Microsurgical vaso-epididymostomy in 2 layers.

Eleven patients with epididymal obstruction were treated with microsurgical techniques. A 2-layer, end-to-side anastomosis between the vas deferens and a single loop of the epididymal duct was created. At follow-up, 9 patients had spermatozoa in their ejaculate and 3 of them achieved pregnancies with their partners. The technique described not only yields better results through the application of microsurgery but also gives a better understanding of epididymal function and pre- and per-operative diagnosic proceedings.