Overview of Vasectomy Reversal
Vasectomy reversal is often the best option to restore fertility in men who have had a vasectomy. According to the National Institutes of Health (NIH), the number of men who undergo a vasectomy each year in the United States is approximately 500,000. This type of birth control is popular among adult males who are interested in preventing future pregnancies. For a variety of reasons, however, nearly 10% of men who undergo a vasectomy later change their minds and undergo a vasectomy reversal.
Just as with vasectomy, a vasectomy reversal causes no physical changes to the scrotal area, and after a normal healing period, sexual relations may continue. In most cases, vasectomy reversal is performed as an outpatient procedure in a hospital or outpatient surgical center. Once the physician determines that there are no complications (e.g., excessive pain, swelling) from the procedure, the patient is released.
Vasectomy reversal cost varies and depends, in part, on the type of procedure used. This surgery is an elective procedure and most insurance plans do not cover the cost. In general, vasectomy reversals performed in the United States cost between $5000 and $15,000. Many physicians offer patient financing options.
Vasectomy reversal is performed by an experienced surgeon who specializes in urology. Using micro-surgical techniques, the cut ends of the vas deferens are reconnected, allowing the small tubes to carry sperm from the testicles and thus enabling sperm enriched semen to be ejaculated during orgasm.
Although this type of procedure is similar to vasectomy, a vasectomy reversal takes more time and is a more complex surgical procedure. General or regional anesthesia often is used during the procedure, and this adds some time to the recovery period. From the time the patient arrives at the hospital or outpatient surgical center and begins to fill out the necessary paperwork, approximately 4 or 5 hours will pass before he is released.
In most cases, the risk for vasectomy reversal complications is low. Possible risks include the following:
- Collection of sperm (sperm granuloma), which causes inflammation (pain and swelling)
- Infection (may require antibiotics or, in severe cases, hospitalization)
- Swelling or the collection of blood (hematoma) in the scrotum
The recovery time following vasectomy reversal usually is about 4 weeks. For the first 24 hours after the procedure, the patient should remain on bed rest and will be advised to refrain from all physical activity, especially heavy lifting.
Patients may also be instructed to apply an ice bag to the scrotal area for a day or 2 following vasectomy reversal. In most cases, pain from the procedure is minimal, and a regular over-the-counter pain reliever (e.g., Tylenol®) can be used to reduce any discomfort. Patients should consult with the physician for complete instructions regarding recovery time and medications.
The physician will schedule a follow-up appointment a few weeks after the vasectomy reversal. In some cases, the doctor also may request semen specimens, but patients may be advised not to ejaculate for up to 30 days, unless instructed to do so by the doctor.
After a normal healing period of about 4 weeks, patients can resume regular sexual relations. The success rate of vasectomy reversal and the pregnancy rate vary in each case. Following vasectomy reversal, the chance of achieving the presence of sperm in the semen is high, but this does not guarantee pregnancy. Other factors, including potency of the sperm released in the seminal fluid, are just as important as the reconnected tubes of the vas deferens.
According to statistics, if the vasectomy reversal is performed less than 3 years after the vasectomy, about 97% of men have sperm in the ejaculate, and the pregnancy rate is about 75%. If the vasectomy reversal is performed between 3 and 8 years after the vasectomy, the rate for sperm in the ejaculate is about 90%, and the pregnancy rate is about 50%. If the vasectomy reversal is performed more than 15 years after the vasectomy, the rate of sperm in the ejaculate is about 70%, and the pregnancy rate is about 30%.