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The initial vasectomy reversal undergone by patients may have failed for several reasons:

• Microsurgical technique may not have been used

• Surgeon may have had limited experience performing vasectomy reversals

• Surgeon may have had limited experience using an operating microscope

• Suture size may have been too large

• New vas connection may have strictured due to inadequate blood supply

• Indications for vasoepididymostomy may have been present but not recognized

• A blowout or block may be present in the epididymal tubule, not allowing sperm to bypass the blockage

• If blockage exists in the epididymal tubule, surgeon must identify sperm further back in the epididymal tubule and connect this site to the abdominal side of the vas

• If any of these situations apply to previous surgery, Dr. Wosnitzer can identify such a problem by reviewing the operative note from the first vasectomy reversal (operative note may be obtained from the surgeon or hospital in which surgery was performed)