When Dr. Werthman performs a vasovasostomy, he reconnects the ends of the vas deferens that were separated during the original vasectomy.
This procedure restores the flow of sperm from the epididymis through the vas to the prostate, and enables a man to father more children.
Dr. Werthman pioneered and refined reversal so that it requires only a small incision to be made over the vasectomy site.
He then removes the blockage, and harvests a drop of fluid at the bottom end of the vas. The drop is examined under a microscope to check for sperm. Swimming, active sperm in this drop will confirm that the route from the testicle to the end of the vas is open.
Examining this tiny drop is crucial to the success of each vasectomy reversal operation. If sperm are not found in the fluid, it means that a “blow out” or rupture has occurred in the epididymis, the organ where the sperm are stored. This can happen when the pressure builds up over time. The body has tried to repair the situation, creating scar tissue and a new blockage in the epididymis.
If no sperm are found in the vas fluid, simply restoring the cut end of the vas will not restore fertility. It will be necessary for Dr. Werthman to perform a vasoepididymostomy instead.
Dr. Werthman and his team are fully prepared in each vasectomy reversal surgery to perform either of these surgeries. Because Dr. Werthman is expert in both of these procedures, you won’t need to undergo a second procedure if sperm are not found in the vas fluid.
Dr. Werthman uses a special surgical microscope to reconnect the vas deferens
When sperm are found in the vas fluid, demonstrating that there is no secondary blockage, Dr. Werthman will proceed with the vasovasostomy.
Using a special surgical microscope, Dr. Werthman will re-connect the ends of the vas. The inner layer is brought together with special micro-sutures half the thickness of a hair, and the muscle layer is closed over it with a heavier suture to add strength. Sperm can then flow through the new connection.