Frequently Asked Questions about Vasectomy Reversals
- Why should I choose Dr. Larry Lipshultz?
- What is a vasectomy reversal?
- What are the success rates of a vasectomy reversal?
- How much will it cost?
- How can I pay the fee?
- Are they any other fees that I might incur?
- What if I need to cancel my surgery?
- How long is the procedure?
- How long is the follow-up period?
- How do I make an appointment?
- How can I get more information?
Q: Why should I choose Dr. Larry Lipshultz?
In his active clinical practice, Dr. Lipshultz specializes in male infertility and male reproductive disorders including treatment of erectile dysfunction and male hormone deficiency. As a pioneer in urological microsurgery, Dr. Lipshultz is one of the world's leading experts in male infertility. Dr. Lipshultz is Professor in the Scott Department of Urology at Baylor College of Medicine and is a popular teacher, having trained more than 50 fellows now in practice throughout the U.S. He serves as Clinical Director of the Laboratory for Male Reproductive Research and Testing.
Active in numerous scientific organizations, Dr. Lipshultz 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. Dr. Lipshultz was also President of the American Society for Reproductive Medicine from 1998-1999. His research includes newly developed techniques for the evaluation of the infertile male and has assisted a large number of infertile patients to achieve pregnancies. His clinical practice uses only the latest microsurgical equipment and performs approximately three vasectomy reversal procedures weekly on an outpatient basis. Dr. Lipshultz' credentials and experience speak for themselves.
Dr. Larry Lipshultz was born in Philadelphia, Pennsylvania, and graduated from Franklin and Marshall College. He earned his M.D. and completed residency training at the University of Pennsylvania. He also completed a two-year fellowship in male reproductive medicine at the University of Texas Medical School at Houston.
View Dr. Lipshultz' Curriculum Vitae.
Q: What is a vasectomy reversal
A vasectomy reversal is an operation that reestablishes a connection between the two ends of the vas deferens that were separated at the time of a prior vasectomy. Sometimes the vas deferens is reconnected to the epididymis (epididymovasostomy) because of a secondary obstruction in the epididymis. The entire procedure is performed under a special operating microscope.
Sperm production takes place in the testis. After passage through the efferent ducts, sperm are stored and undergo maturation within the epididymis. Those sperm that have not passed through the epididymis are generally not able to fertilize eggs under normal conditions. The epididymis is a continuous, tightly coiled tube approximately 15-18 feet in length, which leads into the vas deferens. The vas deferens is responsible for directing and propelling the sperm into the urethra.
Q: What are the success rates of the vasectomy reversal?
The success of a vasectomy reversal depends on:
- The skill of the surgeon.
- The finding at the time of surgery.
Skilled Surgeon
The surgeon should be skillful with microsurgical techniques, as precise suture placement is critical to the success of the procedure. The surgeon must also have the ability to perform the more difficult epididymovasostomy procedure.
As mentioned previously, other important factors in determining a successful outcome are the surgical findings. When the vas is opened, fluid will flow from the testicular side of the vasectomy site. If sperm are present, then Dr. Lipshultz finds that 90% or more of patients demonstrate a return of sperm with an associated 60%-70% pregnancy rate. If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production (e.g., clear, watery), then a direct vasovasostomy is performed with a successful outcome of approximately 70%. If poor-quality fluid is present (e.g., thick, pasty) and sperm are absent, or no fluid at all is found, then an epididymovasostomy (connection of the vas to the epididymis) is performed with a successful outcome of approximately 60-65%.
Dr. Lipshultz uses a two-layer anastomosis utilizing microscopic sutures and the latest microsurgical equipment and performs approximately three of these procedures weekly on an outpatient basis. This arrangement allows you to return home or to a nearby hotel without actually being admitted directly to the hospital, thus saving considerable expense and making the overall experience much more pleasant. We perform the surgery at the day surgery unit at St. Luke's Episcopal Hospital featuring state-of-the-art microsurgical equipment and a hospital staff well trained to assist in these procedures.
