Vasectomy Reversal : How it Works

Vasectomy Reversal : How it Works


Drs. Raymond A. Costabile & Stuart S. Howards

University of Virginia Urology Department
Vasectomy Reversal Specialist
P.O. Box 800422
Charlottesville, VA 22908
Toll free Appointment Number – 800-251-3627 ext 3-9392


What is Vasectomy Reversal?

drawing, vasectomy reversal in black and white

Vasectomy reversal consists of microsurgical reconstruction of the spaghetti-shaped vas deferens which was ligated (cut) during vasectomy. The tube that the sperm moves through is the size of the period at the end of this sentence, therefore precise microsurgical techniques using an operating microscope and sutures thinner than a hair are needed to carefully realign the tube.

What is the chance for success?

Success can be defined by the presence of sperm in the ejaculate after surgery or by pregnancy. Using either definition the experience of the surgeon(s) is the most significant indicator for surgical success. Other factors that influence success are the time since vasectomy, patient age and the quality of the fluid found in the vas deferens during the surgery. Overall success at obtaining sperm after surgery for Drs. Costabile and Howards exceeds 95% for men less than 10 years after vasectomy.

What are the options to vasectomy reversal?

In vitro fertilization with testes extracted sperm is the alternative to a vasectomy reversal. A minor surgical procedure is needed to extract the sperm.

Vasectomy reversals have been shown by intensive cost-benefit analyses to have the highest success rate at restoring fertility after vasectomy at a lower cost. Vasectomy reversal also allows the couple to conceive in a “natural” fashion without the risks of fertility drugs and have as many children as they desire.

What anesthetic techniques are used for vasectomy reversal?

Any anesthetic technique from local anesthesia with sedation to general anesthetic can be used with vasectomy reversal based on surgeon and patient preference. Modern anesthetic techniques are very safe with few side effects and no long-term risks.

How much will vasectomy reversal cost?

Many centers will only quote a “surgeons fee” while the total facility cost including anesthesia services will often double the price. At the University of Virginia we have a total procedure cost of approximately $8,500 for vasectomy reversal (vasovasostomy) that includes all the above. The Department does provide a discount to Military personnel.  For patients living more than an hour or two from the University we recommend an overnight stay at one of the local area hotels.

What about post-operative care?

Vasectomy reversal is performed through a very small (less than one inch) incision in the scrotum. The procedure is done on an outpatient basis with patients leaving the surgery center the same day. Patients are advised to wear a scrotal support (jock strap) for a week and decrease vigorous activity for two weeks. Patients can get around the house for activities of daily living the same day as their surgery. Ice packs and pain medication is used for the first two days after surgery for comfort. Patients will need to refrain from ejaculating for 21 days following the vasectomy reversal procedure.

Recommended Links & Video

Additional information on vasectomy reversals and general urology can be obtained from the following sites:



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