Vasoepididymostomy: the role of the microscope

Reconstructive surgery of the epididymis has been facilitated by the use of the microscope. The author describes his technique for end-to-end and end-to-side anastomoses and reports the results of reconstruction in 23 patients over a 10-year period. The pregnancy rate following reconstructive surgery was 39% overall: 40% after vasoepididymostomy (performed in 10 patients) and 35% after repair of primary epididymal obstruction (performed in 13 patients). With the aid of the microscope end-to-side and end-to-end anastomoses between the vas deferens and epididymis can be performed with greater precision because the anatomy can be defined precisely and reconstruction planned better.