Chesapeake Urology Associates :: Epididymavasostomy

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Epididymavasostomy

Epididymovasostomy is a much more complicated procedure requiring a great deal more expertise at microsurgery. A single epididymal tubule is incised just before the obstruction and gently squeezed for fluid. The fluid is checked for sperm and, if none are present, a more proximal transection is made. Unlike vasovasostomy, epididymovasostomy is never successful if sperm are not present within the tubule at the site of the anastomosis. The anastomosis is then performed with two layers of extremely fine suture under the operating microscope. Again, microsurgery is mandatory for an epididymovasostomy because of the small size of the epididymal tubule.

The procedure is performed on an outpatient basis our surgical center. This facility boasts state of the art microsurgical equipment and experienced anesthesiologists and staff to assist in these procedures. This arrangement allows you to return home or to a nearby hotel without actually being admitting directly to the hospital, thus saving considerable expense and making the overall experience much more pleasant.

Operating time for a vasovasostomy or epdidymovasostomy is approximately 3-4 hours. A general anesthetic is usually used. We prefer that out-of-town patients stay in the Baltimore area for at least one day after surgery. Postoperative follow-up includes an evaluation of the healing wound at two weeks and a semen analysis at six weeks. Monthly semen analyses are then obtained for approximately 4-6 months, or until the sperm count stabilizes. It can take up to six months for sperm to return to the ejaculate following a vasovasostomy and up to one year following an epididymovasostomy. If semen quality is less than expected, anti-inflammatory medications are often introduced to decrease scarring.

Cryopreservation of sperm (sperm banking) can be performed at the time of vasectomy reversal if whole, motile sperm are present. Cryopreservation is performed as a safety "backup" in case inadequate sperm counts are present after surgery. Because vasectomy reversals may infrequently scar despite good initial results, cryopreservation may also be performed on ejaculated specimens early in the course of recovery when semen quality is exceptionally good.

Contact Us

Please contact one of the vasectomy reversal specialists at the Chesapeake Urology Male Fertility and Sexuality Group, for an appointment:

Karen Elizabeth Boyle, M.D.
David M. Fenig, M.D.
Brad D. Lerner, M.D.

Chesapeake Urology's premier vasectomy reversal specialists serve patients in Maryland and in the Mid-Atlantic Region including Virginia, West Virginia, Pennsylvania, Delaware, and Washington, DC.