Background
Vasovasostomy (VV) and vasoepididymostomy (VE) are surgical procedures designed to bypass an obstruction in the male genital tract. These procedures are usually performed to restore fertility, although they are occasionally undertaken to relieve pain, such as in postvasectomy pain syndromes.
Vasovasostomy involves the anastomosis of segments of the vas deferens above and below an obstruction. The vast majority of vasovasostomies are performed to reverse a prior vasectomy, but the procedure is occasionally indicated for repair of an iatrogenic vasal injury secondary to prior surgery (eg, inguinal herniorrhaphy).
Vasoepididymostomy is a technically more demanding procedure than vasovasostomy. It involves anastomosis of the vas deferens to the epididymis in order to bypass an epididymal obstruction. This obstruction may be secondary to long-standing vasal obstruction resulting in damage to an epididymal tubule (epididymal blowout) or may result from epididymal infections or trauma