The reverse vasectomy is the political flip flop of surgeries: One day, it’s, “I would not like to have more kids,” the next, it’s, “I meant to say I would like to have more kids.” (It’s so easy to get those two mixed up!) Still, the upshot is, you want your tubes reconnected: What now?
For the uninitiated, a vasectomy is a sterilization of sorts whereby a doctor cuts the vas deferens — the part of the male reproductive system that carries sperm from the testicles to the urethra — and ties or seals them to prevent your swimmers from entering into the urethra and impregnating a woman during sex. Changing your mind about doing this after the fact is far from unheard of, though, with Johns Hopkins Medicine claiming, “About six percent of men end up wanting the process reversed.”
Jamin Brahmbhatt, a urologist who specializes in vasectomy reversals, tells me that there are three categories of men who ask for reversals: “The most likely category consists of men who are in new relationships that want to have a natural pregnancy,” he explains. The other scenarios, he continues, include men who are married and have a change of heart, and men who have complications after their vasectomy. “Guys who complain of having chronic pain or chronic feelings of congestion may decide to reverse the original procedure,” says Brahmbhatt. “It’s less than one percent, but I see it all the time because I specialize in it.”
As is the case with most things — whether it be a wall, a piece of paper, a relationship or your nutsack — ripping it apart is far easier than putting it back together again. In fact, while vasectomies are successful nearly 100 percent of the time, the varying success rate of a reversal is based on a few different factors, including how much time has passed since the vasectomy, as well as how much scar tissue has developed from the initial surgery — or multiple surgeries, as Brahmbhatt says he’s had a patient who’s undergone two reverse vasectomies. (Decisions are the worst!)
In both cases, the longer you wait to have the procedure reversed and the more often you change your mind, the less likely it is to be successful. According to Brahmbhatt, there are two types of vasectomy reversals. (“I won’t know which one the patient will need until we look inside,” says Brahmbhatt.)
The first — which is considered a simple reversal — is when the doctor ties the tubes of your vas deferens back together. The second, more complex procedure, includes tying the tube closer to the testicle, and is performed mainly on men who have a lot of scarring from the first procedure, or for men who’ve waited a long time to get a reversal since their vasectomy. “The numbers we quote are 90 percent success rate for simple reversals, and 50 to 60 percent for the complex reversal,” says Brahmbhatt.
When it comes to assessing the success rate of a reverse vasectomy, though, there are two ways to measure how well the procedure went. The first is how likely a man is to have moving sperm in their ejaculate after a reversal (patency rate); the second is how likely said sperm is to create a baby (pregnancy rate). “All these elements explain why the success rate for men who have reversed vasectomies falls somewhere between 40 and 90 percent, according to the Mayo Clinic,” reports Live Science. “Or, more precisely: about 90 percent of reversals resulted in sperm making it through the final stretch, while 50 percent ended in pregnancy, according to one of the only studies that’s given the odds a close look.”
Brahmbhatt agrees, telling me that success doesn’t necessarily mean pregnancy. “Success is getting the tubes flowing again so sperm comes out,” he says.
Either way, the recovery time for a reversal is roughly four to six weeks. “You go home the same day, and you’ll have a bit of swelling, pain and bruising,” says Brahmbhatt. “Typically we tell our patients to wait a few weeks before they start having sex again.”
So how much will this change of heart cost you? According to Brahmbhatt, the cost varies between $6,000 to $20,000. “Our cost is currently $7,000,” he says. “Most reversals, unless they’re dealing with complications from the initial vasectomy, aren’t covered by insurance.”
Changing your mind, it seems, can come with a hefty price.