Insider Secrets of Discount Vasectomy Reversal Doctors
This review, written by leading authority Sheldon Marks, MD, discusses some of the “insider” secrets that some doctors may use to offer discounted vasectomy reversals.
Secrets of the Discount Vasectomy Reversal Doctors
There are many ways that doctors may cut their costs so they can offer low cost vas reversals. It is important to know that to correctly perform a microsurgical 3 to 4 multi-layer vasectomy reversal, there are fixed costs that we believe simply should not be bypassed – these include a high quality, high power surgical microscope, specialty vas reversal designed microsutures and micro-instruments specifically designed to minimize trauma and injury to the vas, experienced nurses and surgical assistants for each patients safety, the type of sedation and the appropriate 3 to 4 multi-layer surgical technique as well as unlimited continued after-care and andrology lab services for as long as needed – all necessary to provide the highest vasectomy reversal success rates. Does it make sense to use a doctor that chooses to ignore these to be able to have a lower cost?
Of course, these are generic thoughts and do not reflect on the skill, expertise or results of individual doctors. I can promise that there are some doctors with minimal formal training and who do not follow what I teach and believe to be important who get very high vasectomy reversal success rates and there are others who have had years of additional training and follow all the guidelines yet achieve lower success. Each doctor is different. It is recommended that every patient to do the necessary research so that they can make an intelligent, informed shared decision based on what they learn and which doctor is best for them.
“Men Get What They Pay For”
I keep hearing this from our patients that had a failed vas reversal elsewhere before a redo vas reversal here at ICVR. How much is saved if the vas reversal doesn’t work or if there are complications and so couples do not achieve their dream of having children after a vasectomy because they chose a discount or less expensive doctor? The following is a review of some of the issues that we have been told by patients about failed vasectomy reversal experiences elsewhere, before each came to ICVR for a redo vas reversal.
Sedation Nightmares
Some doctors sit by themselves, alone, performing vas reversals without anyone administering sedatives throughout the surgery or monitoring the patient’s vitals, comfort or safety. We frequently hear horror stories of some doctors that simply give their patients a pill or handful of pills as the total sedation, not knowing how it will be absorbed by that individual, whether it might be too much or not enough or not last long enough (1), and so they then have to provide another Valium to chew when the pain gets too bad.
Safety
There may be some vas reversal doctors that may put their patients at added risk because they do not have professional nurses, critical support staff as well as important safety and vitals monitoring equipment present during and after the vas reversal. What if there’s a complication or medication reaction during the surgery?
We choose to have a team of highly experienced, trained senior medical professionals, as we would want for ourselves or our families if we are have surgery. Not having support staff may be fine for. most patients, to get by until there is a problem or question during or after the vas reversal. Every member of our ICVR surgery team is trained and up-to date with ACLS (Advanced Cardiac Life Support) certification.
The Facility
The vasectomy reversal should be performed in a state-of-the-art operating suite designed, built and equipped for vasectomy reversals as we have here at ICVR. There are some “experts” that surprise their patients when they discover that the OR is really a converted garage, living room or a fancy office procedure room that they call an OR. Others perform the vasectomy reversal at a surgery center or hospital where there is constant pressure for the doctor to go fast to make room for the next surgery. At many of these institutions, the doctor often has no say or control about which microsutures, specialized instruments or microscope they can use.
Surgical Microscope…or Not
I have heard of some doctors that may not use a high quality, high-powered surgical microscope such as our Leica microscope to perform a vas reversal. Instead, they may use old style magnifying glasses (called Loupes) which has been proven to be inadequate decades ago or a cheap, training microscope not designed for the precision and magnification necessary for a correctly performed personalized vas reversal (2,3,4).
Follow-Up Care
Many doctors do not understand the need for or offer important follow-up care. If patients have any issues or questions after the vas reversal with some doctors, then they are usually on their own as many doctors do not provide follow-up care. The doctors must think that each patient “paid for the vas reversal” and nothing else. Because these doctors don’t understand the importance of close monitoring of sperm counts and medical care for low or dropping results, these doctors commonly offer no or substandard advice, telling their patients incorrectly “go try to get pregnant and if it doesn’t work then get a sperm count in 6 to 12 months” rather than the correct guidance to check semen analyses every 4 to 6 weeks with prompt medical management if the counts are not good or are decreasing (5). We have also heard from patients that when they reach out to their vasectomy reversal doctor they were told that they should see a local doctor for follow-up care and management.
Quickie Vas Reversals
A correctly performed vasectomy reversal takes about 2 to 2 ½ hours. In my mind, there is just no way that I can understand how anyone can do a correctly performed multi-layer precision vasectomy reversal in an hour or less. Others may choose to perform multiple vas reversals each day, rather than the one-a-day approach of most experts which eliminates the pressure to rush to move fast to get to the next surgeries or fatigue from earlier vas reversals.
Technique – Do They Use the most Current, Advanced Technique or a Cheaper, Faster Abandoned Old Technique?
Many of these doctors don’t perform a true 3 to 4 multi-layer state-of-the-art vas reversal or don’t even use the finest microsutures. Instead, they are satisfied to use much thicker sutures with an outdated one or two layer reverse vasectomy technique. Some may even announce they don’t look at the fluid microscopically, which is proven to be absolutely necessary to know what technique needs to be done. Many won’t even perform the epididymal bypass, even though all top experts will explain that this is the correct procedure to perform when there is deeper blockage (6). Others will look at the vasal fluid but then only do the easier vas-to-vas connection even when no sperm are seen and a vas-to-epididymal bypass is the correct technique.
Highest Vasectomy Reversal Success Rates – the Bottom Line
When a vasectomy reversal is performed correctly by a true master using the right tools, then the chances for the highest success rates are achievable – success as high as 99.5% here at ICVR for vas-to-vas connections (7). This higher success translates to a higher chance for achieving a couples dream of having a baby together after a vasectomy.
Why settle for anything less?
To find out more about ICVR or precision microsurgical vas reversals, call (888) 722-2929 . our team of senior professionals can answer any questions and when ready, set up a no-cost consultation with one of our two microsurgeons for phone, Zoom, Face Time, Skype or in office.
This page was reviewed, edited and updated January 4, 2023 by Sheldon Marks, MD.
References:
1. Marks SHF. Vasectomy Reversal: Manual of Vasovasostomy and Vasoepididymostomy. New York; Springer; 2018.
2. Gopi SS, Townell NH. Vasectomy reversal: is the microscope really essential? Scott Med J 2007;52(2):18-20.
3. Jee SH, Hong YK. One-layer vasovasostomy: microsurgical versus loupe-assisted. Fertil Steril 2010;94(6):2308-11.
4. Safarinejad MR, Lashkari MH, Asgari SA, Farshi A, Babaei AR. Comparison of macroscopic one-layer over number 1 nylon suture vasovasostomy with the standard two- layer microsurgical procedure. Hum Fertil (Camb) 2013;16(3):194-9
5. Perkins A, Marks MB, Peter Burrows PJ, Marks SF. Anti-Inflammatory Treatment for Asthenozoospermia Following Microsurgical Vasectomy Reversal. Presented at American Society of Andrology 38th Annual Meeting, San Antonio, Texas: April 13-17, 2013.
6. Chawla A, O’Brien J, Lisi M, Zini A, Jarvi K. Should all urologist performing vasectomy reversal be able to perform vasoepididymostomies if required? J Urol 2004;172(3):1048- 50.
7. Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Angled vas cutter for vasovasostomy: technique and results. Fertil Steril 2014;101(3):636-639.