Phone: (713) 798-4001 | Houston, TX

Feb 25, 2014 — by Larry Lipshultz

Dallas EpididymovasostomyThere are two microsurgical techniques available for performing vasectomy reversal, both of which urologist Larry Lipshultz has mastered through the course of performing more than two-thousand vasectomy reversal procedures. The most commonly used technique is vasovasostomy, during which the ends of the vas deferens that had been severed during vasectomy are sewn back together through the aid of a special high-powered microscope. This technique is used when sperm are still present in the vas deferens at the time of vasectomy reversal.

If there are no sperm present, however, a more complex technique known as epididymovasostomy must be used. At Dr. Lipshultz’s fertility clinic, serving Dallas, epididymovasostomy offers men who are experiencing epididymal blockage - blockage of the tube that connects the ducts inside the testis to the vas deferens, preventing sperm from making their way into the vas deferens - an opportunity to restore fertility. Although the success rates are significantly lower with epididymovasostomy than with vasovasostomy - roughly 50 to 60 percent versus 95 percent - the procedure has helped many men who had previously undergone vasectomy to father healthy, beautiful children.

What Is Epididymovasostomy?

Epididymovasostomy is a microsurgical vasectomy reversal technique in which the vas deferens is reconnected directly to the epididymis in order to circumvent a blockage upstream of the vasectomy site. An incision is made in an epididymal tubule to check for sperm. If there are no sperm present, another incision is made and checked. Sperm must be present at the site where the vas deferens is connected to the epididymal tubule for fertility to be restored.

Dr. Lipshultz then uses two layers of microscopic sutures to connect the vas deferens to the epididymal tubule. Because this tubule is so small, the procedure is much more complex than vasovasostomy and requires even more finely honed microsurgical skills. Although Dr. Lipshultz’s rate of success performing epididymovasostomy is better than most, the odds of success are never much higher than 60 percent.

Patients will attend a post-operative wound evaluation appointment two weeks after the procedure. Dr. Lipshultz also performs regular semen analyses in order to gauge whether sperm are present and, if so, in what amount. Even with a vasovasostomy, it may be months before sperm return to the ejaculate; after an epididymovasostomy, it may take up to a year. Dr. Lipshultz generally recommends that patients “back up” their sperm through cryopreservation (freezing) at the time of the epididymovasostomy, especially if it is necessary for the technique to be used on both sides.

Dr. Lipshultz performs epididymovasostomy at the state-of-the-art day surgery unit at St. Luke’s Episcopal Hospital, which features advanced microsurgical equipment and a highly trained staff with extensive experience in assisting in vasectomy reversal. Patients are provided with clear, detailed post-surgical instructions to promote the fastest, most comfortable healing possible and to maximize the chances of a successful outcome.

Learn More about Epididymovasostomy

To learn more about epididymovasostomy or vasectomy reversal in general, we encourage you to contact the practice of Larry Lipshultz, M.D., today. We would be pleased to answer any questions you might have and assist you in scheduling your initial consultation with Dr. Lipshultz.