Dr. Larish performs vasectomy reversal micro-surgery at Gramercy Surgery Center. This state of the art facility utilizes the most modern and advanced high quality surgical microscope, micro-instruments and the most highly trained nurses and support staff.
Dr. Larish has helped many men successfully reverse their vasectomies.
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In general, a vasectomy is performed when a man decides that he no longer wants to be able to have children. However, people and circumstances change over time, and there are several factors which may affect your decision and cause you to have a change of heart in the future. If you have had a vasectomy in the past and have recently decided that you’d like to become a father, you may want to consider undergoing a vasectomy reversal procedure. Read on to find out more about what to expect from this procedure.
A vasectomy reversal procedure can be done using one of two different methods. The first and most popular option is through vasovasostomy, a procedure where the surgeon sews the tubes, or vas deferens, back together from the testes to the penis. The vas deferens transports sperm from the testes to the penis, where it is ejaculated during sexual intercourse. The second method is known as vasoepididymostomy, which is more complex and involves the vas deferens being attached to a small organ at the back of each testicle, which contains sperm. The latter option tends to be reserved for men who are unlikely to experience success with vasovasostomy.
Vasectomy reversal procedures are typically carried out in a hospital or clinic. During the procedure, you will be given anesthesia to ensure that you are not conscious throughout. The entire procedure will usually last for around two to four hours, and most men will return home the same day. In general, the recovery takes around two weeks, although you should allow around six weeks to resume life as normal.
If you’ve had a vasectomy in the past but have had a change of heart regarding your family life, you may want to consider having the procedure reversed. Vasectomy reversal is usually considered by men who have changed their mind about becoming a father or adding to their family, along with men who have experienced the loss of a child after undergoing the procedure. A small percentage of men may find vasectomy reversal useful for relieving pain in the testicles and groin area caused by a past vasectomy.
If you’ve had a vasectomy in the past and want to turn back time, call us today at (646) 862-5500 to book a free consultation with one of the best urologists in NYC.
For many men, decisions previously made can be undone. If you’ve had a vasectomy, you may wish to reverse it. The goal of this procedure is to reverse what occurred during the vasectomy, a surgery in which semen is unable to be ejaculated from the penis. That procedure does not change a man’s ability to produce sperm. As a result, for some men, it is still possible to conceive children by reversing the previous procedure. That is what vasectomy reversal is.
In a vasectomy, the pathway by which sperm travels is cut. This is called the vas. When it is cut, sperm cannot get into the semen that is produced. As a result, sperm cannot travel out of the penis during ejaculation. However, vasectomy reversal may help to reconnect the two ends of the vas to allow for sperm to flow successfully through the pathway again.
If you are a man that has had a vasectomy and you wish to conceive children, potentially, in the natural way, you will need to consider a reversal. Once the tubes are rejoined, the process is considered normal. However, there are some limitations to this procedure and it does not work in all cases. For many men who wish to start having a family again, such as in a new marriage or later in life, it may be possible to do so.
There is no doubt this is a big decision to make. The procedure itself is considered safe for most men. And, while it is not a very invasive procedure, it is a delicate one that may not be effective. If you are considering having a vasectomy and there is any chance in the future that you may want to have children, it is best to avoid vasectomy in the first place. However, if you have already had it done, it may be possible to reverse it.
Vasectomy reversal isn’t the type of procedure you should take lightly. It is best to sit down and talk to your doctor about it, why you want it, and what your chances of success are, as these can differ from one person to the next. When you call our offices to schedule a consultation with the best urologist in New York City, you’ll gain the information and insight you need to make the best decisions for your future needs.
Erectile dysfunction is an inability to achieve and sustain an erection that is adequately firm to engage successfully in sexual intercourse. Erectile dysfunction may affect half of American men between the ages of 40 and 70. Occasional erection difficulties do not constitute erectile dysfunction, and are experienced about 20% of the time by all men, but inability to achieve and maintain a firm erection 50% or more of the time signifies erectile dysfunction.
Erectile dysfunction can be caused by a variety of physical or psychological problems. Many times, erectile dysfunction is caused by diseases that affect the blood flow to the penis, which is how an erection takes place. These chronic diseases, like atherosclerosis, diabetes, and vascular disease, are responsible for 70% of cases of erectile dysfunction. Neurological causes of erectile dysfunction include things like Parkinson’s disease, multiple sclerosis, or as injury to the spinal cord. Some men experience erectile dysfunction after nerves and blood vessels in the pelvis are damaged during prostate or bladder surgery.
