The vasovasostomy is performed on an outpatient basis. Patients receive mild analgesics and antibiotics postoperatively and may return to work after a few days. Patients are advised to wear a scrotal support and to avoid ejaculation and heavy lifting for 2 weeks. Postoperative care also includes careful monitoring of the healing process and, after 6 to 8 weeks, monthly semen analyses to note improvements in sperm count and motility. This procedure is performed most commonly if vasal fluid cannot be found or is of poor quality at the time of cutting the vas deferens during a vasovasostomy.
Postoperative care is similar for both procedures.
When sperm cannot move through the genital tract due to an uncorrectable blockage, sperm can be extracted directly from the epididymis or the testicle by microsurgical techniques. Congenital absence of the vas deferens or seminal vesicles, failed vasovasostomy or epididymovasostomy are all conditions where MESA might be used. Usually performed as an outpatient procedure, MESA can provide sperm for in vitro fertilization cycles. Epididymal sperm are usually not fully motile and, therefore, cannot be inseminated into the uterus or cervix successfully without sophisticated techniques that place the egg and sperm in direct contact so fertilization can occur. If MESA is done in conjunction with an IVF cycle, it will be performed around the same time as egg retrieval from the female partner.