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A guide to vasectomy reversal

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Sometimes men are the ones to take care of birth control through a surgical procedure. But when those men and their partners have a change of heart about children for any number of reasons, they seek to reverse their vasectomies. And that's usually possible, even long after the original procedure, says Dr. Brad Lerner, co-director of the Vasectomy Reversal Center of America a division of Chesapeake Urology. Lerner answers questions about getting and reversing a vasectomy.

How common are vasectomies?

It is estimated that approximately 500,000 vasectomies a year are performed in the United States.

How often do men want them reversed, and what's the average time between the vasectomy and the reversal?

Approximately 50,000 vasectomy reversals are performed a year, according to Urology Times. The most common reason is a change in marital status, such as divorce and remarriage. Less common causes include a change of mind to have another child within the same marriage, death of a child or a widower who remarries. While a vasectomy can be successfully reversed after any length of time, most men decide to have a reversal within six to 12 years after the vasectomy. Our practice has successfully reversed vasectomies for men who had theirs as long as three or four decades earlier.

Is reversal always possible?

Using a state-of-the-art operating microscope and with proper surgical technique performed by a microsurgeon who is typically fellowship-trained, the success rate of a vasectomy reversal should be consistently above 90 percent. Sometimes a much more complex microsurgery may be needed if an additional level of blockage is detected during the vasectomy reversal. This blockage is closer to the testicle in a structure called the epididymis and requires a procedure called an epididymovasostomy. In very rare situations, significant scar tissue related to lack of blood supply from prior surgery may prevent a successful vasectomy reversal.

How is recovery and are there potential complications?

The surgery is carried out on an outpatient basis usually under general anesthesia and can take two to three hours to complete. Patients typically can return to work within one week and full activity within two to three weeks. The complication rate is very low with a low incidence of hematoma (collection of blood), infection or prolonged pain taking place.

How long before conception is possible?

Sperm may return within a short period of time, but it typically takes six to 12 months for sperm quality to reach the point where a pregnancy can realistically occur. A faster return of improved sperm quality and resulting pregnancies tend to occur for patients who had a shorter period of time (less than five years) elapse since they underwent the vasectomy. Occasionally, patients conceive babies in just a few months after the reversal.

How expensive are vasectomies and reversals, and does insurance usually cover both procedures?

With any surgical procedure, there may be three components that comprise the overall cost: the surgeon's fee, the facility fee for the hospital or outpatient center, and the anesthesia fee. The surgeon's fees for both procedures range from $500 to $1,200 for a vasectomy and $5,000 to $15,000 for vasectomy reversal. The majority of insurance companies cover vasectomies and about 30 percent cover vasectomy reversals.

meredith.cohn@baltsun.com

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