Peyronie’s disease, an inflammatory disorder that results in scar tissue in the penis, can cause erectile dysfunction. Between 1% and 4% of all men with may have some degree of Peyronie’s disease, which usually occurs in middle age.
Alcoholism and cigarette smoking are both associated with erectile dysfunction. Sometimes, men with erectile dysfunction have low levels of testosterone, which can be easily corrected. Psychological problems, like stress or depression, can result in erectile dysfunction. If you are experiencing an inability to achieve or sustain an erection that is preventing your from enjoying sexual intercourse, you should call Dr. Larish, a top New York urology doctor, today.
If you are experiencing problems achieving or maintaining an erection, the first step in treatment is finding the cause. Dr. Larish will take an extensive medical history at your consultation, which include questions about physical, social, and psychological aspects of your life. He will also ask questions about stressors, habits, and your relationship with your partner. After obtaining a thorough medical history, Dr. Larish will complete a physical examination. A simple exam of the penis can reveal many clues through characteristics like sensory responses of the penis to touch, pulses, and hair growth patterns. Unusual characteristic of the penis may reveal a problem like, for example, Peyronie’s disease.
Dr. Larish will also obtain blood tests that measure hormone levels, blood sugar, cholesterol, thyroid function, and function of the liver and kidney, to search for conditions that impact normal erectile function. An ultrasound examination will evaluate blood flow to the penis and any leaks from the veins or signs of atherosclerosis. You will be tested to see if you have nocturnal erections, and there are several highly specialized tests that can be performed by an experienced urology doctor to check the state of the blood vessels in the penis, if further investigation is required.
Depending upon the results of your examination and diagnostic tests, there are a variety of treatment options available for the treatment of erectile dysfunction. You can be successfully treated for your problem, so you can once again enjoy sexual intercourse.
Millions of couples with fertility problems have been able to conceive with the help of assisted reproductive techniques. These technologies require harvest of both sperm from the male partner and the eggs from the female partner to succeed. After collection, the sperm and egg are examined to ensure that they are healthy, and then, one of four techniques is utilized to fertilize the egg.
When a couple decides to undergo in vitro fertilization, she typically takes hormones to stimulate production of eggs. After the eggs are harvested, they are placed in a Petri dish with sperm, and natural fertilization can then occur. After fertilization, between one and three healthy embryos are transplanted into the woman’s uterus, through the cervical os (opening).
This procedure mixes the sperm and eggs, which are then placed into the woman’s fallopian tubes, using a fiber-optic laparascope. The procedure is performed through small incisions in the low abdomen of the female partner, and it has a higher success rate than in vitro fertilization. However, it does require that the male partner has an adequate sperm count, and the woman must have normal fallopian tubes. The advantage of this procedure is that multiple eggs are not fertilized, so ethical concerns about transfer or creation of an embryo are avoided.
A zygote is a fertilized egg, and in a ZIFT procedure, the fertilized eggs are placed directly into a woman’s fallopian tubes.
This procedure relies upon fertilization of each egg with a sperm, after collection of both eggs and sperm. The fertilized egg is subsequently transferred to the uterus, as with IVF. The microscopic technique used in this procedure may render it more effective than IVF, but it is also more expensive.
Success Rates Associated With Assisted Reproduction Techniques
The CDC reports that in 2009, 37 percent of assisted reproduction technique procedures led to pregnancy, with 30 percent leading to a live birth.
Vasectomy reversal has a higher success rate than in vitro fertilization or assisted reproduction techniques. The rate of success for reversals is between 40 percent and seventy five percent, and it appears that the length of time since the vasectomy may correlate negatively with the success of a reversal.
If you have had a vasectomy, and now are considering a reversal in order to conceive your own genetic child, you should call Dr. Larish, New York’s leading vasectomy reversal doctor, for an evaluation today. Dr. Larish can advise you of the best available option to restore our fertility. Call 646-862-5500 to schedule a consultation.
