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About Vasectomy Reversal

What is a vasectomy reversal?

A vasovasostomy is the procedure most commonly referred to as a vasectomy reversal. Under anesthesia, and through a 1-3 inch incision in the scrotum, an operating microsope and extremely fine microsutures are utilized to re-connect the previously cut ends of the vas deferens. Extreme precision and advanced surgical skills are required to re-attach the lumen of the vas deferens which has the diameter the size of a pen-dot (0.2-0.3mm). Under certain conditions, when poor fluid quality and/or no sperm are found at the end of vas deferens, the more complex vasoepididymostomy procedure is performed. In this modification, the vas deferens is re-attached directly to an epididymal tubule observed in the operating room to contain sperm. A vasectomy reversal procedure usually lasts approximately 1.5 - 4 hours.

Will it work?

Fortunately, in the last 20 years, numerous breakthrough improvements have been achieved for reconstruction of the vas deferens specifically utilizing microsurgical techniques. At present, in experienced hands, a vasectomy reversal can be performed as an outpatient procedure and achieve excellent results. Success following a vasectomy reversal depends on many important factors. These include the training and experience of the operating surgeon, the elapsed time since the vasectomy was performed, as well as the fertility status of the female partner. While the interval between the vasectomy and the reversal is correlated with success rate, there is no “cut-off” date for a reversal. Men with intervals greater than 20 years have undergone the procedure with success. Following the procedure, approximately 70-95% of men have sperm appear in their semen, and 30-75% of couples become pregnant without assisted reproductive technology.

One of the key contributors to a successful vasectomy reversal is the expertise of the operating surgeon. Your vasectomy reversal will be performed by Dr. Natan Bar-Chama who is the Director of the Center for Male Reproductive Medicine at the renown RMA of New York. He is one of a select number of fellowship trained and accomplished male reproductive microsurgeons practicing in Manhattan. Since 1994, Dr Bar-Chama has been the Director of Male Reproductive Medicine and Surgery at The Mount Sinai Hospital and School of Medicine. He is on the board of directors of the Society for Male Reproduction and Urology of the American Urological Association (AUA) and the American Fertility Association (AFA). Annually, since 1995, Dr. Bar-Chama has been highlighted as a New York Top Doctor in New York Magazine as well as named by Castle Connolly’s Best MDs in America. His clinical practice is exclusively dedicated to male reproductive and sexual medicine and microsurgical reconstruction for the treatment of male fertility, including vasectomy reversal.

Is vasectomy reversal right for me?

While approximately half a million men a year elect to undergo a vasectomy, a segment of this population will later return with the desire to regain their fertility and explore the option of vasectomy reversal. While alternatives exist that include using donor sperm insemination or surgical testicular sperm retrieval which must be accompanied with IVF/ICSI, however, for many couples vasectomy reversal offers the most natural and cost effective option for achieving a desired pregnancy. There are many reasons men choose vasectomy reversal. While only you know what decision will best fit your life and relationships, our expert team of urologists and reproductive endocrinologists are available to answer any of your questions, help you further explore the options, and determine which treatment plan suits you best.

Have I waited too long for a vasectomy reversal?

There is no deadline for a successful vasectomy reversal. While the interval between vasectomy and reversal, as well as the age of the female partner, is related to the success rate, some men have waited more than 20 years and experienced success.

The Vasectomy Reversal Procedure

Where does the vasectomy reversal take place?

Vasectomy reversals are performed on site as an ambulatory procedure at our Madison Avenue surgery facility. We are fully accredited by the American Association for Accreditation for Ambulatory Surgery Facilities (AAAASF). This outpatient facility enables us to provide affordable microsurgical reconstruction without the addition of often prohibitive hospital costs.

Will I be asleep?

Yes, anesthesia is used during the vasectomy reversal procedure.

What should I expect after the procedure?

After the surgery, you will be groggy. You must arrange for someone to pick you up. You should allow 1-2 full days for recovery, 4 weeks before engaging in strenuous activity, and 6-8 weeks before resuming normal sexual activity. If you are traveling by plane to Manhattan for the vasectomy reversal, it is possible to fly home the next day.

You may experience these common side effects:

• Slight swelling, discoloration and/or discomfort in the scrotal area
• Aching and nausea immediately following the procedure, due to the anesthesia

Dr. Bar-Chama and the team will provide you with a detailed post-procedure care plan to manage discomfort. We recommend placing ice packs on the scrotum for approximately 10 minutes every hour for the first day in order to reduce pain and swelling. Dr. Bar-Chama will also prescribe pain medication for the first few days following surgery, after which, ibuprofen or acetaminophen should be sufficient.

How should my doctor and I follow up?

You will have a post-operative appointment 10-14 days after the surgery simply to ensure you are healing as expected. The sutures placed during the procedure will not need to be removed, as they will dissolve.

However, if you are traveling to New York for the vasectomy reversal procedure, we can arrange for a telephonic follow up with our team and an exam with your local physician.

Beginning one to two months after the surgery, semen analyses will be performed at 2-3 month intervals to test for the presence of sperm.

How long after vasectomy reversal before I regain fertility?

After a successful vasovasostomy sperm often appear in the ejaculate after about 3 months, with results usually improving over time. Improvement after a vasoepididymostomy, the more complex procedure, usually requires an additional 1-2 months of healing before sperm will appear in the ejaculate. Occasionally the presence of sperm is delayed and may take up to 12 months post procedure to be observed on semen analysis. However, if the vasectomy reversal procedure was successful sperm should be present in the semen at 6 months and the average time from surgery to conception is 12 months.

Getting Started

Ready to schedule a consultation for vasectomy reversal?
Call 212-756-5777 or fill out an online appointment request. New patients can download consultation paperwork prior to their appointment.

Out of town patients can take advantage of hotel discounts through RMA of New York.

Have additional questions about vasectomy reversal?
We are happy to answer any questions you may have or provide more information about vasectomy reversal. Email or call the main line 212-756-5777.

Have additional questions about the cost of a vasectomy reversal?
Our finance team is happy to assist you, please call 212-756-5777 and ask to speak to a finance professional about our affordable vasectomy reversals.

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