Microsurgical reversal of vasectomy
Mr Michael Swinn carrying out a microsurgical reversal of vasectomy.
What is reversal of vasectomy?
Around 4% of men undergoing a vasectomy subsequently need for it to be reversed. The reversal operation involves finding the site of the previous vasectomy on both sides, removing any scar tissue and delicately joining the two cut ends together.
What techniques for reversal of vasectomy are there?
There are essentially two ways of doing this:
- with the naked eye (or glasses)
- using an operating microscope to achieve a microsurgical anastomosis.
Which technique is best?
It is very clear from a variety of studies that the best way of doing a reversal of vasectomy is by achieving a microsurgical anastomosis (join) by using an operating microscope. However, the technique is all important and outcomes depend also on the training and experience of the surgeon. It is important to choose a surgeon who has undergone an extensive period of training in microsurgery.
What are the success rates?
Success depends not just on surgical factors, but other issues also play a role. The key ones are:
- the length of time since the vasectomy
- the technique that was used to perform the original vasectomy
- female factors such as age
- presence of antisperm antibodies
A surgical success is defined as the presence of viable spermatozoa in the ejaculate postoperatively.
How long does the operation take?
In my own series the average operation time is about 2 hours.
How long will I be in hospital?
Patients normally stay overnight and go home the following morning.
What is the follow up?
Approximately 3 months after the microsurgical reversal of vasectomy is the optimum time to check the sperm count. This is arranged on discharge with an outpatient appointment shortly afterwards to discuss the result.
Do I need a referral or even an appointment first?
I am happy to accept referrals without a letter from the GP. An appointment before surgery is required so that a full discussion of the procedure together with alternative treatments is discussed.
How much does it cost?
The initial consultation is £150.
The price of the microsurgical vasectomy reversal is: £4400
This includes:
- the surgeon’s fee
- the anaesthetist’s fee
- use of the operating microscope
- all hospital fees including theatre time and overnight stay
- semen analysis 3 months post vasectomy reversal
How do I make an appointment?
I have a split appointment between Surrey and Sussex NHS Trust based at Redhill and The Royal Surrey County Hospital where I am a member of the specialist bladder MDT and robotic surgeon carrying out cystectomies. (see details on “contact” page of website).