If you decide to reverse a previous vasectomy, you should be aware that it is a more complicated procedure than a vasectomy. A vasectomy reversal procedure usually requires the use of general anesthesia, and may take place in an outpatient surgical center or in a hospital. If the procedure is not successful, you may have to pay for the repeat procedure again, should you decide to have a second attempt. These are all reasons that it is particularly important for you to look for a skilled vasectomy reversal surgeon. Dr. Yaniv Larish is the best vasectomy doctor in New York, and performs many successful vasectomies and reversals for his patients.
Experience and training are two key indicators of potential success when you are deciding upon the right doctor for your vasectomy reversal. Although a general surgeon may be able to perform a vasectomy reversal procedure, a board-certified urology specialist has additional training through fellowship in male genitourinary surgery. If you are looking for a surgeon with specialized microsurgery training and a sound knowledge of male infertility issues, you should choose a board-certified urologist for your vasectomy reversal.
Microsurgery is similar to other kinds of surgeries that use a hand-held microscope loupe, but intraoperative use of a surgical microscope has been shown to result in better outcomes in successful vasectomy reversal rates. Doctors who have had experience with vasovasostomy and epididymovasostomy surgeries are generally more able to successfully complete a vasectomy reversal, and since the surgeon will not know which procedure you require until you are already in surgery, it is extremely important to choose a doctor with experience in both procedures.
It’s important to have reasonable expectations when you undertake a procedure like a vasectomy reversal. Your doctor will tell you that it will take several sperm cycles before your semen reaches the optimal sperm count for conception. If you are hoping to quickly achieve conception, then you may want to consider other options, like sperm retrieval and in vitro fertilization.
There are several tips that you can take in order to more rapidly return to fertility. These include simple measures like eating a healthy diet and avoiding stress. Your doctor will also tell you to avoid certain things that might result in a lower sperm count, including exposure to heat by sitting in a hot tub or by resting your hot laptop near your testicles.
If you have had a vasectomy and have made the decision to try a reversal in order to regain your fertility, you will want to be certain to have all possible factors working in your favor. By choosing New York’s best vasectomy doctor, Dr. Larish, you will have an excellent opportunity to successfully reverse your vasectomy and to achieve conception with your partner. Call 646-862-5500 today for your consultation with Dr. Larish, New York’s top vasectomy reversal doctor.
The length of time since a vasectomy is probably the most important factor when trying to estimate the potential for a successful vasectomy reversal procedure. Because there are several important factors that must be taken into consideration, just this one factor will not necessarily determine your success, but research does suggest that the greater the amount of time that has elapsed between the vasectomy and reversal, the lower the chance of successful restoration of fertility.
The skill and expertise of the urologic surgeon is important, and this includes the surgeon who initially 
performed the vasectomy as well as the surgeon who will attempt to reverse that procedure. The procedure requires special training and experience using microsurgical techniques with a surgical microscope that allows good visualization of the tiny (0.4 millimeter) vas deferens during the operation. Dr. Yaniv Larish is New York’s best vasectomy reversal doctor, and has the experience to give you the best opportunity for a vasectomy reversal.
Restoration of Sperm Count
It will take at least two cycles of sperm production to produce a normal amount of healthy and motile sperm in the semen. Patients will usually have a semen analysis at three to six months after their procedure for vasectomy reversal. Things that can increase the likelihood of successful healthy sperm production include good nutrition and avoiding heat or trauma to the testicles, where sperm is made. Men who have previously had a healthy sperm count are more likely to have a sperm count that returns to normal after their vasectomy reversal. Normal sperm counts vary between individuals, but below a certain percentage of healthy, motile sperm, conception may be difficult.
If you are interested in vasectomy reversal, a consultation with Dr. Larish, New York’s top vasectomy reversal specialist, can help you decide if the procedure is likely to result in restored fertility and conception. While no one can determine the exact outcome before the procedure, it is worthwhile to determine if you have any problems that decrease the likelihood of your success. Call Dr. Larish today at 646-862-5500 for your appointment for a vasectomy reversal consultation. A careful review of factors that impact the likelihood of return of your fertility will allow you to make an informed decision about whether or not you should attempt a vasectomy reversal.
Although a vasectomy is considered a permanent method of birth control, if you have had a vasectomy in the past you may have reasons to consider a reversal of this procedure. There are many good reasons to decide to reverse a vasectomy, including remarriage, or the desire to have another child after the loss of a child. If you have had a vasectomy and circumstances of your life are causing reconsideration of that decision, don’t despair – there are options available to restore fertility. Dr. Yaniv Larish , the best vasectomy reversal doctor in New York City, can discuss the many options for reversal of your vasectomy to restore your fertility.
