Vas and epididymis reconstruction


What are various reconstructive surgeries done to restore male infertility?

Vaso-vasostomy (vasectomy reversal) and vaso-epididymostomy are the surgical reconstructive procedures done to improve sperm parameters if there is blockage in vas deferens or epididymis.


Vas and epididymis reconstruction

Is vasectomy reversal possible?

Vasectomy is a simple day care procedure which takes less than 30 min of surgical time whereas Vasectomy reversal requires high level microsurgical skills and 3-4 hours of surgical time depending on the complexity of each case. Dr Pramod Krishnappa is exclusively trained in male reproductive tract microsurgeries. The previously divided cut ends of vas deferens tube will be identified and their edges trimmed to make them feasible for re-attachment. One can wait upto 3 months since vasectomy reversal to see if sperms appear in the semen. The success of the vasectomy reversal surgery depends on surgeon’s microscopic expertise, baseline semen analysis report (prior to vasectomy), healing of prior vasectomy wound, presence /absence of significant anti-sperm antibodies and time since the vasectomy was done.


Vas and epididymis reconstruction

In which conditions, Vaso-vasostomy and vaso-epididymostomy are done?

Short segment blockage in scrotal part of male reproductive tract (vas deferens and epididymis) may be corrected by microscopic reconstructive surgeries such as Vaso-vasostomy and vaso-epididymostomy. Very specialised sutures finer than a human hair are used to join the two ends. Success of vasovasostomy is around 90% and vasoepididymostomy is around 60% depending on many patient factors. The most common causes of correctable obstruction (blockage) in male reproductive tract are infection and previous surgeries (like inguinal hernia mesh repair, childhood difficult hydrocele surgery).

How long is the recovery time after Vaso-vasostomy and vaso-epididymostomy ?

The patient is usually discharged the same day if general anaesthesia or the next day if spinal anaesthesia is given. It is advised not to indulge in strenuous activities including sex, outdoor and indoor sports, but does not need any bedrest. He can resume his work-from-home (WFH) from the very next day after the surgery. If working outdoors and the job is physically very demanding, then better to apply leave for a week.

Who is the best doctor for reconstruction surgery in male infertility ?

Dr Pramod Krishnappa is the best andrologist dealing with Men’s’ Sexual Health and Male Fertility. He has been trained extensively in high volume Andrology centres in Madrid (Spain), Belgrade, Budapest, Chicago, and New York.

Dr Pramod Krishnappa has undergone microsurgical training and a dedicated male infertility fellowship under Prof Dr Craig Niederberger at the University of Illinois at Chicago (UIC), who was the Chief Editor of “Fertility Sterility” Journal, the official journal of the American Society of Reproductive Medicine (ASRM).

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