Microsurgical Vasectomy Reversal
Robert U. Finnerty M.D. FACS
Microsurgical Vasectomy Reversal
Robert U. Finnerty M.D. FACS

About Vasectomy

vas deferens micro cross-section

Vasectomy is a minor surgical procedure for permanent male fertility control, performed on about 700,000 men each year in the United States. The duct which carries sperm from the testicle (called the vas deferens) is cut and sealed in order to prevent sperm from leaving the testes. The vas deferens measures about 1/10th of an inch in diameter (2.5 mm), the majority of which is a thick muscular wall. The actual passageway for the sperm (called the lumen) measures less than 1/100th of an inch (0.25 mm).

The testes continues to produce sperm after a vasectomy — this is what makes vasectomy reversal possible. The challenge is to accurately reconstruct the duct system, which is extremely small and delicate. While the vas is very easy to cut, it is much more difficult to successfully reconnect. After vasectomy, there is continued production of a small amount of sperm fluid from the testes. This results in a slight increase in pressure in the vas below the site of the vasectomy, which over time will stretch the inside of the vas duct. As a result, the inside diameter of the vas below the vasectomy site is often 3-5 times larger than the original diameter above the vasectomy.

As the vas deferens gets closer to the testes (below the vasectomy site), its thick muscular wall thins out and disappears, and it merges into a structure called the epididymis. This portion of the duct is attached to the testes, and it contains nearly 20 feet of a delicate, coiled microscopic tubule. Back pressure from ongoing sperm production and the blockage caused by vasectomy may cause this delicate tubule to become extremely thin and rupture over time (this is sometimes called a “blowout“).

When this occurs, the resulting inflammation will cause scarring and a secondary blockage, (which may be partial or complete) between the testes and the vasectomy site. Even precise repair of the vasectomy site, without addressing this epididymal obstruction, will result in failure to restore fertility.

The problem of epididymal obstruction becomes more likely as the time after vasectomy increases — although it is quite common even in men only a few years out. While most men have few problems after vasectomy, a small percentage may also experience post-vasectomy pain, either intermittently with sexual activity, or in some instances, on a chronic basis. When this occurs, it can be a difficult and frustrating problem to overcome, as medical therapy rarely if ever helps. Surgery to reverse the vasectomy is almost always the best solution to this challenging complication of vasectomy.

More Information on Vasectomy

My husband had his vasectomy nearly 13 years before the reversal, which resulted in the birth of our daughter.
R.B., California
The reversal surgery was a great success! We are sorry we didn''t contact you sooner. Thank you again for your willingness to provide such a special service for families.
M.F., California
Our family now has 7 blessings, 3 of which you had a very special part in. Thank you!
G.S., Alaska
I am writing to send our heartfelt thanks to you for your expertise. On September 9th, you performed my husband''s procedure. Three weeks later, we conceived our first daughter. She was born exactly 43 weeks post-op. Since then, we have welcomed a son and also another daughter. We''ll always be grateful.
M.H., Vancouver, WA
A little over 5 years ago, my husband and I flew from Chicago to your office to have his vasectomy reversed. We both want you to know how grateful we are -- to you, to your staff, and for your expertise. Since the surgery, we have had Michael (almost 4!) and Mary Jo (10 months) ... We feel it is important for you to know what a difference you made in our lives, and what an awesome grace it was to have you as our surgeon. Words cannot convey how much we appreciate what you have made possible for us -- we will be eternally grateful!
C. & K.P., Chicago
Our child is a true gift from God. God bless you for turning my vasectomy around after 30 years with so much care and love. We will always love you.
J.C., Tennessee
We were very excited to learn just before Christmas that the surgery was a success. We saved the news for out kids until Christmas Eve and what a blessing their reaction was, it couldn''t have been a better Christmas present! We do thank you so much for providing your services at realistic fees, we could never have done it had there not been options other than what we found locally.
T.S., California
A child is God''s most precious gift. We joyfully announce the birth of our son.
J.C., Idaho
My husband had a vasectomy reversal four and one-half years ago performed by Dr. Finnerty. Three and one half years after, we were able to conceive a child. Our daughter is such a constant joy in our lives.
C.J., California
Easter blessings to you and your family from us. We are having a special celebration and invite you to join us -- we celebrate the life of our new daughter.
C.K., California
We have been so excited about our new son and he has been such a joyous addition to our family ... Thank you so much for your devotion and belief in vasectomy reversal, we have been so blessed by our little guy. Of course, he can never take the place of our daughter who died, but he sure brings new joy to us ... Again, thank you for all you did! We have been so blessed....
M.M., Camas, WA
Thank you again for making possible the blessings God had in store for us in the way of children ...
T.P., Minnesota
We wanted to share our delightful news with you. We were blessed with a beautiful baby daughter in October.
D.W, Oregon
Thank you for helping our dreams come true.
J.W., Atlanta
My wife and I would like to give you and your staff a hearty "thank you" for the professionalism and care given us...following my son''s departure to our heavenly Father. Your calming manner and assurance that we had a reasonable chance at reattaching my vas deferens, which might allow us to get pregnant, was at fruition soon after our stay in Tacoma. 14 days following the procedure, my wife ... had become pregnant!. We lost our first son, and Dr. Finnerty, touched by God, enabled us to have another son ...
J.G., Washington