When you have a vasectomy, the sperm duct is cut, preventing fertility. A sperm duct, known as the vas deferens, is located in each side of your scrotum, and can be reconnected. There are other surgical options available, including the connection of the sperm duct to the epididymis, a small testicular organ where sperm mature. There are a number of procedures available to restore fertility after a vasectomy, and an experienced urologist, like Dr. Larish, the best vasectomy reversal doctor in NYC, can guide you to the best option for your situation.
Vasectomy reversal is usually performed in an outpatient clinic, and is performed under general anesthesia, depending upon the surgeon and patient preference. Typically, a small opening on each side of the scrotum will allow the urologist to remove the scarred portions of the vas deferens that result from a vasectomy. A fluid sample will be obtained by the urologist to ensure that sperm is present, and that there is no blockage between testicle and sperm duct, or in the epididymis. If sperm is present, the ends of the cut vas deferens can be re-connected to allow the sperm passage, and this procedure, called vasectomy, restores fertility. If there is no sperm in the fluid, other approaches to restoration of fertility by vasectomy reversal are utilized. It is important to find an experienced top vasectomy reversal doctor for your vasectomy reversal. Dr. Larish is a top vasectomy reversal doctor in New York City, and has successfully treated hundreds of men who have decided to reverse a previous vasectomy.
Dr. Larish, a top New York vasectomy reversal doctor, can use a microsurgical approach, with a high-powered microscope to magnify the structures of the vas deferens up to 40 times the original size, allowing him to restore fertility to 70 to 95 percent of patients who have had a previous vasectomy. If you are considering a vasectomy reversal, call us today at 646-862-5500 to schedule your consultation with Dr. Larish, the best vasectomy reversal doctor in New York City
Here at our urology clinic here in New York City, we have performed many successful vasectomy reversals where our patients have experienced a return of sperm to their ejaculate within two months after the procedure and healing period. The vasectomy reversal rates are usually quite high, but there is always the chance that it may take up to 12 months to report a stable semen analysis test result. In rare cases there was no return of sperm at all, these of course are considered unsuccessful cases.
The successful results of a procedure are affected mainly by the quality of the previous vasectomy. Damaged sperm can also contribute to the unsuccessful production of viable sperm. Studies also substantiate that the more recent the vasectomy, the more likely a patient is to have a successful reversal, after ten years the chances for success is minimal.
Circumstances for a successful vasectomy reversal may be hindered by other factors and should be carefully considered before deciding on the procedure. These factors may include an elevated follicle stimulating hormone level, which may be a sign of testicular failure. In addition, factors like testicular degenerate, infertility of the female partner and possible complications during or after the vasectomy reversal may affect your ability to conceive after the procedure.
Before deciding whether you would like to have a vasectomy reversal, your female partner and you will need to make an appointment to discuss the pros and cons of having a vasectomy reversal. So call us today to schedule an appointment with the best urologist in New York City and get the answers you need.
You aren’t alone when it comes to the question concerning vasectomy reversal approximately 10 percent of men who have a vasectomy change their minds and want their vasectomy reversed? Have you gone through a divorce and remarried or has your wife and you changed your mind and wish to have another baby? Then the answer to your question; can a Vasectomy be reversed- is yes it can.
The best way to make a decision about a vasectomy reversal is to consult your vasectomy reversal surgeon in New York City- he can help you both make the right choice.
Usually a vasectomy is considered a permanent method of birth control, but it isn’t a total end to the possibility of being versed and giving you back your fertility. Vasovasostomy is the clinical name for just one of the procedures used to reverse a vasectomy; it is a vasectomy reversal technique.
With a Vasovasostomy your urologist reconnects the vas deferens (the tubes) which was cut during the vasectomy. Vasovasostomy is an outpatient procedure which can take from 2 to 4 hours to perform, with a recovery time of a few hours, so you can recover from the anesthetic, and you usually will go home the same day of the procedures.
