“Re-do” of Failed Vasectomy Reversals

This year we have noticed an increased number of new patients inquiring about re-doing of failed reversals.

A significant part of Dr. Gatewood's microsurgical practice is “redoing” failed reversals, done by other surgeons. If no sperm appears in the ejaculate by six months, the reversal is considered a failure.

We have achieved an overall 90% patency rate and 39% pregnancy rate in redo reversals of all ages. Most experts agree that it is well worth the effort to redo failed vasovasostomies and even failed vasoepididymostomies. Dr. Gatewood has redone reversals successfully where other doctors have failed twice.

 Reversals fail for several reasons. The most common cause is obstruction or “scarring down” at the anastamosis site. This can result from inadequate surgical technique such as using too large a suture size to do the anastamosis or using too few sutures that result in sperm leakage. 

We have seen a case where a sterile abscess occurred at the anastamosis site. We have encountered cases where the vas was encased in scar tissue.

Needless to say, meticulous, skillful, proper microsurgical technique, in which Dr. Gatewood is a master, is the key to success for these patients. Re-do’s can be very difficult and careful planning and judgment are needed. We enjoy the challenge of performing redos. Our whole staff is very happy when one of our redo’s achieves a pregnancy.

On all redo reversals, Dr. Gatewood requires the records from the previous reversals. If he is concerned about vasal length left over for another operation or significant scarring from tissue manipulation, he may, depending on the complete medical history of the patient, suggest the re-do be done at Gulf Coast Surgery Center, an ambulatory surgery center, under general anesthesia, rather than the office setting. This is to assure patient comfort and allow for the maximum surgical effort to be made in achieving success.  (Click here to obtain driving directions to the surgery center).

Dr. Gatewood considers patient safety and comfort to be important factors along with technical skill.