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.

[PATIENTS] 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.