Dr. Williams' Urology Resource

Vasectomy reversal is performed for a man who wishes to father more children following his vasectomy. This is an outpatient, same-day procedure. Using a high-powered operating microscope, the abdominal and testicular ends of the vas deferens are reconnected using delicate sutures that are thinner than a piece of hair.  In this video, a 2-layer microsurgical vasovasostomy is performed.  For more information about microsurgical vasectomy reversals, click here.

This is an unedited video of Dr. Williams performing a no-scalpel vasectomy.  No stitches are necessary as the skin edges seal back together on their own.  Click here for more information about vasectomy.

This surgery is offered to men with erectile dysfunction for whom other treatments have been unsuccessful.  Surgery generally takes less than one hour and is performed through a small (~3-4cm) incision.  It is performed either as an outpatient procedure or includes a short overnight hospital stay.  This treatment carries a very high patient/partner satisfaction rate and excellent long-term mechanical reliability.  All components of the penile implant (cylinders, reservoir, and pump device) are concealed discretely under the skin.

Penile tunica plication surgery is performed to treat the curvature caused by Peyronie's Disease.  This is an outpatient, same-day surgery that generally takes less than one hour.  Click here for more information about Peyronie's Disease and treatment.

Surgery to treat lower urinary tract symptoms (LUTS) due to an enlarged prostate (BPH) using the GreenLight Laser for photoselective vaporization.  This minimally-invasive surgery is performed same-day as an outpatient or with a short, overnight hospital stay.  Click here to read more about the medical and surgical treatments of benign prostatic hyperplasia.

This same-day surgical procedure is performed as an outpatient under general or spinal anesthesia.  Laser urethrotomy allows for precise removal of the diseased scar tissue.  A urethral catheter is typically placed at the end of the surgery and then removed about 3 days later.  Follow-up flexible cystoscopy in the office is recommended about 6 weeks after surgery to check for early recurrence of the stricture.

Vasectomy reversal procedure with microsurgical epididymovasostomy.  This type of vasectomy reversal is performed when no sperm are found in the vas deferens at the time of surgery.  If a standard vasectomy reversal (vasovasostomy) is performed in this setting, sperm will not return to the semen, and the vasectomy reversal will fail.  Therefore, the surgeon must be prepared to do either technique.  The complex microsurgical vasectomy reversal with epididymovasostomy (also known as the "bypass" procedure) requires specific microsurgical training and skills.

In the setting of obstructive azoospermia (no sperm in the semen due to a blockage in the reproductive tract), sperm production is typically normal.  Obstructive azoospermia can be due to ejaculatory duct obstruction, congenital bilateral absence of the vas deferens (as is seen in men with cystic fibrosis), epididymal obstruction, or most commonly vasectomy.  MESA is an outpatient, same-day procedure, performed under a general anesthetic with an operating microscope through a small ~2-3cm scrotal incision.  Once sperm are obtained from the epididymal fluid, they are cryopreserved (frozen) and can be used at any time in the future for IVF/ICSI.