Delay of appearance of spermatozoa in the ejaculate after vaso-epididymostomy e vaso-vasostomy

After ultimately successful microsurgery for male infertility the delay for appearance of spermatozoa in the ejaculates of the patients is not uniformly immediate. For the older latero-lateral epididymo- vasostomy it could take several months. It is much shorter when the actual microsurgical techniques are used. Occasionally however, even in the latter group, very long delays have been observed. There is no definite satisfying answer for this. The most likely explanation is a combination of reinforced peristalsis in the previously pathologically dilated epididymal tubules and the secondary breakthrough of a plug of epithelial sloughs and fibrin at the site of microsurgical anastomosis.