Vasectomy Reversal Australia
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VASECTOMY REVERSAL AUSTRALIA
Dr Robert Woolcott
Frequent questions about vasectomy reversal
How successful is vasectomy reversal?
It depends on who does the surgery, how it is done and how long it has been since your vasectomy.
For the average patient, when vasectomy reversal is performed using microsurgical methods by a well trained and experienced microsurgeon the technical success of vasectomy reversal is excellent with an overall chance of sperm being present following the operation of 95%. The length of time since the original vasectomy is significant in that if the vasectomy was performed more than 20 years ago the percentage of men with sperm present after vasectomy reversal falls to about 70%.
Following vasectomy reversal sperm appear progressively in semen in the months following the procedure. At 6 weeks about 50% of men have sperm; by 3 months this is approximately 90% and by 6 months it rises to 95%. Most couples contemplating vasectomy reversal automatically and optimistically round the percentage up to 100% - which is simply not the case. To put this another way, about 1 in 20 men end up with a zero sperm count following vasectomy reversal. Given that I perform at least 20 procedures per month, it means that about one patient per month will ultimately have no evidence of success from vasectomy reversal. Vasectomy reversal will be technically successful for the vast majority of men - but not everyone.
There is a major difference between the chance of sperm being present and pregnancy. In all situations female age is the single most important influence of the prospect of pregnancy - the older the women, the lower the chance. This is particularly so when female age exceeds 40.
How much does vasectomy reversal cost?
This depends on where you have your vasectomy reversal performed, whether you have health insurance and what level of health insurance. Depending on these variables the cost of vasectomy reversal can vary.
For those with health insurance the out of pocket expense for vasectomy reversal is between $2,500 and $4,100.
If you do not hold health insurance the out of pocket expense is between $7,000 and $8,200.
A booking payment is due 4 weeks prior to your surgery.
Are pre-operative tests required?
You may read on some web sites about pre-operative tests prior to vasectomy reversal. In short there is no evidence that they are of benefit. In the American Society of Reproductive Medicine’s most recent guidelines they have stated that such tests are not necessary – worse – they may mislead you in to believing that you have a higher or lower chance than you actually do.
Sperm antibodies - the presence or absence of sperm antibodies has no influence on the prospect of vasectomy reversal surgery being successful. The majority of men who have sperm antibodies in their blood will achieve pregnancy following vasectomy reversal.
Ultrasound - do not influence the decision to operate or not operate as there is no way of using this indirect test to be sure that surgery is possible or not. In fact, even when examining the scrotum and vas deferens immediately prior to surgery under anaesthesia it is still impossible to tell.
In short, to know if vasectomy reversal is possible and likely to be successful it is necessary to operate.
Can complications occur from vasectomy reversal surgery?
Complications occur in less than 1% of men undergoing vasectomy reversal. Over the last 20 years I have never personally seen a complication which has led to any long term difficulty. Having said this, there have been very rare and very serious infections which have been reported in the medical literature. For this reason I always use preventative antibiotic treatment and coat key stitches with a potent antibiotic gel.
In addition to infection, haematoma (a collection of blood in the scrotum), unusual scar tissue causing post operative pain and short term urinary retention can occur, although I have seen less than 20 complications in over 2000 operations over the last 20 years.
Do I need a referral from my local doctor?
For Australian citizens a referral from your general practitioner is necessary in order to obtain a Medicare rebate or health insurance rebate.
How long after vasectomy reversal can I attempt to achieve a pregnancy?
One month.
Some surgeons suggest that waiting for or five months because they fear that there might be an increase risk of abnormalities in babies following vasectomy reversal. Published scientific and medical studies are reassuring in that there are no studies that demonstrate a statistically significant increase risk.
Can I have a letter for my employer?
Yes. Please ask our secretary if you require a letter or medical certificate.
Do I have to fast prior to surgery?
Yes. You should have nothing to eat or drink from the evening before your surgery for vasectomy reversal.
How long will I stay in hospital?
It depends on whether you have your surgery in the morning or afternoon and on where you live. If you live close to the hospital in which your operation is performed then you may, if you choose go home the same day. On the other hand should your operation be in the afternoon or you live at a distance then an over night stay may be more convenient.
Are there any Medicare rebates for vasectomy reversal?
Yes. The Federal Government has recently reinstated Medicare rebates for vasectomy reversal. The Medicare rebate will however be less than the cost of your surgery.
Are there any health rebates for vasectomy reversal?
Yes, but this will depend entirely on the exact details of your health insurance policy. Generally the major benefit of being in a health fund is the rebate provided for the cost of the fees charged by the hospital. We advise that you check with your health fund in advance of your vasectomy reversal.
How do I pay?
Payment is expected at the time of your initial consultation. Payment for Vasectomy Reversal is required prior to admission to hospital and can be by bank transfer, EFTPOS or Credit Card.