Vasovasostomy and Vasoepididymostomy are vasectomy reversal surgeries performed to restore fertility and to occasionally to relieve chronic pain from post-vasectomy pain syndrome. (1)

These two surgical procedures are designed to bypass an obstruction in the male genital tract but can also be used to repair vassal injuries caused by prior surgery.

Differences Between Vasovasostomy & Vasoepididymostomy

Ease Of Procedure

A vasovasostomy is often the preferred procedure for most vasectomy reversals and is an uncomplicated procedure that involves the reattachment or undoing the blockage of the vas deferens. Simply put, it is the reconnection of the previously detached ends of the vas deferens.

There are times, however, when the initial vasectomy causes a blockage in the epididymis. In this case, a vasovasostomy cannot be effective and a vasoepididymostomy has to be performed. 

It is a more complicated procedure that involves creating a new connection between the testis and the cut vas deferens by reattaching it to another portion of the epididymis.

This makes a vasovasostomy way easier and a less complicated procedure than the vasoepididymostomy.

Conditions Necessary For The Procedure To Be Performed

Vasovasostomies are the most common vasectomy procedures and are performed when there is good sperm quality present at the testicular end of the vas deferens.

The vasoepididymostomy procedure, given its complications and technical procedure, is used sparingly, and mostly when a vasovasostomy procedure will not effectively reverse the vasectomy. 

This happens when there is a blockage on the testicular end of the vas deferens, resulting in the sperm quality being compromised, or if there is an obstruction in the epididymis. The obstruction may result from hereditary conditions, infections, or occur during the vasectomy.

It is important to note that the longer you stay after the vasectomy before having a reversal, the higher the likelihood that you will need a vasoepididymostomy. If more than 15 years have passed since the procedure there will be minimal chances of having your vas deferens connected effectively with healthy sperm passing through them. 

Specialists Performing The Surgery

The vasovasostomy, being fairly easier and less complicated, can be performed by your urologist. The vasoepididymostomy on the other hand is a more technical procedure that can only be performed by specially trained reproductive urologists with microsurgical expertise. 

Vasoepididymostomy vs. Vasovasostomy: Which One Is Better?

The choice between the best procedure to use will largely depend on the quality of sperms in the testicular side of your vas deferens. If you decide to have a vasectomy reversal before too much time has passed, a vasovasostomy will be the best option. It is less risky and is a fairly simple procedure.

If the quality of your sperm is compromised or it is difficult to reconnect the cut ends of the vas deferens, you may have to undergo a vasoepididymostomy which is more complicated and requires technical expertise. 

Links to sources used

  1. Vasectomy reversal for post-vasectomy pain syndrome – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503916/