Ohio State University Menís Health and Male Infertility

Pregnancy goals can be obtained with very successful procedures such as vasectomy reversal and microscopic testicular sperm extraction.

Vasectomy reversal

The department of urology at the Ohio State University Medical Center is proud to offer the latest in male infertility and menís health.† Dr. Gregory Lowe has undergone extended training to perform vasectomy reversal, micro-dissection sperm extraction, varicocelectomy, and other operations requiring the use of a microscope during surgery.† We work closely with the embryologist and reproductive endocrinologist to maximize a couples ability to have a child.†

 

Vasectomy Reversal (Vasovasostomy)

Vasectomy is a very common procedure with around 500,000 US men having this procedure performed each year.† Up to 5% of these men will wish for further children after a change in life circumstances.† Additionally, 7% of men who have primary infertility (never had a previous pregnancy or child) will have a blockage in the transport of sperm which can be corrected with surgery.

 

What is vasectomy reversal?

Vasectomy reversal is the repair of the damaged portion of the vas deferens.† This is usually due to the prior vasectomy, however may also be caused by inguinal hernia surgery with mesh.† A similar cause of sperm blockage occurs with an obstruction of the ejaculatory duct by cysts, stones or prior infection.

The ends of the vas deferens are put back together to bypass the blocked portion.† This returns sperm to the manís ejaculate in the vast majority of cases.† The unique aspect of this surgery is the size of the repair needed.† In general, the vas deferens is repaired with suture that is smaller than a human hair.† It requires skill in using an operating microscope or robotic surgery.† The size of the tube sperm travel through is similar to the period at the end of this sentence.† It is important to find someone who has been fellowship trained in this procedure for the best chance of success.

 

Why is a microscope or robot necessary?

The size of the tube to be put back together is at the limit of the human eye without magnification.† To ensure the sutures are placed in the correct position, a microscope or robotic assistance is necessary.† Studies have shown a microsurgical vasovasostomy produces superior results to surgery done without magnification.

 

What are the alternatives to vasectomy reversal?

Several options exist for a patient not interested in vasectomy reversal.† Sperm can still be extracted from the man and used for in-vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI).† This still requires the man to undergo a procedure to remove the sperm after vasectomy.† Other options include adoption, donor sperm, donor embryo, or not having children/further children.

 

Vasectomy reversal has been shown to be more cost-effective than other approaches.† This procedure also allows couples to attempt to conceive in a ďnaturalĒ fashion, which some patients prefer.

 

What is the success rate for vasectomy reversal?

In experienced hands, vasectomy reversal is very successful.† The return of sperm to the ejaculate is expected in greater than 90% of men less than 10 years after vasectomy.† Factors that influence success include the time since vasectomy, age of the patient and partner, quality of the fluid found at the time of surgery, and the experience of the surgeon.† Even men up to 30 years after vasectomy have seen the return of sperm to the ejaculate after vasectomy reversal.† It is of critical importance to find the right surgeon to maximize your chances of success.

 

At the time of surgery, the fluid from the vas deferens on the testicle side is evaluated for the presence of sperm.† This fluid helps the surgeon to decide if a vasectomy reversal can be performed or a patient may need a vasoepididymostomy.† If sperm are not present, a vasoepididymostomy attaches the vas to the epididymis to bypass any other blockages that may have developed.† This decision is made while the patient is asleep, and the overall success rates with this approach are lower.† The epididymal tube is even smaller than the vas deferens, requiring exceptional care for repair.

 

What is the cost of vasectomy reversal?

At Ohio State University, the total cost for vasectomy reversal is approximately $8800.† This includes the surgeon fee, anesthesia fee, and facility fee.† Other advertisements for vasectomy reversal will only quote the surgeon fee and often have a higher total cost.† For those that qualify, please ask about the Ohio State Employee and Military discounts.† Insurance will often not cover this procedure.

 

What can I expect from the surgery?

Vasectomy reversal is generally performed at an outpatient surgery center.† It can be performed with local anesthetic or a general anesthetic.† The anesthesia used is very safe and most patients prefer to be asleep for the procedure.† With the use of a microscope, it is important for the patient to not move so that the surgery field does not change.† Most patients experience a similar discomfort after vasectomy reversal as they did with the vasectomy.† The majority of men are able to return to work after a few days with the only limitation of no heavy lifting for one week.

 

What else can I expect after surgery?

Recovery guidelines after vasectomy reversal are included on this website.† A copy of this information is also provided after the surgery.

 

For an appointment to discuss vasectomy reversal, please contact Dr. Gregory Lowe at (614) 293-4696.† We are pleased to serve Ohio, Pennsylvania, West Virginia, Indiana, Kentucky, and any individual interested in a trip to Columbus, Ohio.

 

Dr. Gregory Lowe

Ohio State University Medical Center

Columbus, Ohio

 

Helping couples achieve their goals for reproductive and sexual health.

Cramblett Medical Center

3rd Floor

456 W. 10th Ave

Columbus, Ohio 43210

To contact us:

Phone: 614-293-4696

Fax: 614-293-3565

E-mail: gregory.lowe@osumc.edu

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