Vasectomy Reversal: The First Steps
Performing a correctly performed microsurgical vasectomy reversal is so much more than throwing a few microsutures. There are a number of preparations the surgeon should take as well as key concepts before and during the reversal to ensure that the patient receives the very best care and surgical outcomes. It is important to understand crucial principals about preserving the tissues, locating the vasal defect, confirming abdominal patency, and transecting the vas. Analysis of the vasal fluid, both gross and microscopic, guides the intraoperative decision-making as to whether to perform a vasovasostomy or vasoepididymostomy. Challenges often occur with indeterminate vasal fluid with concerns about cross contamination. Sperm banking during the reversal is an option to be discussed preoperatively with the patient.
KeywordsProphylactic antibiotics Pre-reversal examination Scrotal incisions Vasectomy site Transseptal vasovasostomy Transecting the vas Abdominal patency Gross and microscopic vasal fluid analysis Intraoperative decision-making Indeterminate vasal fluid Cross contamination Sperm banking