About Vas Reversals
In September of 1988, Bill Gothard and I discussed the possibility of creating a ministry to aid the alumni of the Institute of Basic Youth Conflicts, in reestablishing the opportunity for pregnancy at a reasonable cost. The surgeon's fee for this procedure ranges from $4,000.00 to $15,000.00 plus operating room fees. Bill and I both agreed that this was beyond the means of most families. I have reduced my fees to make the procedure more affordable to families desiring the blessing of more children.
The total charge for a vasectomy reversal (vasovasotomy) done under a local anesthesia is $3000.00. After 4 months you should have a semen analysis performed. If sperm in the ejaculate is not achieved, I will repeat the procedure with local anesthesia for a total cost of $2,500.00 within 1 year of your initial surgery.
There is a phenomenon that occurs occasionally after 10-15 years of obstruction called an epididymal blowout. This means that the vas is obstructed at 2 levels; at the vasectomy site and by rupture of the tube in the epididymis. Both require repair for a successful outcome. The surgeon cannot make the decision by age of vasectomy but by examination of the semen. If there are no sperm and the semen is pasty rather than liquid this is very suggestive that additional surgery will be required. Both procedures can be accomplished at the same time.
A free standing operating room was established in my office building to avoid the costly expenses of a hospital or surgicenter based procedure. The other advantage is that we can seat your wife at the head of the table to also minister to you.
The thrust of this program has been directed to Christian families desiring the blessing of more children, but it is not restrictive in any manner. The same costs are offered to any family, despit race, color, or religion.
I have been involved in the treatment of fertility since 1971. Vas reversals have been a special interest to me for several reasons: (1) the joy of participating in the good news of new children; (2) following God's principles of raising up Godly seed; (3) and the need for it personally.
Technique: I do a microscopic repair of the vas deferens using a Zeiss OPMI-MDM operating microscope using a 10-0 nylon suture (delicate as a spider's web). The repair requires 12-15 stitches. The goal is to create direct and careful alignment of the lumen of the two ends of the vas and a watertight closure.
The technique for VE (vasoepididymostomy) is a microscopic invagination of the epidymal tube into the lumen of the vas deferens using 10.0 nylon sutures.
If you have surgeons who state they do this for less money, you would be prudent to check their technique. Ask these specific questions; (1) size of suture should be no larger than 9.0 or smaller than 10.0 nylon; (2) what type of operating microscope and power of magnification. If they do not use an operating microscope , then you are not getting a state of the art procedure and you are signing up for a greater failure rate and probably not showing the most of prudent use of your health dollar. Cheap is not always a good deal. I have had to repair many vasectomy reversals done with large sutures and low magnification (optical loupes).
Using this technique, there has been a 92-95% success rate of having sperm in the ejaculate post operatively, and a 50-60% pregnancy rate. This compares favorably with other large reversal centers across the U.S.
When you sought a vasectomy for sterilization, you were probably informed of the potential for complications. The same list of complications still exist for the vas reversal, which are as follows, in order of frequency; (1) swelling; (2) pain; (3) hemorrhage; (4) infection; (5) testicular atrophy; (6) loss of testicle; (7) loss of life.
You must understand, "loss of life" I have never seen, but I did read about it in the world literature. Pain and swelling are common, but quickly disappear and hemorrhage and infection are rare in my practice. Out of greater than 3000 reversals, I have had to sacrifice three testes for post operative hematomas, and infection which compromised the blood supply. Happily, I can say all men now have new reversal babies to compensate for their loss of a testicle.
It is my policy to interview you the morning of the surgery and I will answer any questions that you may have. You will be dismissed the day after surgery; however, about 1/4 of the patients choose to return home the same day. I prefer you come as a family because you wife will play a significant role in your convalescent care. However, their have been times when the husband has come alone and this has worked out satisfactorily.
My operating schedule for reversals is Monday through Thursday mornings. We require a $500.00 deposit, which is non-refundable, to schedule your case. The vasectomy reversal on the average is a 1 1/2 hour procedure. I usually only will do two reversals a day. The surgery is done as a day patient under local anesthesia. The day of surgery, you should bring a bottle of Advil or Nuprin (Ibuprofen), snug fitting underwear, and shave as did for your vasectomy.
If I can be of any further assistance to you please do not hesitate to contact me. My office phone is (830) 625-2229, you may write to me at: 1619 E. Common St. Bldg B-202 , New Braunfels, Texas 78130. I will be happy to talk to you.
Or, you can e-mail me at:
Warmest Regards,
Cary L. Leverett, MD, F.A.C.S.