If your wife and you are considering a vasectomy reversal, you will have a lot to consider before you can make this extremely important decision. Only you in consultation with your urologist can make the decision to proceed. Make sure you have all the facts. Get answers to all your questions. Please contact us today to schedule an appointment with the best urologic surgeon in New York City for Vasectomy Reversal information. You both deserve peace of mind and the attention and support of a clinical staff that cares!
When it comes to a Vasovasostomy you will need a well trained, highly skilled urology microsurgeon to obtain the most successful results possible. Our urology microsurgeon here in New York City can give you the answers and guidelines you need to decide if this procedure is right for you.
The Microdot method is a special method where the skilled urology surgeon places tiny dots on the ends of the vas deferens while performing a Vasovasostomy. These dots are marked with a microtip pen so the urology surgeon can see exactly where the sutures need to be placed. The microdots are placed at 12, 3, 6 and 9 o’clock, with additional dots in between. The goal of these microdots is ensure an accurate placement of each suture, preventing any mishaps.
Our urologist is the best Vasovasostomy microsurgeon in New York City for this procedure, ensuring an extremely accurate suture placement with a high rate of success and happy outcomes for our patients. Avoid the disappointment of a failed vasectomy reversal, the future of your family depends upon this success rate.
Our caring, understanding staff is pleased to answer any questions you may have about the microdot method or vasectomy reversal surgery. Contact us today to schedule an appointment with the best vasectomy reversal specialist in New York City.
There are circumstances where your urologist may prompt against Vasectomy reversal and propose different choices, for example, IVF (in vitro treatment) as the favored technique for having a baby. In a few cases, if your wife has had her tubes tied, has a blockage, or in the event that she is of advanced reproductive age, IVF would be the savvy decision. Our urologist works with fertility centers in New York City to accomplish effective sperm recovery systems in combo with IVF treatment.
A treatment choice to a vasectomy reversal is to utilize sperm recovery as a part of vitro fertilization to increase the odds of becoming pregnant. The woman’s eggs and the man’s sperm are recovered to be joined in the lab through intracytoplasmic sperm infusion (ICSI).
Sperm recovery rates are exceptional at 95% success rate, particularly if the male has had former pregnancies in the past. Pregnancy rates are roughly half 
in fertile females depending upon their age. There are a few diverse sperm recovery strategies besides Sperm recovery and IVF are much more extravagant and expensive alternatives. At the point when female fertility is a real concern or when convenience is requested, sperm recovery joined with in-vitro treatment is an excellent option, with great success.
We understand your desire to start or add to your family and we are here to help you during this important time. Our patients have numerous decisions to make with regards to selecting a vasectomy reversal specialist. Our clinic has urologists who are highly trained and experienced when it comes to your urologic needs; call us today to schedule an appointment with the very best urologists in NYC.
Over the years, there has been impressive progress in the field of reproductive surgery. What you can now achieve with vasectomy reversal reflects these advancements. Dr. Larish possesses not only the latest equipment, but also expertise at performing the most advanced techniques.
Vasovasostomy and vasoepididymostomy are two techniques involving the microsurgical reconstruction of the male reproductive system. These and other advancements including ICSI (or intracytoplasmic sperm injection) and techniques involving surgical sperm retrieval from the epididymis ensure that all men who have encountered obstructions can now become fathers.
A vasoepididymostomy is a surgery that deals with repairing obstructions of the epididymis. Experts consider this to be one of the most advanced microsurgical procedures. Years of experience and top-notch skills are necessary. As a result, if you are seeking vasectomy reversal surgery in NYC, be very diligent in selecting only the most accomplished surgeons.
There are a wide variety of reasons why men may need this procedure. Reasons range from everything from issues like Young’s Syndome and abnormalities from birth to an infection or accidental injuries. Men also regularly receive a vasoepididymostomy to reverse vasectomies.
Surgeons select the vasoepididymostomy procedure for patients when either low vas fluid or no vas fluid is found during a vasectomy reversal. In this situation, this additional surgery is required to express fluid from the vas deferens. The surgeon then connects the vas deferens directly to the epididymal tubule and this directs the sperm around the blockage.
Once this procedure has been successfully performed, men have a very high likelihood of being able to get their partner pregnant. Sperm rates can return between 52%-92%.
It is also interesting to note that during the microsurgical procedure, sperm can be collected and frozen for use at a later date. This can be useful in the rare chance that the procedure fails completely.
