1. What is a vasectomy reversal?
A vasectomy reversal is the surgical reconnection of the vas deferens. The vas deferens is the tube that carries the sperm away from the testes, and generally there is one on each side. These are the tubes that are divided when a vasectomy is performed. They are about the diameter of a strand of spaghetti. Although the sperm are no longer able to get out of the body after a vasectomy, sperm production continues. The reversal procedure allows the sperm to be ejaculated with the semen again.
2. How is the reversal procedure performed?
A small incision is made in the scrotum, and the vas deferens is isolated and dissected microscopically. The vas is divided above and below the obstruction. The fluid from the testicular side of the vas is inspected. The vas deferens is then reconnected. The vas is then placed back into the normal position, and a small drain is inserted on each side. The incision is closed with absorbable suture that will dissolve on its own.
3. What are the chances of success?
Success rates are generally high. If the vasectomy was less than 5 years ago, there is a >95% chance of sperm in the ejaculate; 5-10 years, about 90%; and over 10 years, 80-90%. Pregnancy rates are lower, and depend on a number of factors that we can discuss together.
4. What factors affect success rates?
Sperm are fragile cells. It takes millions of sperm in each ejaculate for conception to occur through sexual intercourse. After reversal, the sperm may be lower in number, or not as motile as previous. There may also have been the development of “anti-sperm antibodies” that can damage the sperm. After the procedure, scar tissue can grow which can obstruct the vas deferens. There may also be issues with the female partner. A women’s ability to conceive generally declines with age. She may have undiagnosed fertility issues as well. Sometimes she will need the services of a female infertility specialist for assisted reproductive techniques.
5. Has it been too long since my vasectomy to have a successful reversal?
As discussed above, success rates are better the less time has passed since vasectomy. However, most men continue to produce sperm for their entire lifetime. There is no defined duration since vasectomy that would prohibit reversal. Dr. Sabharwal has performed successful reversals on patients over 10 years after vasectomy.
6. I have already had one unsuccessful reversal. Should I consider another?
There are a number of factors that should be taken into account before considering a “re-do” procedure. Was the surgeon a specialist in reversals? Were there sperm in the ejaculate after the procedure? Was there any infection or trauma after the reversal? Dr. Sabharwal has significant experience in the reversal procedure, including re-do operations, and would be happy to discuss your individual case with you.
7. Do I need any testing before surgery?
We may request a medical clearance from your primary care physician prior to surgery. You will be notified prior to the procedure of anything you will need to have.
8. What should I expect on the day of surgery?
Dr. Sabharwal will meet with you prior to surgery. The surgery generally takes between 2 to 3 hours. Most men awaken from the procedure with minimal discomfort, as a long-acting local anesthetic is used as well. Once you are awake and alert, you can leave with a driver.
9. What should I expect after surgery?
Most men describe some discomfort and aching for the first 24-48 hours after surgery. They usually say that it was not as bad as they expected. Many men describe the discomfort as similar to after their vasectomy. It is very important that you wear a snug scrotal support for the first 30 days after surgery to keep the testes from hanging down and pulling on the repair. Ice packs on and off every 20 minutes for the first day helps to keep down swelling. Please refrain from sexual activity for at least the first 3 weeks after the reversal.
10. What are the risks of surgery?
Thankfully, complications after vasectomy reversal are uncommon. While it is likely that you will have some bruising of the skin, it is also possible to develop bleeding within the scrotum after surgery. Generally, this resolves on its own with time and the use of the scrotal support.
11. How much does vasectomy reversal cost?
The cost of the vasectomy reversal is $5900. This includes all pre-operative and post-operative visits, as well as all surgery fees. The only other cost you can expect is a semen analysis 6 weeks after surgery at a lab close to your home.
12. Is financing available?
Our office offers financing and a payment plan. Please contact our office for more information on this.
13. Why should I have my vasectomy reversal with Dr. Sabharwal?
There are a number of reasons why we feel that Dr. Sabharwal stands out from other doctors who perform reversals:
Personal attention: Dr. Sabharwal takes pride in developing a
relationship with each of his patients. He takes the time to
personally answer any questions that you may have, and he remains
available to you well after the procedure is over.
Patient safety: Dr. Sabharwal is a Board Certified Urologist and our
office ensures we have your full medical clearance prior to any
Surgical Expertise: Dr. Sabharwal has over 20 years of experience and
has performed hundreds of vasectomy reversals and is proud of his
excellent success rates.