While vasectomies are meant to be permanent, a new life partner, the death of a child or other reasons might lead a man to want to have the surgery reversed. While vasectomy reversal success rates are relatively high, the skill of the microsurgical specialist is key to helping a couple conceive a baby after a vasectomy.
Basics of Vasectomy Reversal Surgery
A vasectomy reversal is a surgical procedure designed to restore the flow of sperm into the vas deferens. In order to achieve this, an incision is made on the underside of the scrotum, and the surgeon uses a microscope and tiny sutures to reconnect tiny and delicate tissues in the patient’s testes.
Most vasectomy reversals are performed on an outpatient basis in a hospital or surgical center using either general or epidural anesthesia.
One of two procedures will be used to achieve the reversal:
- Vasovasostomy. A vasovasostomy involves stitching both ends of the severed vas deferens back together. It is the easier of the two surgeries and achieves the highest rates of success.
- Vasoepididymostomy. If a vasovasostomy cannot be performed due to a blockage or other problem in the vas deferens, the surgeon will attempt to connect the vas deferens directly to the epididymis (a coiled sperm receptacle on the testicle).
The surgeon won’t be certain which procedure will be required until the patient is on the table, and both sides may require a different technique. Post-operatively, patients can experience tenderness for up to seven days and should refrain from sexual activity for approximately four weeks.
Vasectomy Reversal Doctors
Reconnecting and repairing the severed ends of the vas deferens is meticulous work, and skilled microsurgical specialists who perform a large number of vasectomy reversals each year tend to get the best results. Also, not all surgeons are skilled in the more difficult vasoepididymostomy procedure. Should that technique be required, it is important to know that the surgeon can perform it competently.
At this time, laser surgery for vasectomy reversal is not available. The initial research conducted on lasers versus microsurgery has found the laser techniques inadequate as compared with the highly successful microsurgical procedures.
Vasectomy Reversal Success Rates
The effectiveness of vasectomy reversal surgery is described in terms of patency (sperm flow) and pregnancy. The major factors affecting success rates are the number of years since the original vasectomy, the type of surgery (vasovasostomy has better success rates) and the surgeon’s experience and skill. Reversals performed fewer than 3 years after the original procedure restore sperm flow (patency) approximately 97% of the time and achieve a pregnancy in 76% of cases. From three to eight years post-vasectomy, patency is achieved 88% of the time and a pregnancy 53% of the time. (“Vasectomy Reversal: Success Rates and Their Determinants,”Vasectomymedical.com, January 2009)
It generally takes 12 months for couples to get pregnant after a vasectomy reversal.
How Much Does a Vasectomy Reversal Cost?
Vasectomy reversals are considered elective procedures and are generally not covered by insurance in the United States. The procedure costs about $10,000 on average, depending on the surgeon and the hospital or surgical center as well as the anesthesia costs.
When considering a vasectomy reversal, cost may not be the best determining factor. The best results are achieved by experienced and skilled microsurgical specialists, who may cost more than the average physician offering his services. Also, not every surgeon will be able to perform the more complicated vasoepididymostomy should it be required.
Vasectomy Reversal Complications
Problems that can occur with the surgery include hematomas (pooling of blood in the scrotum), infections, sperm granuloma (inflammation due to leakage of sperm) and failure of the procedure.
Should the procedure fail, a second attempt can be made, often with very positive results. Couples can also opt to have sperm removed and frozen for in vitro attempts should the procedure fail.
With such high success rates, many couples dealing with infertility due to a previous vasectomy are enjoying parenthood with fewer costs and problems as compared with in vitro fertilization. If the vasectomy occurred fairly recently, the man’s partner is fertile, and the surgeon is skilled and experienced, chances are that a couple can become pregnant again in just a few months after having vasectomy reversal surgery.
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