What Is a Vasoepididymostomy?

Vasoepididymostomy defines a delicate form of vasectomy reversal surgery performed when part of the sperm duct is blocked. A section of the duct called the epididymis attaches to the testes and allows sperm to become mobile. If scar tissue from a vasectomy or from injury forms, a blockage might occur, requiring this bypass procedure to restore male fertility.

Vasectomy severs the vas deferens, a tube that links the urethra and testicles. This tube carries sperm from the epididymis so it can be ejaculated during sexual intercourse. In some men who undergo vasectomy, scar tissue forms in this part of the duct, creating an obstruction that must be corrected through microsurgery. If the sperm duct is not affected, a vasovasostomy might successfully reattach the cut vas deferens.

Both procedures are typically performed under local anesthesia or a spinal block on an outpatient basis. A surgeon usually decides which operation is needed as he or she begins the procedure. Samples of seminal fluid from the vas deferens near the testes can determine if sperm is present. If no sperm is found, or fluid appears thick, it usually indicates the need for vasoepididymostomy to bypass a blockage in the epididymis. This complication might occur on one or both sides of urological tract.

Success of the surgery, which can take up to four hours to perform, usually depends on the skill of the surgeon. Doctors who specialize in vasoepididymostomy might be able to reverse infertility in 80 percent of patients. The amount of time that passes between vasectomy and vasoepididymostomy affects the patient’s chance of becoming fertile, which averages about 50 percent.

It might take up to 15 months before sperm can be detected after vasoepididymostomy. Sperm is often collected during surgery in case the procedure fails. Live sperm can be implanted into a female egg as an alternative fertilization technique if the patient desires children. The surgery can be repeated, but chances of success decline with each operation.

During the recovery process, a man might experience mild pain that is commonly treated with over-the-counter medication. He can usually return to normal activity, including sexual intercourse, after a few weeks, but must avoid lifting that puts strain on the scrotum. Swelling might be reduced with ice packs.

In addition to scar tissue after vasectomy, a birth defect might block ducts and cause infertility. Infection can also create a blockage that might be corrected through surgery. In rare cases, a prior surgery done improperly damages the epididymis and obstructs the passage of sperm.