Vasectomy Reversal

The urologists at MBUA are vasectomy reversal specialists

Vasectomy reversal is a complex microsurgical procedure that requires training and experience to perfect. The urologists at MBUA are all specially-trained microsurgeons and are very experienced with vasectomy reversal. Our expert, David Benjamin M.D., has years of experience with this complex microsurgical procedure and results that equal those reported by major medical centers. We perform this surgery at Central Coast Surgery Center, a state-of-the-art outpatient surgical center in Freedom, CA. Please click here to make an appointment to see our specialists and discuss the vasectomy reversal procedure, the costs, and your chances for success!

Introduction

When men undergo vasectomy the narrow, muscular tube that leads from the testis, called the vas deferens, is divided and closed so that sperm cannot pass through into the semen. The semen is produced by the prostate and seminal vesicles, and is still present after vasectomy but it does not contain sperm. Vasectomy reversal is an operation to re-establish an open channel from the testes so that there will be sperm present in the semen, which allows the possibility of natural conception and pregnancy. Vasectomy reversal is chosen by men of all ages, usually because of changes in their life which cause men and their partners to wish to become pregnant in the most natural way possible. Rarely, a patient will choose vasectomy reversal for persistant pain after vasectomy.

How is vasectomy reversal performed?

Vasectomy reversal is a micro-surgery to reconnect the ends of the vas deferens which were divided by vasectomy. Vasectomy reversal is much more difficult than vasectomy! The vas deferens is roughly the size and consistency of a leather boot lace, but the channel down the middle is smaller than a piece of angel hair pasta. Re-connecting the ends requires a high-powered surgical microscope and sutures which are smaller than a human hair.

The simplest and most common form of vasectomy reversal is called vaso-vasostomy, in which the two cut ends of the vas deferens are re-connected. During the surgery the site of the vasectomy is excised and fluid from the testis side is examined for sperm. If clear fluid is present then the ends of the vas deferens are re-connected, a procedure called vaso-vasostomy. In some men, however, the sperm ducts upstream from the vasectomy site may become scarred due to back pressure in the system, and no fluid can be expressed from the vas deferens. In this case the vas deferens may need to be connected to the epididymis, part of the sperm ducts closer to the testis. This procedure is called vaso-epididymostomy. It is not usually possible to determine if this will be necessary prior to surgery, so your surgeon is ready to perform this type of reconstruction if it is necessary.

How successful is vasectomy reversal?

Successful vasectomy reversal is defined as the return of motile sperm to the semen in numbers that are adequate for pregnancy. The success rate of vasectomy reversal depends on a number of factors, including patient age, time since vasectomy, and surgical technique. Men who are under age 50 at the time of reversal or who undergo reversal less than 5 years after vasectomy have the highest chance of successful vasectomy reversal, but age alone should not be a main factor in choosing vasectomy reversal, since normal men will have healthy sperm production their entire life. Studies show that the modified two-layer microsurgical technique that we employ has the highest chance of success, and our success rate in achieving sperm in the semen with vaso-vasostomy is 90%. The success rate of vaso-epididymostomy is lower, but the chances of success are still good, approximately 70%. The rate of pregnancy after vasectomy reversal depends not only on the male sperm count, but also on the female age and reproductive health. The pregnancy rate after vasectomy reversal is 50-70%, and the average time to pregnancy is one year.

What can I expect after vasectomy reversal?

Vasectomy reversal is an outpatient procedure which lasts 2-3 hours. It requires general anesthesia so that patients will not move during the microsurgery. Patients may have a sore throat for 1-2 days after the surgery. There will be a 1/2 inch incision on each side of the scrotum for the vasectomy reversal, and most patients have mild pain or soreness for 3-5 days after surgery.Patients can shower 48 hours after surgery, and can resume normal activities of daily living immediately after surgery. We ask our patients to refrain from active sports or heavy lifting for 14 days after vasectomy reversal. Patients may resume sexual activity 14 days after surgery.

How much will vasectomy reversal cost?

Vasectomy reversal is not covered by most insurance plans, and the patient is responsible for all of the financial arrangements. We perform vasectomy reversal at Central Coast Surgery Center in Watsonville, a state-of-the-art outpatient surgery center, that has the lowest cost to the patient of any facility in the area. We will collect a single payment for the procedure that covers the cost of the surgeon, the surgery center, and the anesthesiologist. Our cost is usually much lower than other options for vasectomy reversal in the San Francisco Bay area. Please click here to make an appointment to see our specialists and discuss the vasectomy reversal procedure, the costs, and your chances for success!