Dr. Marks Answers Questions about Vasectomy Reversals (video transcript, edited)

Our success rate here at ICVR is some of the highest in the world. If we can do a straightforward vas-to vas connection, we can see a 99.5% success (Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Angled vas cutter for vasovasostomy: technique and results. Fertility and Sterility.2014;101(3):636-639).

Do the number of years from vasectomy to reversal make a difference?

The number of years from vasectomy to reversal does usually not make a difference. We actually reviewed our numbers and showed that it makes no difference at all three years ago and recently another study confirmed that the number of years from vasectomy to reversal (Mui P, Perkins A, Burrows PJ, Marks SF, Turek PJ. The need for epididymostomy at vasectomy reversal plateaus in older vasectomies: a study of 1229 cases. Andrology 2014;2(1):25-9) when the reversal was performed at a top center such as ours makes no difference at all.

Are vasectomy reversals covered by insurance?

Reversals are not usually covered by insurance. The good news is that ICVR we offer a no surprise, all-inclusive package so that our patients don’t have to worry about hidden fees coming in later on and the same time we also offer in-house, no interest payment plans.

Is a vasectomy reversal painful?

Vasectomy reversals at our center are not painful. In fact, most men don’t even ask for a single Tylenol post-op. We do a lot of re-do reversals, we hear horror stories from elsewhere but because of the technique we use mild conscious sedation and plenty of long-acting numbing medicine, most of our men are thrilled, in fact surprised, how easy the reversal is.

What if I have questions after my reversal?

If men have questions after the reversal, what makes ICVR special is that each doctor provides their own personal cell phone number. Men also get our head nurse’s personal cell phone number and our head andrology lab director’s cell phone number so that if they have questions – call us directly. We don’t use answering services. We don’t have residents or covering physicians: we do it all.

What kind of anesthesia do we use?

At ICVR we use a mild conscious sedation technique using micro pulse minimal medication. That way patients don’t have to worry about the toxicity and side effects of more dangerous and deeper general anesthesia (Harris M, Chung F. Complications of general anesthesia. Clin Plast Surg. 2013 Oct;40(4):503-13. Devereaux, P.J., Xavier, D., Pogue, J. et al, Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011;154:523–528).

How many reversals has the doctor done?

At ICVR, we’ve performed more than 5,000 (now more than 7000 since the video was recorded) vasectomy reversals over the past 25 years. What makes this especially notable is that each doctor limits his practice to no more than one reversal a day that way each patient gets our full and undivided attention. We’re not rushing off to do a second case nor we’re fatigued from an earlier reversal.

What’s the recovery like after the reversal?

Recovery after the reversal here at ICVR is surprisingly easy for most men. In fact our biggest problem is getting men to take it easy with lots of ice for the first few days because they’re going to feel so good that they’re going to want to get up and start resuming normal activity. Most men, in fact, don’t even take a single Tylenol afterwards.

What are the benefits to having an all-inclusive comprehensive reversal center?

One of the benefits of having an all-inclusive comprehensive reversal center is that everything is included. And that also includes during the surgery; we analyze the fluid with our andrology team, we take digital photographs throughout as well for the patient’s record. If men want to bank sperm, we can do that as well as follow-up care so our andrology people and our entire team is there for our patients if they have questions during the reversal, after and for months even years later, if they should (Schrepferman CG, Carson MR, Sparks AE, Sandlow JI. Need for sperm retrieval and cryopreservation at vasectomy reversal. J Urol. 2001; 166:1787–9).

What other qualities make ICVR so unique?

What makes ICVR unique is that we understand that it’s more than just medical care; it’s about taking care of patients as a family, understanding it’s about children, after all we are here to “Make Men Dads AgainTM”.

What accolades and awards have the doctors and ICVR obtained?

At ICVR, Dr. Burrows and I are very honored to have received a number of awards including many Top Doctors awards where we’re nominated and voted on by our peers. In addition to that we actually travel and teach courses, hands-on micro surgery classes and lecture to other doctors about how to perform vasectomy reversals. In this past year, I was very excited that a manufacturer of an instrument that I invented actually named this after me; making it available to other urologists so that doctors that perform reversals can actually use this instrument and improve their chances for success.

Why did I choose this profession?

People always ask me how I chose this profession. Why I do vasectomy reversals? And the answer to me is very simple – because it allows me to help “Make Men Dads AgainTM.”

For more information about vasectomy reversals, the International Center for Vasectomy Reversal, or to answer questions specific to each person’s care, please call 888-722-2929.

This video transcript was reviewed, edited and updated January 4, 2023 by Sheldon Marks, MD.