The essence of the below study is that it is reasonable and proper to perform a vasovasotomy (cut out the vasectomy scar and and reconnect good vas to good vas) when the fluid is not “favorable.” That indeed the vasoepididymostomy may be performed too often and unnecessarily and with less favorable results.

Indian J Urol. 2014 Apr-Jun; 30(2): 164–168.

Conclusion:

This study suggests that VV (vasovasostomy) is the preferred method of reconstruction during vasectomy reversal (VR) when SHST (sperm heads and short tails) are present within the intravasal fluid.

The high patency rates in this cohort exceed the expected patency of EV (epididymovasostomy), despite poor fluid quality and longer occlusive intervals.

Our study adds further credence to the growing body of literature suggesting that VV is preferred in this subpopulation of men undergoing VR. Urologic microsurgeons may be reassured about performing VV in the setting of SHST irrespective of fluid quality and occlusive interval.