Pregnancy rates improve when a highly advanced surgeon performs this procedure. Technical perfection makes a big difference. Vasoepididymostomy is the most difficult to perform surgery for male infertility.
Dr. Larish has achieved expertise at performing the Vasoepididymostomy as well as other vasectomy reversal surgery.
Contact our office today and we will be pleased to offer you a consultation.
When you are opting for a vasoepididymostomy, selecting the best urologist for vasectomy reversal in NYC is essential.
A vasectomy is a simple procedure where the vas deferens is cut to prevent sperm from entering the ejaculate and serves as a method of male sterilization.
In a typical vasectomy reversal, the two cut ends of the vas deferens are rejoined to once again allow sperm to enter the ejaculate. It is a procedure used to restore male fertility.
Men are typically cautioned that a vasectomy procedure is permanent. The truth, however, is that most vasectomies can be reversed. Success rates are critically linked to the skill and experience of the surgeon. Macroscopic vasectomy reversals typically have low success rates. Vasectomy reversals performed by skilled and experienced urologists utilizing a high-powered surgical microscope have high success rates.
Most general urologists perform less than five vasectomy reversals per year. Obviously, their limited experience in this procedure will negatively affect their success rates. It is important to determine if the surgeon you select actually specializes in microscopic vasectomy reversals. Relevant questions to ask include whether the surgeon has had specialty training in microscopic vasectomy reversals and what the extent of his or her experience is in the complicated vasdoepididymostomy procedure. Ask for permission to speak to a few of their patients who have had the reversal performed. Dr. Larish has performed thousands of vasectomy reversals and, for him, even the more complex vasoepididymostomy is routine.
Evidence does suggest slightly better results with more recent vasectomy procedures, but the success rate with vasectomies performed over 15 years ago is at least 70% with a 30% pregnancy success rate. Dr. Larish has successfully reversed vasectomies performed up to 30 years ago with pregnancies occurring in as little as a few months. Regardless of the length of time since vasectomy, vasectomy reversal remains the most effective and least expensive means of restoring male fertility.
Vasectomy reversals typically fail for one of two reasons. At the time of the first surgery, a vasovasostomy may have been performed when, in actuality, a vasoepididymostomy procedure was indicated. The other reason for failure is poor surgical technique in reconnecting the two cut ends of the vas deferens leading to scarring. Success rates following repeat reversals are slightly lower than for first reversals but are not so low that a repeat reversal should be avoided. It remains the procedure of first choice for restoring male fertility. Dr. Larish has performed numerous revisions of failed vasectomy reversals and is justifiably proud of his rate of success.
A vasovasostomy is the standard vasectomy reversal procedure. It consists of simply reconnecting the two cut ends of the vas deferens and restoring sperm flow into the ejaculate. A vasoepididymostomy is where the vas deferens is connected directly to the epididymis on the testicles. This procedure is necessary when a “blockage” is identified in the vas deferens coming from the testicle. This blockage may be due to scarring or inflammation. The blockage prevents sperm from exiting the testicle through the epididymis to the vas deferens and must be bypassed. A vasoepididymostomy is a highly demanding and complex surgical procedure. Only a highly qualified urologic microsurgeon should attempt this procedure. Therein lies the importance of choosing an excellent surgeon.
What will the vasectomy reversal surgery be like?The surgery is performed on an outpatient basis at the Gramercy Surgery Center. You will be at the center anywhere from three to five hours. The surgery itself is performed under general anesthesia. You must be accompanied by a responsible adult in order to be released from the center. You cannot drive yourself home. The post-operative pain is not unlike the pain you experienced following your vasectomy. You may notice swelling, bruising or discoloration of the scrotum. Pain medication will be prescribed for the first two days after surgery. After that, over-the-counter analgesics such as Tylenol or Motrin should suffice in alleviating any discomfort. Ice packs applied to the scrotal area will also help relieve any soreness.
Severe complications following vasectomy reversal are rare. They include infection or hematoma. If your incision becomes warm, swollen or painful or you develop a fever, or if you notice excessive bleeding under the skin (black and blue swelling), you will need to contact Dr. Larish immediately.
After a simple vasovastomy procedure, sperm typically reappear within three months. The first semen analysis is usually performed six to eight weeks after surgery. It may take up to six months for the sperm count and motility to stabilize. A semen analysis is performed every three to four months thereafter. After a vasoepididymostomy, it normally takes at least six months for sperm to reappear in the semen but may take as long as 12 to 18 months.
