed through inner portion of the vas deferens to bring the inner tubing of the vas deferens together. The remainder of the outer portion of the vas deferens is then approximated.
The vasoepididymostomy is performed when the vas fluid does not have sperm and therefore makes the chances a vasovasostomy will work highly unlikely. The decision to perform this vas to testicle bypass depends on whether a portion of the tubules exiting the testicle is occluded. If so, Dr. Avila will find a small tubule before the occlusion and connect the vas deferens to that segment.
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