Vasectomy Reversal FAQ: What to Expect from Your Procedure

If you are considering vasectomy reversal, Dr. Larry Lipshultz and his team want to provide you with as much reliable information about the procedure as possible. Please read our vasectomy reversal FAQs below and then feel free to reach out to the team of urological experts at our Houston, TX, practice for answers to your specific questions.

Q: What is vasectomy reversal?

Vasectomy reversal is a microscopic surgical procedure during which the vas deferens are reconnected in order to restore fertility in men. The vas deferens, the tubes that propel semen into the ejaculate, are separated during a vasectomy.

There are two basic techniques used to perform vasectomy reversal. Vasovasostomy, the more common of the two, involves directly reattaching the severed ends of the vas deferens. If Dr. Lipshultz does not detect sperm or fluid in the vas deferens during surgery, he will perform an epididymovasostomy instead. This technique involves connecting the ends of the vas deferens to the epididymis, the tubes where sperm is stored and transported from the testis. Both techniques are performed microsurgically; that is, they are performed using a special microscope that allows Dr. Lipshultz to use extremely small sutures even smaller than a human hair. Microsurgical techniques offer a wealth of advantages over traditional surgical techniques, including the ability to restore higher quality sperm to the ejaculate.

About 600,000 vasectomies are performed every year in the U.S., and about 5 percent of those patients later seek a vasectomy reversal. Learn more: Vasectomy Reversal Facts & Figures.

Q: How long does the procedure take?

The amount of time required for either vasovasostomy or epididymovasostomy is approximately three hours. Out-of-town patients should plan on staying in Houston for at least one day after their surgeries so they are comfortable and safe before traveling.

Q: How long is the typical recovery period?

This outpatient surgery allows you to heal in the comfort of your own home. Recovery times differ patient to patient, but minor to moderate pain is typically limited to the first 24 to 48 hours after surgery. Three days after surgery, patients are generally able to resume non-strenuous activities, and most are able to return to work about a week after that. At two weeks, patients are usually able to resume rigorous activities, including sex.

Between 10 and 14 days after your procedure, you will return to our office or to your local physician for a follow-up appointment to ensure that you are healing properly. Your first semen analysis will be at six to eight weeks. You will have semen analyses every other month for the next four to six months, or until the semen analysis stabilizes. If semen quality is less than expected, anti-inflammatory medications may be recommended to reduce scarring.

Q: Are there side effects?

As with all surgeries, there are risks associated with vasectomy reversal; however, they are rare. Possible vasectomy reversal side effects include bleeding and infection at the surgery site. By entrusting your surgery to Dr. Lipshultz, one of the world's most reputable urologists and experts in male reproductive health, you are greatly reducing your risk of complications.

Q: Is erectile dysfunction a risk of vasectomy reversal?

Vasectomy reversal is generally not associated with changes to sexual functions, such as ejaculate patterns. Vasectomy reversal complications contributing to erectile dysfunction have not been identified.  Of more importance, when the procedure is performed by an experienced, skilled microsurgeon such as Dr. Lipshultz, the chance of such a complication has not been experienced.

Q: Is urinary incontinence a risk of vasectomy reversal?

Vasectomy reversal is not connected to changes in urinary function, including incontinence.

Q: Are their alternatives to vasectomy reversal?

Besides vasectomy reversal, the only alternative for a vasectomy patient seeking to impregnate his partner is to have his sperm retrieved and used in an assisted reproductive procedure, such as in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). These procedures can run in the tens of thousands of dollars, making a vasectomy reversal a particularly cost-effective solution. Nonetheless, some couples may have reasons to prefer the extraction of sperm for IVF or ICSI over vasectomy reversal. Sperm retrieval methods include microscopic epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE).

Q: Can a vasectomy reversal be reversed?

Yes, you can reverse a vasectomy reversal. Essentially, this procedure results in the patient undergoing another vasectomy.

---

Q: How effective is vasectomy reversal?

