Vasovasostomy & Vasoepididymostomy

Blockages in the vas deferens and in the epididymis (where sperm is stored) can be repaired with these procedures. Blockages may be caused by hernias, birth defects and vasectomies. Up to 6% of the men who undergo a vasectomy want it reversed.

How It Works

For a vasovasostomy, the healthcare provider reconnects the ends of the vas deferens back together. The procedure restores continuity to the vas deferens to restore sperm to the ejaculate. Vasoepididymostomy is a bypass procedure, wherein the inner and outer layers of the vas deferens are stitched to the epididymis.

Both surgeries are done on an outpatient basis under local anaesthesia with intravenous sedation or general anaesthesia. Semen analyses will be required at one month and again every 3 months after a vasovasostomy. The repeated monitoring is done to make sure that the scar tissue from the surgery does not block the vas or epididymis.

If sperm does not appear in the ejaculate six months after a vasovasostomy, the surgery was not successful.

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Risks/Side Effects

Major complications after a vasovasostomy are rare. The most common post-operative complaint is scrotal bruising. Infection may occur, but you will likely be given a dose of antibiotics before the surgery. Secondary blockages and resulting azoospermia are also possible.

The risks of a vasoepididymostomy are related to the length of the procedure, possible bruising and the potential for injury to blood vessels. Additionally, the amount of previous scar tissue and degree of repair needed may lead to venous blood clots (as with any surgical procedure). The risk of blood clots, however, is relatively small with this procedure. Infection is rare, with antibiotics typically given before the surgery.

Both procedures require sedation or general anaesthesia with the associated risks. Your healthcare provider will discuss important safety information and post-operative care with you about these procedures.

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These surgeries don’t always produce the desired result and depend on the length of time the vas and seminal tubules have been blocked. The patient may not produce sperm after the surgery or produce anti-sperm antibodies after a vasectomy, which can interfere with the sperm’s ability to travel through the woman’s mucous.

If the man’s vasectomy is less than three years old, statistically his chances of impregnating his partner are favorable after vasovasostomy. The sperm return rate is 97% for men in this category, and the pregnancy rate is 76%. If more than 15 years have passed, the sperm return rate is 71% and the pregnancy rate is 30%.

If the patient does not produce sperm, alternative retrieval techniques such as testicular biopsy may be used with sperm being cryopreserved for possible future use with IVF and/or ICSI.

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