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Vasectomy Reversal: Why You Need the Right Surgeon

Sheldon Marks, MD - Blogs
By Sheldon Marks, MDBoard-certified urologistFebruary 6, 2017
From the WebMD Archives

Every year, one out of every 20 men who have had a vasectomy change their minds and want a reversal to restore their fertility. Sometimes it’s because a man has a new wife or it may be because a couple decides they want more children.

The good news is, even if it has been up to 20 years or longer since your vasectomy, your chances for success can still be excellent – as high as 99.5% – if you seek out a top expert.

Because a reversal is one of the most technically challenging surgeries in all of medicine, your best results will always be with the most experienced doctor (which often requires travel).

So how do you know that a doctor has the expertise you’re looking for? Here are some specific questions to ask:

How frequently do you perform the procedure? Look for a urologist that performs more than a few a year. Some top experts perform 2 to 5 reversals every week and so achieve higher success. And be sure they only do one reversal a day – this will allow them to focus all their energy and concentration on your reversal without being preoccupied with finishing up in time for the next surgery, as well as insure that they won’t go into your surgery fatigued from earlier cases.

How long the surgery will take? A correctly performed reversal takes about 2.5 hours. Watch out for doctors that do quickie reversals in 45 to 60 minutes. Just as bad are the doctors that take 4 to 6 hours or more.

Are you a urologist? Urologists are the only doctors that are trained in male fertility surgery. Surprisingly, many doctors advertise that they are experts, but don’t have the training.

Do you use a surgical microscope? Because a reversal requires extreme precision, and because your vas deferens is the size of a single strand of spaghetti, true experts will only use a high-powered microscope – not magnifying glasses.

Do you look at the vasal fluid under a microscope? This is essential to make sure that the vas is open or if there is deeper blockage.

If no sperm are seen, do you perform an epididymal bypass? Since many men have a deeper obstruction in their vas that makes a traditional vas-to-vas procedure ineffective, your urologist should be able to perform vas-to-epididymal bypasses (connecting the vas to the tube that carries sperm to the testicle) when needed.

Do you perform redo reversals? On rare occasions reversals can scar up, though usually with less experienced surgeons – either because they don’t have the skills required or they didn’t look at the fluid and so ended up performing the wrong procedure. Top experts often have a busy practice fixing other doctors’ failures.

This is why it makes sense to do your research and seek out the best expert you can, the first time.

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About the Author
Sheldon Marks, MD

Sheldon Marks, MD, is director of the International Center for Vasectomy Reversal in Tucson, one of the leading specialty centers in the world. Dr. Marks is a best-selling author and frequently teaches other urologists about advances and techniques with vasectomy reversals. He has been writing for WebMD since 2005.

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