What Are the 4 Types of Vasectomy Reversal Doctors (and the Smart One to Choose)?

This article, compiled by international vasectomy reversal authority Sheldon H. F. Marks, MD, reviews the four types of doctors that perform reversals, and the potential issues and concerns with those that are not true top experts.

There are four categories of doctors that legally perform vasectomy reversals, even if they are not trained. It can be challenging to find the real experts among so many that look great on their websites but are not actually trained or qualified. Remember what this is all about – having the highest vas reversal success rates to achieve the dream of children. The vasectomy reversal is simply the tool used to achieve that goal.

Of course, these 4 categories describe generally accepted levels of training, which many assume will then reflect on the skill and expertise of the doctors and so high success rates. We all know that this may or may not apply to individual doctors, as some of the most trained or published may not be technically skilled or may not offer state-of-the-art aftercare, while others with minimal to no training my be gifted, talented microsurgeons. It is up to each couple to do their own research, consider all the facts and then decide which doctor is right for their needs.

1. True Experts. These are the doctors to seek out – respected by other experts, experienced, trained urologists (1) that are true micro-surgeons who perform vasectomy reversals frequently, stay up-to-date attending fertility and specialty society meetings, publish papers in fertility journals, write textbooks and chapters and teach courses to other vasectomy reversal doctors. These are the doctors that most often give each patient the highest chances for success with the fewest complications. Among this group there are a very small number of elite urologists who have dedicated their entire practice to only vasectomy reversals. It is generally smart to limit one’s choices to a urologist in this “true expert” category.

2. “Wannabe” Experts. These are general urologists who promote themselves as vasectomy reversal experts and want potential patients to think they are the same as the true experts. They hope that if they have an impressive website and claim to be a “trained” microsurgical expert (when they really just had a regular urology residency often with with some training and experience), patients may incorrectly assume that they are a trained expert when they really are not. Many may provide lesser care, use old, easier techniques and have some successes but possibly with a lower vasectomy reversal success rate with potentially more problems that a true expert.

Just because a doctor can do a vasectomy reversal does not mean that he or she should.

3. Hobby Doctor. This category of general urologists will gladly do the vas reversal, explaining that they are “trained” and claiming they can do a great job, but only as small part of a busy general urology practice while they also care for everything else – prostate cancer, prostate enlargement, bladder tumors, erectile dysfunction, infections, stones and kidney issues. These are usually excellent, competent and knowledgeable urologists who are often just down the street, but they may only perform a few vas reversals a year (2). Some I have found quote the published success rates of true, high-volume experts as if they were their own. But without the specialty training and day-to-day hands on vasectomy reversal experience, some cannot not have perfected and maintain the hard-to-achieve skills and judgment to perform challenging microsurgical vasectomy reversals with the highest success rates.

4. Non-Urology Experts. Yes, these are doctors and surgeons, but they are not urologists. Urologists are the only doctors that have completed 4 years of an intensive urology residency then an additional 1 to 2 years of specialty fellowship training and experience in male reproduction and urologic microsurgery. There are some self-proclaimed “vas reversal” doctors from many medical specialties that have no significant training in male fertility, understanding male hormones and the technical skills and challenges, decision-making and aftercare of microsurgical vasectomy reversals. I understand their passion and motivation to perform vas reversals is admirable. However, some of these doctors incorrectly believe the desire alone to perform vas reversals with experience in an unrelated specialty, or from a weekend course or watching a few vas reversals somehow qualifies them to claim to be an expert in urologic microsurgery. It usually does not. Some of these essentially untrained experts have gone on to actually train other non-urologists. Of course, if a doctor does enough vas reversals, even with a lower success then they will have plenty of babies to brag about and happy families to sing their praises.

As one patient asked, would anyone trust an orthopedic surgeon to do their father’s heart surgery or an obstetrician (OB) to do their sister’s brain surgery? We have asked many of our patients who are surgeons in other fields, after experiencing what we have done, do they feel that they could or would it even be appropriate for them to perform vasectomy reversals? Their answer has always been a resounding no! They have consistently told us that there was nothing in their training or practice that would adequately train them to do vas reversals or manage routine and complex vasectomy reversal patients. They all said that vasectomy reversals and aftercare are well outside their scope-of-training and practice.

What these non-urology doctors don’t understand is that there is much more to vasectomy reversal success than throwing a few sutures. Staying up-to-date by attending specialty society meetings on critical aspects and advances in microsurgery, male fertility, medications and supplements that impact on sperm, sperm function and hormones are just as important before, during and after for the very highest success rates. Yet I worry that some of these doctors just don’t get it, and that’s the problem.

Every prospective patient considering all options has the right to know all this information in addition to what training that the doctors have had or don’t have so that they can make an intelligent, shared, informed decision about which doctor is best for their needs and resources. This information is only a small part of the information that couples should gather while doing their own research and vetting each doctor they are considering.

We are confident that, like more than 7000 others that have come to ICVR from every state in the US and more than 85 countries around the world, couples will quickly understand what makes a smart choice and why there is no reason to settle for anything less than Dr. Marks or Dr. Burrows, true world-class urologic microsurgeons.

Experience matters!

Call our professionals at (888) 722-2929 to answer any questions, for more information or to set up a no-cost, zero obligation phone, office, Zoom, Face Time or Skype consultation with Dr. Marks or Dr. Burrows at our full time, reversal only “Center of Excellence.”

This page was reviewed, edited and updated January 4, 2023 by Sheldon H.F. Marks, MD.

References:

1. Akanksha Mehta, Philip S Li. Male infertility microsurgical training. Asian J Androl. 2013 Jan; 15(1): 61–66.

2. Crain DS, Roberts JL, Amling CL. Practice patterns in vasectomy reversal surgery: results of a questionnaire study among practicing urologist. J Urol 2004;171(1):311-5.