Vasovasostomy is a microsurgical procedure to restore fertility after vasectomy, a surgery that sterilizes the patient by severing the vas deferentia, the tubes that carry the sperm from the testes to the penis. After a vasectomy, a patient may have various reasons for wanting to reverse the procedure, such as new opportunities for having children or a new romantic partnership. A vasovasostomy involves reestablishing the flow of sperm through the vas deferens by reconnecting the severed ends of the tube. In 1919, in the United States, William C. Quinby performed the first recorded successful vasovasostomy. Modern improvements on the surgery have led to its adoption as a microsurgery, a procedure that involves a microscope and specialized microscopic instruments. Surgical research over the twentieth century into reconnecting a blocked vas deferens and the resulting microsurgical technique for vasovasostomy has provided a way for people to regain their fertility after a vasectomy.

No-scalpel vasectomy, or NSV or keyhole vasectomy, is a surgical method of sterilization that involves puncturing the skin of the scrotum to access the vas deferens, a tube that carries spermatozoa, or sperm, from the testes to the penis. The surgeon performing the procedure blocks the flow of sperm through the vas deferens, sterilizing the patient. NSV is a less invasive procedure, as it does not use a scalpel to make a deep cut on sensitive scrotal tissue. Typically, urologists perform NSV with the purpose of rendering the patient sterile while not altering other functions of the testes, scrotum, and penis. Li Shunqiang developed the technique in China in 1974 as a less invasive method of vasectomy for male patients. Li’s development of NSV provided an alternative method to vasectomies that rely on making incisions into the scrotum with a blade. NSV gained wide use as a sterilization technique, providing a path for males to take greater responsibility for contraception and family planning.

Harry Clay Sharp was a surgeon who performed one of the first recorded vasectomies with the purpose of sterilizing a patient. Sterilization is the practice that makes a person unable to reproduce, and vasectomy accomplishes that by severing the vasa deferentia, the sperm-carrying tubes in the male reproductive system. Historically, sterilization procedures have varied in techniques, goals, and risks, but Sharp’s method of vasectomy allowed restriction of a patient’s reproductive functions without significantly affecting other bodily functions. Historians have associated Sharp’s use of the procedure, primarily on prison inmates, with eugenics, a movement with the goal of bettering humans via selective reproductive practices. With vasectomy, Sharp was able to sterilize people whom he did not deem fit to reproduce. Beyond simply pushing forward a new surgical method of sterilization, Sharp’s political advocacy led to the use of his technique as a method of eugenicist control over human reproduction, especially in Indiana.

In 1998, urologists Marc Goldstein, Philip Shihua Li, and Gerald J. Matthews published “Microsurgical Vasovasostomy: The Microdot Technique of Precision Suture Placement,” hereafter “The Microdot Technique,” in The Journal of Urology. The authors describe a novel technique for reversing a vasectomy, which blocks a patient’s flow of sperm, preventing the patient from fertilizing a partner’s egg. The technique relies on the placement of microscopic dots to guide the placement of the stitches that reconnect the vasa deferentia, which is a part of the male reproductive system. The authors, working from the Center for Male Reproduction and Microsurgery at Weill Cornell Medicine in New York City, New York, published the article to instruct surgeons on how to properly employ the surgical technique and provide data to indicate the technique’s effectiveness. Through the publication of “The Microdot Technique,” Goldstein, Li, and Matthews provide guidelines to conduct a more successful and accurate method of a vasovasostomy.

A vasectomy is a surgery that works to inhibit reproduction by interrupting the passage of sperm through the vas deferens, a tube in the male reproductive system. The procedure is a method of inhibiting an individual’s ability to cause pregnancy through sexual intercourse without altering the other functions of the penis and testes. In the US, into the early 1900s, proponents of eugenics, the belief that human populations can be made better by selecting for so-called desirable traits, used the procedure to forcibly sterilize people whom they deemed undesirable. Despite its early associations with eugenics, physicians’ use of vasectomy eventually transitioned into an option for elective contraception. Even with the various shifts in motivation for performing vasectomies, as of 2023, patients have the choice to undergo a sterilization procedure if they want to restrict their own ability to have children.

Laparoscopic tubal sterilization is a set of surgical techniques that use laparoscopy to render people with female reproductive systems sterile, or unable to reproduce. In a laparoscopy, a surgeon uses small incisions in the abdomen to feed in a camera or other viewing tool that aids in diagnosing internal medical issues or treating those issues via surgery. To sterilize a patient, the surgeon uses a camera with attached surgical tools to guide the procedure and interfere with the fallopian tubes to stop the passage of an egg. Laparoscopic sterilization was developed as an alternative to surgical sterilization that requires larger incisions to open the abdomen to access the fallopian tubes, which can pose a greater risk of complications. Due to decades of technical development, laparoscopic tubal sterilization allows people with female reproductive systems to control their fertility more safely and less invasively than with other surgical methods.

Vasectomy is one of few widely available methods of contraception for people with male reproductive systems aside from condoms, abstinence, and the withdrawal method, and it is the only one of those options that can be permanent (Amory 2016). The procedure’s prominence has led me to investigate the history of vasectomy and particularly the evolution in vasectomy technique over time. Since its introduction in the late nineteenth century, the procedure has had a variety of impacts on many people across the world. In this research project, I have sought to analyze what the technical evolution of vasectomy reveals about the changing priorities of the medical systems that use it. In particular, I point to ways the eugenics movement’s attempts to control individual reproduction have led to both vasectomy’s efficacy and its restrictiveness.

Robert Lawson Tait was a physician who practiced abdominal surgery in the United Kingdom during the late nineteenth century. Physicians and historians credit Tait with introducing a number of gynecologic surgeries, or surgeries related to women’s reproductive health. Those included procedures for treating abscesses, removing ovaries, and fallopian tubes, and treatment of the gallbladder. Beyond his work as a surgeon, Tait advocated against vivisection, which is the practice of medical experimentation on living animals. Tait also argued for strict cleanliness during surgery as well as a more specific focus on performing surgeries to treat diseases of the female reproductive system. Tait’s surgical techniques and advocacy not only aided in the development of hygiene in surgery, increasing patient survival, but also helped develop the field of gynecology, which contributed to a centralized focus on the health of the female reproductive system.