The fluid is checked for spermatozoa and if none are present, a more proximal transection is made. The anastomosis is then performed with 10-0 nylon, a suture as fine as hair. The single epididymal tubule is sutured to the mucosa of the vas, usually with four quadrant sutures. A second out layer of sutures reinforces the all of the vas to the epididymis. However, recent reports indicate that the microsurgical approach offers a somewhat better prognosis.
Postoperative care is similar to that for the vasectomy.
Whichever technique is used, it is wise to remember that the more distal the epididymal anastomosis, the more completely sperm can progress.