MMHC - Vasectomy Reversal

FAQs

  1. Why should a specialist perform a vasectomy reversal?
  2. How does a microsurgical technique improve results of vasectomy reversal?
  3. What are your success rates associated with vasectomy reversal?
  4. Do you perform your vasectomy reversals in your office or at a hospital?
  5. Can all vasectomies be reversed?
  6. My vasectomy was done years ago. How does it affect my chances for a successful reversal?
  7. I already had a vasectomy reversal with no success. Does it make sense to try again?
  8. When would you perform a vasoepididymostomy rather than a vasovasostomy?
  9. Is there an additional charge for a vasoepididymostomy?
  10. Is in vitro fertilization (IVF) with TESE a better option for me than vasectomy reversal?
  11. What type of suture do you use?
  12. What type of anesthesia do you use?
  13. What will the recovery be like?
  14. What is a sperm granuloma?
  15. How soon can I have sex after the surgery?
  16. How long after the surgery will it take for sperm to appear?
  17. Is there a chance that my sperm count will decline after the vasectomy reversal?
  18. How soon can I expect a pregnancy to occur after a vasectomy reversal?
  19. How long after surgery do I schedule a semen analysis?
  20. Does health insurance cover vasectomy reversal?
  21. How would I pay for the procedure?

Frequently Asked Questions

1.  Why should a specialist perform a vasectomy reversal?

A male fertility specialist has been specially trained to perform microsurgical vasectomy reversals. The specialist is also trained in male infertility and can provide proper consultation about your options. General urologists typically have not had any specialized training outside of the urology residency and tend to perform less vasectomy reversals on an annual basis than specialists.

2. How does a microsurgical technique improve results of vasectomy reversal?

The vas deferens is very small and can only be properly reconnected if using an operating microscope to allow for adequate visualization of the vas deferens.

3.  What are your success rates associated with vasectomy reversal?

Of the last 1000 patients, 97% if a bilateral vasovasostomy is performed, 95% overall including redo vasectomy reversals and patients out to 38 years. My success rates are based on a postoperative semen analysis showing more than one million motile sperm in the sample. The overall success rate for just redo vasectomy reversals is 85% however the rates tend to be better than 85% if less time has passed since the original vasectomy and the reversal.

4.  Do you perform your vasectomy reversals in your office or at a hospital?

MMHC has a fully certified operating suite in the office. The operating suite is certified by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF).

5.  Can all vasectomies be reversed?

Essentially all vasectomies can be reversed unless the vasectomy was performed in the inguinal canal (during hernia surgery). Sometimes the surgeon removes a large piece of vas deferens but this can only be done if the vasectomy was performed under general anesthesia

6.  My vasectomy was done years ago. How does it affect my chances for a successful reversal?

The longer the time interval from the vasectomy the higher the chance of epididymal blockage occurring requiring a Vasoepididymostomy to reconnect, this lowers the success rates. Success rates for a bilateral (both sides) Vasoepididymostomies are about 85% percent at MMHC.

7.  I already had a vasectomy reversal with no success. Does it make sense o try again?

See redo statistics above.

8.  When would you erform a vasoepididymostomy rather than a vasovasostomy?

When there is thick fluid or no fluid coming out of the testicular end of vas deferens, this indicates that there is blockage of the tubes in the epididymis preventing the sperm from getting into the vas deferens.

9.  Is there an additional charge for a vasoepididymostomy?

No, at MMHC there is only one fee which covers the whole procedure no matter what type of reversal is performed.

10.  Is in vitro fertilization (IVF) with TESE a better option for me than vasectomy reversal?

Typically not unless there is some female issues that would necessitate the use of IVF. IVF is more expensive, leads to more risk for the female because of fertility drugs, multiple births and extraction of eggs.

11.  What type of suture do you use?

I use a modified 2 layer technique for vasovasostomies with 9-0 Ethilon suture. I use 10-0 Ethilon suture to perform the vasoepididymostomies.

12.  What type of anesthesia do you use?

Certified Registered Nurse Anesthetists (CRNAs) provide either intravenous sedation with local or general anesthesia using propofol (intravenous) medication to “put you to sleep”. This medication is very safe. Other types of anesthetics requiring the use of gas are not used at MMHC’s National Vasectomy Reversal Center. For this reason, side effects from anesthesia are rare at our center. The type of anesthesia you will receive will be decide upon after you meet with the CRNA. I am typically able to perform the vasectomy reversal using either type of anesthesia although in rare instances I will need to decide in advance the type of anesthesia that will be required.

13.  What will the recovery be like?

There will be swelling and bruising of the scrotum, typically doubles in size and gradually goes back to normal within one week, pain pills are provided if the pain is extreme but most patients do not use more than a few pills in the first few days.

14.  What is a sperm granuloma?

This occurs when sperm leaks out of the testicular side of the vas, this usually protects the epididymal tubes from pressure build up and prevents damage to the epididymis, a sperm granuloma typically indicates that a Vasovasostomy can be performed and this is a good finding.

15.  How soon can I have sex after the surgery?

You must wait 4 weeks to have sex in order to prevent damage to the anastomosis

16.  How long after the surgery will it take for sperm to appear?

As soon as one month but the first check is at 2 months, some women have become pregnant as early as the first month after the surgery

17.  Is there a chance that my sperm count will decline after the vasectomy reversal?

Yes, “transient patency” can occur with delayed blockage of the anastomosis at 6 months or later. This occurs about 3% of the time in successful reversals.

18.  How soon can I expect a pregnancy to occur after a vasectomy reversal?

Sometimes the first month after the surgery, sometimes it takes more than a year.

19.  How long after surgery do I schedule a semen analysis?

The first semen analysis is at 2 months.

20.  Does health insurance cover vasectomy reversal?

Typically not but there are rare exceptions

21.  How would I pay for the procedure?

Insurance normally will not pay for the vasectomy reversal; therefore, you would be paying cash for the procedure. We accept Visa, MasterCard, Discover, American Express or cashiers check for payment.