Crossed vasoepididymostomy: A step-by-step guide

OBJECTIVE: To document a step-by-step guide of crossed transeptal vasoepididymostomy with prioritization of crossover vas deferens measurement. DESIGN: Video presentation. SETTING: University of Miami Lennar Surgical Center. PATIENT(S): The patient undergoing this procedure signed a written, informed consent for video and audio recording. RESULTS: No intraoperative complications were seen during the surgery, and the patient was discharged 6 h after the procedure. Through the steps detailed in the video and manuscript, a proper tubule into vas deferens invagination was formed. CONCLUSIONS: Anatomical indications for crossed vasoepididymostomy exists in 6% of azoospermic males and procedural prevalence is increasing. With a standardized step-by-step procedural approach that prioritizes crossover vas deferens measurement, crossed vasoepididymostomy can be considered in couples desiring natural conception, with previous complications of ART or failed ART.