Vasectomy Reversal

Male reproductive system

Top 14 Things to Know About Vasectomy Reversal

from the experts at UC San Diego Health

Vasectomy reversal is a relatively simple procedure used to restore the flow of sperm in men who have previously undergone a vasectomy. In the United States, about 5% of men with vasectomies later opt for reversal surgery.

Vasectomy reversal at UC San Diego Health is performed by an experienced urologist who is exceptionally skilled in male reproductive medicine and microsurgery. Meet Mike Hsieh, MD.

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1. How is the surgery done?

Vasectomy reversal is typically performed as an outpatient surgery and can be done under regional, local, or general anesthesia.

In an uncomplicated vasectomy reversal, the surgeon simply joins the cut ends of the vas deferens together. If there is no sperm present in the fluid at the time of surgery, then the doctor will perform a vasoepididymostomy. In this procedure, the vas deferens is directly attached to the epididymis (located on the testicle).

At UC San Diego Health, vasectomy reversal is performed using microsurgical techniques to enhance accuracy of reconnection, reduce complications, and ensure the greatest success of flowing sperm.

2. What is the success rate of vas reversal?

Success can be influenced by several factors, but the greatest of these is the length of time between the vasectomy and the reversal surgery. This is due to increased vas deferens blockage over time.

Patients who have sperm in their vas deferens can expect a 90 percent success rate.

3. How much does a vas reversal cost?

The cost for a vasectomy reversal includes a fee for anesthesia, surgeon’s fee, and hospital fee. Overall costs can range anywhere from $7,000 to $9,000, depending on your insurance coverage.

4. Will your sperm still work?

After vasectomy, it is the lack of sperm, not the sperm function that is the reason for infertility. Vasectomy reversal restores the delivery of sperm in the semen which improves the chance of becoming pregnant.

Mike Hsieh, MD, is an accomplished surgeon who will assess your specific situation for optimal success.

5. How long is the procedure?

The length of surgery depends on the amount of scarring from your prior surgery and the type of procedure needed. An uncomplicated vasectomy reversal can take 2-3 hours, while a vasoepididymostomy can take up to 4 hours.

Following the procedure, our team of experts will monitor you for several hours to ensure a safe and swift recovery.

6. How long is recovery, and how soon after can I have sex?

It can take several weeks for the swelling following surgery to go down. Limited activity is recommended for the first week, and most doctors suggest waiting at least 3 weeks before having sex (or until fully healed).

7. What factors affect success rate?

If the reversal surgery is performed within 10 years of the vasectomy, expected success is greater than 90 percent. Other factors that play a role in success include age of patient and partner, quality of fluid found in the vas deferens, and the skill of the surgeon.

8. Is in-vitro fertilization a better option than vasectomy reversal?

Vasectomy reversal is more cost-effective than in-vitro fertilization, has fewer side effects, and higher pregnancy rates. In-vitro is generally considered when reversal surgery proves unsuccessful or when female factor infertility is present.

9. What kind of complications can occur?

The risk of complication(s) during and after vasectomy reversal is extremely low. Examples of rare complications include infection, scrotal hematoma, and chronic pain. Notify your doctor immediately if you develop a fever or experience swelling and pain at the incision site.

10. How much pain can I expect after surgery?

The amount of pain experienced after surgery differs from person to person. The pain could be less or more severe than the pain you felt after your vasectomy. Our team ensures patient comfort by prescribing a pain medication plan that’s customized to your pain tolerance level.

11. How soon can I expect pregnancy to occur after surgery?

On average most vasectomy reversal patients achieve conception within 12 months of their surgery. Of course, each patient is different, so it’s important you talk to with our team about your particular situation and what time frame you can expect.

12. If I’ve already had vasectomy reversal with no success, should I have the surgery done again?

In some cases, vasectomy reversal may prove to be unsuccessful due to persistent blockage from scarring after the initial surgery. This is why it’s important to find an experienced doctor who can properly assess your condition. Dr. Hsieh has successfully helped many patients with failed vasectomy reversals. While a repeat vasectomy reversal tends to have a lower success rate, findings show that 43-75% of these patients will achieve pregnancy.

13. What’s the oldest age to be considered for reversal?

Successful conception is influenced by the age of the female, not the age of the man. Therefore there is no age limit for men with proven fertility.

14. Can a doctor predict the outcome of a vasectomy reversal based on the initial exam?

In many ways a doctor can determine post-surgery success based on the preliminary examination. You will be checked for testicular failure, disorders, epididymal blockage, and abnormalities of your vas deferens. All of these factors play a role in your sperm count following surgery.

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