Frequently Asked Questions
Vasectomy Reversal: 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.
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.
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.
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.
How long does it take to recover from a vasectomy reversal?
Two days after surgery, patients can resume normal, non-strenuous activities, as long as these activities do not cause discomfort. After two weeks, you can resume weight lifting or jogging as long as those activities not do not cause any discomfort as well. If possible, we recommend that patient wait to return to work until 1 week after surgery, longer if work involves strenuous manual labor. We also recommend that patient refrain from sexual intercourse for 14 days after surgery.
Overall, vasectomy reversal is a very well tolerated operation, with a relatively quick recovery period.
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.
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.
Is urinary incontinence a risk of vasectomy reversal?
Vasectomy reversal is not connected to changes in urinary function, including incontinence.
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).
Can a vasectomy reversal be reversed?
“Yes” is the short answer. When an individual obtains a vasectomy reversal, he can easily have another vasectomy to render him once again infertile. However, it is important to discuss the vasectomy procedure with your treating physician. The ability to bank sperm is also important should another change of heart occur. Moreover, with each vasectomy it can become more difficult to perform a subsequent reversal due to scarring and shortening of the vas. However, I have never had a vasectomy that I could not perform due to a previous reversal.
It must be remembered that a vasectomy should be approached as a “permanent form” of male contraception. Although reversal is usually possible, reversing the vasectomy should never be part of the decision-making process when electing a vasectomy. While a vasectomy can be performed in the doctor’s office with only local anesthesia, a vasectomy reversal requires a trip to the day surgery operating room under general anesthesia. Following both procedures, a period of limited activity will be required.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Is a vasectomy reversal an outpatient surgery?
Vasectomy reversal is an outpatient surgery with a very well tolerated, short recovery time. Recovery from a vasectomy reversal is shorter and much easier than larger, more invasive surgeries such as hernia repairs, gall bladder surgery, or appendix surgery. Vasectomy reversal patients return home from the hospital on the same day as their surgeries. Typically patients arrive to the hospital in the morning, have their surgery, and are home by the late afternoon or early evening. Patient can resume a normal, well-balanced diet upon returning home.
How painful is a vasectomy reversal?
Pain is sufficient to be sent home with prescription pain medication, but typically by two days after surgery, extra-strength Tylenol or ibuprofen should be sufficient to relieve your pain.
Can I finance a vasectomy reversal?
Yes, you may be able to find financial assistance from United Medical Credit or Medical Loan Finance (although our office is not affiliated with, nor do we endorse, these organizations).
How much does it cost to have a vasectomy reversed?
- Microsurgical Vasovasostomy Surgical Fee: $3,850
- Epididymovasostomy: $4,400
- Hospital Operating Room Fee: $3,675
- Anesthesia Fee: $1,200
- Sperm Cryopreservation Fee: $850, plus $200 per year
- Late Cancellation Fee (less than 2 weeks before surgery): $2,200
Is sperm count affected by vasectomy reversal surgery?
In general, sperm quality is somewhat affected by the vasectomy and subsequent vasectomy reversal. Sperm production does continue to occur during this time, however, so while sperm count is affected, it is not completely eliminated by the surgery per se.
How long will it take for sperm count to increase and plateau?
For most patients, higher sperm count and sperm motility will return to after about three to six months. We should note that the overall sperm count may be lower than before simply given the nature of the vasectomy and the reversal procedure and how both can lead to potential scarring and other sources of blockage in the tubes.
How long will it take to get my partner pregnant?
This varies from couple to couple since so many factors are at play. Sometimes successful pregnancy will occur within the first few months, though other times it may take up to a year for things to work. If you're concerned about the amount of time it takes, it's important to return to the practice so that your sperm quality can be monitored.
Is there anything I can do to boost my sperm count?
There are plenty of things that you can do to improve your sperm count after undergoing vasectomy reversal. First of all, it's important that you follow all of your post-operative instructions to the letter. This means taking the time to rest and go to follow-up visits as scheduled, and to refrain from sexual activity until you are completely well.
To improve overall fertility and sperm quality:
- Quit smoking and use of other tobacco products
- Do not drink alcohol in excess
- Incorporate more fresh fruits and vegetables into your diet
- Exercise regularly to stay fit
What does sperm motility refer to?
Sperm motility refers to the ability of the sperm to swim and negotiate through the female reproductive system. If sperm are not motile or are weak in nature, it is very unlikely that they will be able to reach the egg and fertilize it. Poor sperm motility and other factors that affect sperm quality make natural conception highly unlikely.
Will vasectomy reversal affect sperm motility?
Yes, the initial vasectomy and the subsequent vasectomy reversal will both have an impact on your sperm motility. While sperm production continues as it normally would after a vasectomy, the sperm quality may not be great. In the first two months or so after the vasectomy reversal, motility can be very low. As the patients heal, however, sperm motility will gradually increase.
How long will it take before sperm motility returns?
This will vary from patient to patient, but some patients experience much better sperm motility just three months after surgery. For others, it can take up to a year for sperm motility to be sufficient.
This is why regular checkups with your urologist are crucial. Semen analysis will determine your current sperm count, sperm motility, and other factors that affect the health of the sperm and your chances of successful conception.
Are there long-term affects on sperm motility?
There may be some long-term effects to sperm motility after the surgeries. This could be the result of minor scarring or other kinds of blockages present in the tubes. This is another matter that can be addressed during your follow-up visits to the practice.