The success of a vasectomy reversal depends on the skill of the surgeon and the findings at the time of surgery. The surgeon should be adept at using microsurgical techniques to ensure the precise placement of the sutures, which is key to a successful procedure. The surgeon must also be able to perform an epididymovasostomy, the less common and more challenging of the two vasectomy reversal techniques, if necessary. During your surgery, the presence and quality of vas fluid and sperm are the two chief indicators of the operation’s efficacy. Post-surgical success can be measured by patency rates (sperm returning to the ejaculate) and pregnancy rates.

Q: What are your success rates?

Dr. Lipshultz is proud to have among the highest success rates for vasectomy reversal in the nation. More than 90 percent of our patients have experienced a return of sperm to the ejaculate when sperm are present in the vas deferens at the time of surgery, with a post-surgical pregnancy rate of between 60 and 70 percent. However, please keep in mind that pregnancy rates involve other factors, such as the fertility of your partner, and we cannot guarantee the success of your results.

If sperm are not present at the time of the procedure, but the fluid that flows into the vas deferens is healthy - clear and watery - then about 70 percent of our patients experience a return of sperm to the ejaculate. However, if the fluid is of poor quality - thick and opaque - or no sperm or fluid is detected, then an epididymovasostomy will be performed. Approximately 65 percent of patients who undergo this procedure experience a return of sperm to the ejaculate.

Scott Department of Urology - Baylor College of Medicine

*Absent or Pasty

Q: Why should I choose Dr. Larry Lipshultz?

Dr. Lipshultz is a recognized expert in male infertility and vasectomy reversals. He is a pioneer in urological microsurgeries, which allow for shorter, more comfortable healing times and higher quality sperm. Dr. Lipshultz has performed thousands of procedures over his long career and has achieved some of the most impressive vasectomy reversal success rates in the field.

An innovator and leader in men’s health, Dr. Lipshultz is Professor of Urology and Chief of the Division of Male Reproductive Medicine and Surgery at the Baylor College of Medicine. He has trained more than 80 fellows who now practice across the country. He is also active in numerous scientific organizations and has served as a member of the Board of Directors of the American Society for Reproductive Medicine and as President of the Society for the Study of Male Reproduction. His respected research includes developing evaluation techniques for infertile males, and he has been published hundreds of times. For his contributions to the study of men’s health, he has received a lengthy list of accolades.

Dr. Lipshultz' Curriculum Vitae.

Q: Is freezing sperm a viable option?

Cryopreservation of sperm, or sperm banking, is routinely offered at the time of a vasectomy reversal when healthy sperm are present. Sperm banking may also be performed with ejaculated specimens collected during the early part of vasectomy reversal recovery and stored at the Scott Department of Urology's Sperm Bank. Freezing sperm is a sound fallback measure in the event that patients experience insufficient sperm counts after surgery.

Q: How much does vasectomy reversal cost?

Your vasectomy reversal will involve three fees: a hospital fee, an anesthesiologist fee, and a surgeon’s fee. The hospital and anesthesia bills are charged separately and are paid at the hospital on the day of your procedure. The hospital fee is $3,675 and the anesthesia fee is $1,200. The surgeon’s fee is $3,850 for a first-time vasovasostomy. An epididymovasostomy, or revision procedure for a surgery initially performed elsewhere, is $4,400. Your two-week postoperative evaluation is included in the surgical fee. Additional office visits and semen analyses are billed separately.

Q: How can I pay the fee?

If your procedure is not covered by insurance, you will need to pay a non-refundable $500 deposit at the time that you schedule your surgery. Four weeks prior to your surgery, an additional $1,950 will be due. The remaining balance of $1,950.00 will be due two weeks before your operation.

Q: Are there other fees?

s a backup plan against insufficient sperm counts, patients often choose to freeze sperm for future use. Sperm can be aspirated at the time of a vasectomy reversal. The fee for sperm banking is $850. This includes the surgeon's fee for sperm retrieval and one year of storage. Sperm storage after the first year is $200 per year.

Q: What if I need to cancel my surgery?

Patients should notify us of a cancellation at least two weeks prior to the date of their surgery; otherwise a cancellation fee of $2,200 will be charged.

Q: How can I learn more?

We welcome you to stop by our office! You can also reach out to us at (713) 798-6163 or send an email. We look forward to speaking with you.