Microsurgery of epididymis: laboratory background for further clinical trial

Based on the experience of 75 microsurgical reconstructions of the obstructed epididymis, the authors conclude that a simple introduction of microsurgery does not improve the results significantly. This experience, however, has provided a better understanding of the most important problems of epididymal surgery and has shown the ways to solve them. The principal means, they believe, is a well organized clinical study. Experimental data are hardly applicable to human sperm viae pathology. This clinical study should satisfy two requirements: a uniform operative technique and special account for an anastomosis level. End-to-side vasoepididymostomy is suggested to be the method of choice. A training model for epididymal microsurgery is elaborated and used for working out the above-mentioned technique. The reliability of the technique is shown in 20 rabbits, with litters from 17 couples. A special investigation of the microsurgically significant details of epididymal anatomy substantiates several separate zones marking out.