Vasoepididymostomy is a delicate microsurgical operation that connects the vas deferens directly to an epididymal tubule above a point of blockage. Its aim is to bypass the epididymal obstruction and let sperm pass again into the semen.
It is usually performed under general anaesthesia. The surgeon exposes the epididymis through a scrotal incision, selects a tubule whose fluid contains sperm and joins it to the vas with extremely fine sutures under the operating microscope. It is among the most demanding urological microsurgeries and is often decided on during a vasectomy reversal.
Surgery usually takes several hours, with discharge the same or next day; scrotal support is advised and exertion and intercourse are avoided for a few weeks as directed. The final result is clear once sperm reappear on analysis, which may take six months to a year or longer.
The final cost is set after a medical consultant reviews your case and photos.
Assoc. Prof. Dr. Zülfü Sertkaya is an Istanbul urologist who focuses on andrology. He graduated from Gazi University Faculty of Medicine in 2008, completed his urology residency at Haydarpaşa Numune Training and Research Hospital in 2014, and holds the FEBU title (2017). He worked at state, university and private hospitals, including Memorial Diyarbakır and Başakşehir Çam and Sakura City Hospital. Since 2022 he has run his own clinic in Zeytinburnu, focusing on penile prosthesis, Peyronie's disease, premature ejaculation and male infertility.
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It offers men with epididymal blockage a chance of natural conception instead of relying permanently on surgical sperm retrieval and ICSI.
Men with epididymal obstruction, for example long after vasectomy or after previous infection, whose testes still produce sperm.
Hormone tests, semen analysis and an anaesthetic assessment are done, and assessing the partner's fertility is advisable. Never stop any medicine, such as blood thinners, on your own; the doctor decides.
The surgeon exposes the vas and epididymis, opens a small tubule containing sperm and connects it to the vas with ultra-fine sutures under magnification.
Anaesthesia prevents pain during surgery; afterwards discomfort is moderate and eased with prescribed painkillers and cold packs.
Light activities can resume within days, while heavy lifting, intense sport and intercourse are avoided for a few weeks as instructed.
Sperm return more slowly than after vas-to-vas repair, often taking six months or more, monitored with periodic semen tests.
Bleeding, haematoma or infection can occur, and the connection may later close. Neither the return of sperm nor pregnancy can be guaranteed.
Yes; freezing sperm aspirated from the epididymis during the operation is often suggested as a back-up for ICSI if sperm do not return.
Staying three to five days after surgery for a wound check is usually advised; your doctor confirms when it is safe to fly.
