VASECTOMY REVERSAL:After vasectomy, the vas ends can be sutured back together, but this does not mean that sperm will be always restored to the semen. Therefore, vasectomy should not be considered a reversible form of birth control. However, within the first 3 years of vasectomy, reversal restores sperm to the semen in over 97% of cases! Even when the interval between vasectomy and reversal is 15 years or more, the sperm recovery rate remains about 70%. More details about the biologic response to vasectomy and various approaches to vasectomy reversal are provided in our Vasectomy Reversal 101 page.
TECHNIQUE:
Vasectomy reversal takes about 3.5 hours. It is performed under local anesthesia similar to the anesthesia used for vasectomy. The separated vasal stumps can be sewn back together through a single 1/2-inch incision. Reconnecting the small vasal tubes requires magnification with either a surgical microscope or optical loupes glasses. A small soft drain covered with a gauze pad is removed in the office the next day, and the small incision will seal by itself within another day or two.
In general, vasectomy reversals involve connecting the vas to either the vas or epididymis. When done in the office setting, only a vas to vas connection can be made; connecting the vas to the epididymis requires a general anesthesia. Therefore, men who have a high probability of requiring a vas to epididymis connection are generally referred to a surgeon who performs these operations in a surgical suite.
DOWN TIME:
Vasectomy reversals are usually performed on Tuesday and Thursday mornings. Patients may return to nonstrenuous work on the following Monday, but should avoid sports and lifting more than 20 pounds for an additional week or two. Detailed instructions for before and after the reversal are available here.
FEES:
The fee for office-based reversal procedures is $6900 (after a $100 consultation fee). We are often told that these fees are less than charges elsewhere. There are a number of reasons for this:
- Since vasectomy reversal is performed in the office, there are no facility fees.
- Because it is done under local anesthesia, there are
no fees for an anesthesiologist.
Sometimes during the procedure, we determine that connecting the vas to the vas has a low probability of success. This can only be determined at the time of the procedure. In this situation, the fee for that "exploration" on each side is only $475, or half of the reversal deposit. This is described in Approach # 3 in our Vasectomy Reversal 101 page. Specifically, if the lower end fluid on the first side evaluated is very poor (thick and without sperm), and a connection is not performed, then the fee for exploring that side is $475. Then the other side is evaluated, because the two sides can be very different. If the lower end fluid on the second side is very poor, and a connection is not performed, then the fee for that side is only $475. By that time, the patient has already paid us $950 as a deposit, so he owes us nothing. If the lower end fluid on the second side is favorable (contains sperm), a connection is performed and the fee for that side is half of the reversal fee, which is 1/2 of $6900 = $3450.
PAYMENT:
A deposit of $950 and a signed reversal deposit agreement are due within 10 calendar days of scheduling the reversal. If not received within 10 days of scheduling, the chosen reversal date will be offered to other candidates. For cancellation or postponement more than 28 days prior to the reversal, $850 will be refunded or credited. Within 28 calendar days of the reversal date, the deposit is refundable only for M.D.-documented illness of the patient. The balance is due on the day of the reversal. A payment plan is not offered by our office, but we accept VISA & MasterCard. According to the Federal Tax Code, the expenses of attaining medical treatment to correct a functional impairment (in this case sterility) are tax-deductible once the total medical expenses for the tax year (including what is spent for health insurance) exceeds 7.5% of adjusted gross income. This includes the reversal fee, airfare, mileage expenses at $0.17 per mile (2020 allowance rate for medical expenses), and lodging expenses up to $100 per night, so keep all of your receipts for tax time. We are usually booked 2-3 months in advance, but cancellations do occur, and we can often accommodate an individual patient's scheduling needs. We do NOT accept CareCredit for reversal consultations or procedures.
OUT OF TOWNERS ...
Our office is about 25 minutes from Tampa International Airport. Patients arriving by air should arrive in Tampa at least one day before the reversal and are cleared to fly home two days after the reversal. After a reversal, patients traveling by air should be cautious to avoid lifting (including suitcases) greater than 20 lbs. Any hotel within 30 minutes of the office would be fine. A deposit of $950 is due within 10 days of scheduling the reversal, but will be returned if the consult examination reveals technical challenges too great to proceed with reversal in the office (this has occurred only twice in over 1600 reversal candidates). Patients who live over 90 minutes away by car should stay in a local hotel on the night of the reversal but may drive home after an office visit next day. This information can also be found at Information for Patients from Out of Town .
SUCCESS RATES ...
Nationwide vasectomy reversal success statistics are readily available, most ones commonly cited are from the Vasovasostomy Study Group, published in the Journal of Urology in March, 1991. Our office success rates compare favorably with these statistics and going over our updated results are part of the consultation process. The most important parameter determining success is the number of years since vasectomy. Within the first 3 years after vasectomy, reversal results in sperm recovery in over 97% of cases. From 3 to 8 years, about 91%; from 9 to 14 years, about 82%; and beyond 14 years, about 69%. Click here to see a recent sperm recovery results graph. Pregnancy rates (involve female factors, which introduce many more variables. After vasectomy reversal, these also decline slowly with time (from about 86% in the 3-year group to 35% in the >15-years group). Click here to see a recent pregnancy results graph. There is no guarantee of success with this, or any other operation, but we do do our best to help each couple achieve their reproductive goals.
To request more information or begin the scheduling process, please visit our Contact Us page, answer a few questions, and Submit. You may also call 813-536-1430 during working hours (M-F 9-4 ET). Dr. Stein answers queries posted on our Contact Us Page from home and can usually respond within 24 hours.