Epididymovasostomy.

There are a variety of causes of epididymal obstruction, but the most frequent indication for epididymovasostomy today is obstruction following vasectomy. We have seen significant advances over the last few decades in our techniques for reconstructing the proximal excurrent ductal system in order to restore sperm to the ejaculate and fertility in men with azoospermia secondary to epididymal obstruction. The patency rates for epididymovasostomy have improved significantly with the use of microsurgical techniques and specific tubule anastomosis. The level of anastomosis plays a crucial role in eventual fertility. These microsurgical techniques are tedious and difficult to master but practice and meticulous attention to detail are rewarded by excellent results.