A 20-year experience with epididymovasostomy for pathologic epididymal obstruction.

A total of 255 patients of 281 patients with side-to-side epididymovasostomy for postpathologic epididymal obstruction were followed from 1964 to 1983. The success rates were higher in patients with nontuberculous epididymitis than in those with tuberculous epididymitis. There were no significant differences among anastomotic levels of the epididymal incision. The success rates were 31% for patency and 12% for pregnancy in the 97 patients with macrosurgery and 37% for patency and 20% for pregnancy in the 158 with microsurgery. The causes of anatomic failure were scar formation at the anastomotic site and blockage of opening of the original epididymal tubule. The cause of functional failure was poor semen quality after epididymovasostomy.