vasovasostomy & vasoepididymostomy

Blockages in the vas deferens and in the epididymis (where sperm is stored) can be repaired with these procedures. Blockages are caused by hernias, birth defects and vasectomies (about 1% of the men who undergo a vasectomy want it reversed).

• how it works
• side effects
• results

how it works

For a vasovasostomy, the healthcare provider stitches the inner and outer layers of the vas deferens back together. The procedure restores continuity to the vas deferens. 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 or general anesthesia. Semen analyses will be required after six weeks, 12 weeks and every three to four months after the procedure. The repeated monitoring is done to make sure that scar tissue from the surgery does not block the vas or epididymis.

If sperm does not appear in the ejaculate a year after either procedure, the surgery was unsuccessful.

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side effects

There are risks and side effects associated with vasovasostomy and vasoepididymostomy. Your healthcare provider will discuss important safety information with you about these procedures.

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results

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 antisperm 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. The sperm return rate is 95% for men in this category and the pregnancy rate is 75%, according to the American Society for Reproductive Medicine (ASRM). If more than 15 years have passed the sperm return rate is 70% and the pregnancy rate is 30%.

If the patient does not produce sperm, alternative retrieval techniques such as testicular biopsy may be needed in conjunction with in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI).

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