Costs of Vasectomy Reversal
By Philip Werthman, M.D., M.M.H., F.A.C.S.
Vasectomy reversal yields the highest success rates when it is performed as a microsurgical procedure. The inside channel of the vas is 0.3 millimeters in diameter, or the size of a pen dot. During a reversal, the surgeon has to put the two ends of the vas back together so that it is water tight and this requires placing six to eight microsutures (half the thickness of a human hair) inside this tiny channel. You can understand why using a microscope to enlarge the view of this channel is so important to the ability to precisely place the sutures; without this the doctor really can’t see what he is doing very well and that bodes poorly for a successful reversal, pregnancy and having a baby. A vasectomy reversal procedure is draining on the surgeon because it requires a high degree of focus and concentration while working under the microscope and that is why most reversal experts will only perform one reversal per day.
The appropriate equipment to perform a microsurgical reversal is very expensive and this procedure is best performed with the patient under general anesthesia. The reason is that when a patient is able to move around then it is very hard to precisely place the sutures. It is impossible to expect someone to hold still for two or more hours during the reversal.
Recently there has been a trend advertising the low cost vasectomy reversal, which is great, provided the patient understands what they are getting and how it is different from the best treatment alternatives.
There is also much more internet advertising for surgeons performing reversals, and it seems like everyone is an expert or world renowned, yet when you examine their resume, they haven’t even published a single research paper regarding reversals. To be classified as a true expert in any field, it usually means you have to spend at least 10,000 hours practicing. There are truly very few reversal experts who have been performing enough reversals for enough years to meet this definition.
So let’s examine the cost breakdown for a vasectomy reversal starting with the operating room. Most operating rooms charge by the time it takes to perform the procedure and for the equipment (fixed and disposable) costs. Operating rooms typically charge between $750-1250 per hour of procedure time, so if a reversal takes a few hours, then costs should run about $1500-$2500 for the procedure.
The custom double-arm 10-0 microsutures used to reconnect the vas cost $35 each (they are so small that they are made by hand). A standard reversal will require 12-16 for the inside layer and other sutures for the outside layer. That means the cost of using the most appropriate suture material is over $500 per reversal. It is possible to use fewer or cheaper sutures but this decreases chances of success although it cuts costs.
Next is the anesthesia fee. A board-certified anesthesiologist charges about $500 per hour. Nurse anesthetists charge less, but they can only give IV sedation, not full anesthesia, unless they are working under the supervision of an anesthesiologist. We discussed above why general anesthesia is best for reversal patients.
Last is the surgeon’s fee. It is hard to imagine a fellowship-trained, expert microsurgeon spending 2-3 hours of time in the operating room performing a highly technical surgery for less than $3500-5000, especially if they are only performing one reversal per day.
Given these very reasonable costs to perform a high quality vasectomy reversal, an expected total charge is no less that $6500-$7500. Remember also that doctors working in large cities have higher overhead than those in smaller or more rural areas. But usually you will also find that the most experienced surgeons in this field practice in large cities, because they need a large population to draw from to perform a high number of reversals.
With all this information you can see how not only can you get a low cost vasectomy reversal, but it can be done from a top professional who people all over the world trust.