Vasectomy Reversal

A vasectomy reversal is surgery to restore the flow of sperm through a man’s reproductive tract allowing him to father children again. The operation is done in out-patient surgery center while the man is under general anesthesia (completely asleep).

The vas deferens (the tubes that care sperm) are very small (about the size of a cooked spaghetti noodle) and the suturing thread is so fine (as fine as a hair), that urologists use an operating room microscope to magnify the surgical field as they work. A surgeon who is skilled at using the microscope while operating is known as a microsurgeon.

Vasovasostomy vs Vasoepididymostomy

When people talk about a vasectomy reversal, they may not realize that there are two procedures that urologists can use depending on the man’s needs.

• Vasovasostomy is an uncomplicated vasectomy reversal. For this procedure, the urologist sutures together the two cut ends of the vas deferens restoring the flow of sperm.
• Vasoepididymostomy is a more complicated vasectomy reversal procedure. It is needed when a part of the epididymis (a tightly coiled mass of tubes in the back of the testis) has ruptured, preventing sperm from entering the vas deferens. To bypass the blockage, the urologist must connect the vas deferens to a point in the epididymis. This operation is technically challenging.
  Your urologist won’t know which procedure you need until the operation is underway and he can examine the area to see whether a blockage is present. Thankfully, only 5-10% of men need the more complicated vasoepididymostomy. Men whose vasectomy 8 or more years ago are more likely to need this procedure.

Fibrin Glue Vasovasostomy

For men who need an uncomplicated vasectomy reversal, Urology San Antonio surgeons use a modified technique, dubbed the “fibrin glue vasovasostomy,” that makes the procedure more affordable without sacrificing results.Rather than using 10-12 sutures to sew together the vas deferens, the fibrin glue technique requires 3 sutures to stitch the vas deferens together. Then the vas are sealed with a surgical product known as fibrin glue that coats the vas while they heal and knit themselves together.

The Advantages

• Success rates for the fibrin glue and conventional vasectomy reversal are statistically the same.
• Placing fewer sutures takes less time – 1.5 hours compared to 3 hours for a conventional vasectomy reversal.
• Less time in the operating room translates to a cost savings for patients – $6,900 for the fibrin glue technique compared to $9,000 for a conventional operation.

Air Force Ingenuity

The fibrin glue vasectomy reversal technique was pioneered by Air Force urologists about a decade ago. Drawing on the success demonstrated in laboratory animals, Dr. Samuel Hakim and fellow Air Force urologists tested the use of fibrin glue for vasectomy reversals in humans. They co-authored a 2005 Journal of Urology article about the procedure and its clinical outcomes. Dr. Hakim brought the technique to civilians and his private practice colleagues when he joined Urology San Antonio.

Vasectomy Reversal Recovery and Follow Up

Men leave the surgery center the same day. They should rest at home for 10 days and can resume sex in 2-3 weeks. It takes 3 – 12 months for a man’s sperm count to return to normal and the couple to conceive.

In the hands of an experienced microsurgeon like those at Urology San Antonio, vasectomy reversal success depends primarily on the time that has passed since the vasectomy. The best odds for success are among men whose vasectomies were eight or fewer years ago.

Average Vasectomy Reversal Success Rates

Patency vs Pregnancy

It’s important to understand that the return of sperm to the semen doesn’t necessarily lead to natural conception. Other factors such as the woman’s fertility affect pregnancy rates. As you consider success rates, keep in mind that among the general population, about 15% of couples will have trouble conceiving. In other words, the success rate for couples who have not had a vasectomy or a vasectomy reversal is 85%, not 100%.

Personalized Projections

During your consultation appointment, your surgeon will review your medical history, your partner’s medical history, conduct a male physical exam and discuss the success results you can except for your specific case.