Surgical Findings
Other important factors in determining a successful outcome are the surgical findings. When the vas is opened, fluid will flow from the testicular side of the vasectomy site. If sperm are present, then we expect 90% or more of patients to demonstrate a return of sperm with an associated 60%-70% pregnancy rate. If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production (e.g., clear, watery), then a direct vasovasostomy is performed with a successful outcome of approximately 70%. If poor-quality fluid is present (e.g., thick, pasty) and sperm are absent, or no fluid at all is found, then an epididymovasostomy (connection of the vas to the epididymis) is performed with a successful outcome of approximately 65%.
Scott Department of Urology - Baylor College of Medicine
| Intraoperative Findings | Results | |||
|---|---|---|---|---|
| Sperm Present | Fluid Quality | Procedure Type | Patency Rate | Pregnancy Rate |
| Yes | Good | Vasovasostomy | 95% | 75% |
| No | Poor* | Epididymovasostomy | 65% | 50% |
*Absent or Pasty
Q: How much does a vasectomy reversal cost?
The surgeon's fee is $3,850.00 USD for a first-time vasovasostomy. The fee is $4,400.00 USD for an epididymovasostomy and/or redo vasovasostomy if the initial surgery was done elsewhere. A two-week postoperative wound evaluation is included in the surgical fee.
Charges for the hospital and anesthesia are billed separately from the surgeon's fee. These are paid at the hospital on the day of your procedure. The hospital fees are $3,675.00 USD and the anesthesia fee is $1,200.00 USD.
Any additional office visits and semen analyses will be charged accordingly.
Q: How can I pay the fee?
If your insurance carrier is not going to pay for the procedure, a non-refundable deposit of $500.00 USD is required at the time your surgery is scheduled. Four weeks prior to surgery you will need to pay $1,950.00. The remaining balance of $1,950.00 is due 2 weeks before surgery.
Q: Are there any other fees that I might incur?
At the time of the procedure, you have the option to harvest sperm to freeze for future use. The fee for this is $850.00 USD, which includes the surgeon's fee for sperm retrieval and one year of storage. Thereafter, storage will be an additional $200.00 USD per year.
Cryopreservation of sperm (sperm banking) is routinely performed at the time of vasectomy reversal if whole, motile sperm are present. Cryopreservation is performed as a safety "backup" in case inadequate sperm counts are present after surgery. Because vasectomy reversals may infrequently scar despite good initial results, cryopreservation may also be performed on ejaculated specimens early in the course of recovery when semen quality is exceptionally good. Sperm are stored at the Scott Department of Urology's Sperm Bank.
Q: What if I need to cancel my surgery?
If your surgery needs to be canceled, we are to be notified 2 weeks prior to the date of surgery. If you do not notify us 2 weeks prior to surgery, an additional late cancellation fee of $2,200.00 will be charged.
You are also responsible for your transportation fees to and from the facilities and accommodation fees.
Q: How long is the procedure?
Operating time for a vasovasostomy or epididymovasostomy is approximately 3 hours. A general anesthetic is usually used. It is recommended that out-of-town patients stay in Houston for at least 1 day after surgery.
Q: How long is the follow-up period?
Postoperative follow-up includes an evaluation of wound healing at 10 days to 2 weeks and a semen analysis at 6-8 weeks. Monthly semen analyses are then obtained for approximately 4-6 months, or until the semen analysis stabilizes. If semen quality is less than expected, anti-inflammatory medications are often introduced to decrease scarring.
Q: How do I make an appointment?
Just call our office to set up and appointment: (713) 798-6163
If you want to make a payment, make your check to Larry Lipshultz, M.D. and mail it to:
Larry I. Lipshultz, M.D.
6624 Fannin, Suite 1700
Houston, TX 77030
ATTN: Jo Vasquez
Q: How can I get more information?
You are welcome to come by our office, call us at (713) 798-6163, or send us an email at drlipshultz@larrylipshultz.com. We will be happy to assist you.