Insider Vasectomy Reversal Tips – What Every Patient Should Know in 2023

The intent of this page, by Dr. Sheldon Marks, is to explain how vasectomy reversal success rates are really the only goal when choosing a vasectomy reversal expert, and what insiders know about vasectomy reversals in 2023.

A doctor that performs an occasional vas reversal, even if he knows what to do, will simply not get the same success rate as a true expert who performs reversals several times each week. Vasal microsurgery requires years of specialized training and weekly practice to achieve and maintain critical and quickly perishable skills.

Even with this, the majority of vasectomy reversals are not performed by true experts but general urologists who perform an occasional vas reversal just a few times a year, if that (1). Just as surprising are the doctors who are not even trained in urology who believe their experience in other fields and desire alone to do vas reversals is enough to give them the skills and knowledge to provide the very highest level of technical success and care to their patients.

Experience matters
The success of a vasectomy reversal depends directly on the skill and expertise of the microsurgeon. Studies show that the highest results with the fewest problems with any technically challenging surgery are always seen with the most experienced surgeon. This makes sense for any challenging skill, whether microsurgery, flying a jet or building a bridge (2).  This is why it makes sense to seek out the most experienced urologic expert with the proven, published highest success rates.

Tools of the trade
A surgeon is only as good as the tools he uses. Having the right equipment, the top-of-the-line custom microsutures, a high quality surgical microscope and a consistent, experienced surgical assist – as we have at ICVR – truly improves every patients’ chances for success with the fewest complications.

The secret is in the art
The secret that separates out the top vasectomy reversal experts from the pack is not only that they have perfected the critical urologic skills and knowledge, but over the years they have developed the rare talent that allows them that degree of finesse – what many call the “art of microsurgery.” This is what only those true masters have developed with time and many thousands of vas reversals. At ICVR, Dr. Sheldon Marks and Dr. Peter Burrows have been blessed with one of the highest vasectomy reversal success rates, up to 99.5 % (3) for vas-to-vas connection in most men, because of their dedication to the art and science of microsurgery.

Decades of vas reversals
These techniques cannot be learned from a book, a video or picked up at a weekend course (4).  Just knowing what to do and actually doing it well are totally different things. Anyone can read about flying a jet but actually being able to fly a jet takes years of training and thousands of hours of time. In order to achieve the highest level of vasectomy reversal success rates, our doctors continue to perform vasectomy reversals every workday, one each day, Monday through Friday, every week for many decades.

ICVR is a full-time, vas reversal only“Center of Excellence”
Vas reversals are all we do. This is not a hobby or a side business. Vasectomy reversals are not just a piece of a larger urology practice (that also includes caring for cancer, prostate problems, stones, pediatrics, incontinence, etc.), which is so common today. ICVR is unique in that we are a full-time, vas reversal only practice dedicated to providing unsurpassed vasectomy reversal results and life long personalized care. Every single employee is here for one reason, one goal – to give every patient world class care before, during and after the precision, personalized vasectomy reversal.

Number of Cases, to a Point
At ICVR, Dr. Marks and Dr. Burrows have performed more than 7000 vasectomy reversals on men from every state in the US and more than 85 countries around the world. Finding a doctor that has performed many thousands of vas reversals is important…but be careful. Another secret is that it is not wise to want the doctor to be a high volume factory, trying to churn out as many vas reversals as they can in a day. That may look impressive to someone who doesn’t know, but is never in the interest of the patient or the vas reversal success rate. A common red flag are those doctors that brag about performing multiple vas reversals each day. Sometimes we perform a vas reversal on a patient just a few years out from vasectomy, expecting an easy 2 hour vas reversal only to discover any number of surprise challenges that require additional several hours of surgery or an unexpected vas-to-epididymal bypass.

There is just no way that men that have a 45 to 60 minute vas reversal can receive the dedicated focus, attention to detail and quality of care. Doctors that perform multiple vas reversals in a day cannot offer the same intensity of focus and level of care with the second, third or fourth surgery that day because of unavoidable fatigue from prior microsurgery cases. It is well known that are the first patient in a busy day of many vasectomy reversals may not likely receive the same undivided attention to detail as the doctor is under pressure to move fast to get to the other surgeries.

Of course, these points are all generalizations and there will always be some doctors with minimal training who have excellent results with many surgeries a day and others with years of training and experience who many not have as high a vasectomy reversal success rate as others. As always, the specifics of the care and success rates are unique to each doctor. We encourage all couples to dig deep and do the research to find the doctor that is best for them.

Here at ICVR, it’s about quality, not quantity.

We’d love to explain more. To have questions answered, learn about vas reversals or to schedule a free, no obligation consultation with one of ICVR’s two urologic microsurgeons, call us at (888) 722-2929 to learn how we can help couples reach their dream of children after vasectomy.

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

References:

1. Crain DS, Roberts JL, Amling CL.Practice patterns in vasectomy reversal surgery: results of a questionnaire study among practicing urologists.J Urol 2004;171(1):311-5.
2. Aikoye A, Harilingam M, Khushal A. The impact of high surgical volume on outcomes from laparoscopic (totally extra peritoneal) inguinal hernia repair. J Clin Diagn Res 2015;9(6):PC15-6).
3. 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.
4. Akanksha Mehta, Philip S Li. Male infertility microsurgical training Asian J Androl. 2013 Jan; 15(1): 61–66.