Cost is a major consideration for most couples considering a vasectomy reversal. Insurance almost never covers the cost of the procedure, which is why Urology San Antonio offers couples the more affordable fibrin glue vasectomy reversal technique. This technique offers the same success rates as the conventional double-suture technique, but because it requires less time in the operating room, it costs half as much.

At Urology San Antonio, the cost of a fibrin glue vasectomy reversal (vasovasostomy) is $6,900.

What’s included

• Initial in-office consultation: $210 (If you decide to go forward with the reversal operation and you schedule the procedure within 3 months of the consultation, we will credit the consultation fee to your account.)
• The surgeon’s services and routine follow-up care
• The anesthesiologist’s services
• The outpatient surgery center costs

What’s not included

• Preoperative laboratory tests (about $150 payable directly to the laboratory). These may be needed to confirm that it is safe for you to undergo surgery; however, healthy men may not need pre-operative lab work. Your surgeon will decide what pre-op lab work is needed based on your unique situation.
• Postoperative semen analysis (about $100 payable directly to a laboratory outside of Urology San Antonio).  The analysis is designed to provide a sperm count. Some couples opt not to have the semen analysis, initially, and instead try to conceive.

Optional Vasoepididymostomy Deposit

If your vasectomy was more than 8 years ago, there is a possibility that your body has developed an epididymal obstruction or “upstream blockage” of the vas deferens. If this is the case, simply reconnecting the vas deferens will not be effective. You may need a procedure known as a vasoepididymostomy to “bypass” the blockage.

There is no way for the surgeon to know if a vasoepididymostomy is required until the reversal operation is underway. The additional procedure requires a $2,000 deposit. If the vasoepididymostomy is not needed, we will refund the $2,000 deposit.

Payment Arrangements

It is incredibly rare for health insurance to cover the cost of a vasectomy reversal operation. (We’ve only seen about 5 plans in the last 10 years that cover even a portion of the cost.)

Because a vasectomy reversal is an elective procedure, payment in full is due before scheduling the procedure. We do not offer pay-plans; however, we accept major credit cards.

Total payment due before procedure is scheduled is:

    Vasovasostomy (55400): $6,900

    Vasoepididymostomy (54901): $2,000 (if vasectomy performed more than 8 years ago)

In order to schedule your procedure, please sign the Vasectomy Reversal Financial Agreement and submit the form by fax (210-679-3720) or email (payment.posting@urologysa.com).

Once Urology San Antonio has received your signed agreement, a representative will call you to process your payment.  You also may make your payment using online bill pay.

If you have any questions regarding the financial process, please call 210-731-2050, ext. 6205.

What are the success rates for a vasectomy reversal?

In the hands of an experienced surgeon, the primary factor influencing success rates is the length of time since the vasectomy. If a vasectomy reversal is performed within 8 years of the vasectomy, the chance that sperm will return to the semen is 88%.

How much does a vasectomy reversal cost?

At our clinic, a fibrin glue vasectomy reversal costs $6,900.

What is a fibrin glue vasectomy reversal?

It’s a surgical technique that speeds the operating time and allows men to have a vasectomy reversal for about half the cost. The military pioneered the fibrin glue technique and has been using it in its health system for since 2005. Success rates have been shown to be the same as a conventional vasectomy reversal.

How long do I need to take off from work and when can I resume sex?

Men leave the surgery center the same day. They should rest for 10 days and can resume sex in 2-3 weeks.

How long does it take to become pregnant after a vasectomy reversal?

On average, couples will conceive 3 – 12 months after a vasectomy reversal, but some couples conceive much earlier and some later.

If a vasectomy reversal doesn’t work, what other options are available?

Sperm retrieval procedures are available if a vasectomy reversal does not result in pregnancy. Working in coordination with a reproductive endocrinologist, the retreatived sperm can be used for Intrauterine Insemination (IUI) or In Vitro Fertalization (IVF). IUI and IVF are very costly, much more expensive than a vasectomy reversal so most couples opt to try a reversal first.