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Advanced Techniques of Vasoepididymostomy

  • Wayland HsiaoEmail author
  • Marc Goldstein
Chapter

Abstract

With advances in surgical technique and the development of microsurgical techniques, modern vasoepididymostomy allows us to accurately approximate the mucosa of a single epididymal tubule to the mucosa of the vasal lumen. With this increased precision, we have been able to achieve even higher patency and pregnancy rates. Microsurgical vasoepididymostomy, however, is the most technically demanding procedure in all of microsurgery. In virtually no other operation are results so dependent upon technical perfection. Thus, microsurgical vasoepididymostomy should only be attempted by an experienced microsurgeon who performs a sufficient volume of microsurgery. Modern IVF–ICSI has opened up reproductive options for those couples desiring fertility. This has caused some to question the need for advanced reconstructive reproductive tract surgery. However, in the hands of experienced microsurgeons, vasoepididymostomy is a safe, effective method of reconstruction for patients who do not want to undergo IVF or desire multiple children.

Keywords

Vasoepididymostomy techniques Epididymal obstruction Obstructive azoospermia Anastomosis Anastomotic technique End-to-side intussusception Anastomotic site Transseptal vasoepididymostomy 

Notes

Acknowledgments

Dr. Hsiao is supported by a grant from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of UrologyEmory UniversityAtlantaUSA
  2. 2.Cornell Institute for Reproductive Medicine, New York Presbyterian Hospital/Weill Cornell Medical CenterWeill Cornell Medical College of Cornell UniversityNew YorkUSA

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