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What is a vasectomy?
A relatively simple, surgical sterilization procedure for men where the vas deferens, a tube that transports the sperm from the testicles, is cut. A small segment of the vas is removed and the open ends of the vas are then closed with stitches, cautery or metal clips. The vasectomy is typically a variation on the same basic theme – damage to the vas and blockage of the flow of sperm.
What’s a Vasectomy Reversal?
This is a challenging surgery where the cut ends of the vas deferens are microsurgically reconnected in multiple layers under a high-powered surgical microscope. When completed properly, the procedure allows sperm to flow again through the vas.
Regardless of how many years have passed since the vasectomy, microsurgical vasectomy reversal in the hands of an experienced microsurgeon is proven to be the most logical and least expensive way to achieve pregnancy.
There are multiple techniques that the surgery can be preformed; however, the reversal will typically not require an overnight stay in the hospital. It usually takes 2.5 – 3.5 hours and needs anesthesia as well as an operative microscope.
Surgeons who preform the surgery are fellowship trained for a year or two longer than the traditionally Urology qualifications. The surgery is performed under anesthesia and with a microscope.
What determines success?
The single most important factor for vasectomy reversal success is the skill and experience of the microsurgeon. In fact, this is the only factor that you control. Every urologist has some knowledge or experience with reversals through their residency training or with an occasional reversal in practice. General surgeons as well as family doctors may also perform vasectomy reversals; however, they are typically not trained and have learned these surgeries as a hobby or because it is “their calling” or the find them “fun”.
As in everything, there will always be a small number of surgeons who have perfected the required skills and achieve the highest level of success. This is especially true for vasectomy reversals.
There are only a very small number of true urologic microsurgeons who have the experience and surgical expertise to offer patients the absolute best technical surgical procedure and the highest rates of success. Most of these urologists know each other and do not hesitate to provide other names, even locally, of surgeons they know to be well qualified.
Patients need to be aware when selecting a vasectomy reversal center. Some physicians will go on messaging boards and pose as patients hyping up their success rates. Anyone can create a slick website or make impressive claims that may not be true.
As the patient, you owe it to your investment in the procedure to find the physician that you are most comfortable with and can give you the best chance of success. Do not be afraid to ask how many surgeries the surgeon does, what their success rates are and if there is anyone else that they would recommend. Experience, reputation and doctor accessibility are other important elements that patients should seek to find in their surgeon.
I perform the most vasectomy reversals in the state of Indiana. Success rates tend to follow experience and this is no different in our situation. For example, men less then 3 years from the time of vasectomy, typically have a 99.5% chance of having success from their repair.