We normally advise patients to wait four weeks before resuming sexual activity.
If your work is performed in an office setting, you will be able to return to work after three days. If your work involves strenuous labor, you will back on the job after four weeks. Patients are advised to avoid heavy lifting or strenuous exertion for four weeks after surgery.
Most medical insurances do not cover the cost of a vasectomy reversal. Dr. Larish has chosen to offer a fixed, all-inclusive price for the standard vasectomy reversal as well as for the more complicated vasoepididymostomy procedure. Patients can thus rely on clear, up front pricing with no surprising hidden costs.
If surgery is unsuccessful, you may consider reoperation or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). In most cases, repeat vasectomy reversal offers the best chance of success. Assisted reproduction (IVF and ICSI) should not be considered as an alternative to vasectomy reversal, but rather, an option in the event of vasectomy reversal failure or when there is a female factor contributing to infertility. The cost of assisted reproduction (IVF and ICSI) is up to three times as high as vasectomy reversal surgery. For the female partner, it involves hormonal therapy. For the male, it involves “sperm harvesting” or extraction of sperm from the testicle by needle aspiration. With IVF, mature human eggs and sperm are incubated in a culture dish. ICSI involves injecting a single sperm into an egg. This procedure greatly enhances the success of IVF. Once the fertilized egg is develops into an embryo, it is implanted into the uterus.
If you are interested in learning more about vasectomy reversal microsurgery, call Dr. Larish , the most experienced micro-surgeon for vasectomy reversal in NYC.
After Vasectomy Reversal FailureVasectomy reversal is one of the most technically challenging surgeries in all of medicine. The skill and experience of the microsurgeon is critical. If no sperm are present in the semen by six months after vasovasostomy or by 12 to 18 months after vasoepididymostomy, then the reversal surgery is considered a failure. Often, the cause of reversal failure is that a vasovasostomy was performed when a vasoepididymostomy was indicated. Or, there was inaccurate approximation of the vas due to poor surgical technique. Or, blockage occurred from scarring as a result of disruption of the vas blood supply. Scientific studies support re-operation in cases of failed vasectomy reversals.
In the hands of a skilled and experienced microsurgeon such as Dr. Larish , the exact cause of a vasectomy reversal failure can be identified and addressed. In the event of epididymal blockage, a vasoepididymostomy can be performed. In cases of poor approximation of the severed ends of the vas deferens or scarring of the vas deferens, a repeat vasovasostomy may do just the trick. Dr. Larish has “redone” many failed vasectomy reversals and corrected “redo” failures by other physicians. Given his advanced expertise, an additional vasectomy reversal procedure may be more cost-effective than in vitro fertilization.
IVF involves incubation of human eggs and sperm in a culture dish. For fertilization to occur, the egg must have optimal maturity and the sperm must function normally. Once a fertilized egg develops into an embryo, it is transferred back into the female. In a man with a vasectomy, sperm must be retrieved from the testicle or epididymis. It involves insertion of a needle under local anesthesia. The cost of one cycle of IVF can range from $8,000 to $15,000.
Because of the expense, lower pregnancy rates, and potential side effects from hormonal therapy for the female partner, reversal surgery, and in most cases, repeat reversal surgery are options of first choice for vasectomized men. IVF is an option to consider if vasectomy reversal is unsuccessful, rather than as an alternative to surgery. Dr. Larish works together with fertility clinics in New York to perform sperm retrieval techniques in combination with IVF treatment.
If you are interested in learning more about vasectomy reversal microsurgery, call Dr. Larish, the most experienced micro-surgeon for vasectomy reversal in NYC.
The vasovasostomy is the standard and most commonly performed vasectomy reversal surgery. The separated ends of the vas deferens are identified. A sample of the vas fluid is examined under a microscope and is considered to be of good quality if its’ consistency is clear and it contains healthy sperm. The finding of motile sperm is an even better sign. The cut ends of the vas deferens are then stitched together.
Dr. Larish uses a high-powered surgical microscope and six sutures of 10-0 or 11-0 diameter (finer than a human hair) to reconnect the inner lumen and the outer layer of the vas deferens. This is called the Multi-layer Microdot technique. This advanced technique has contributed to Dr. Larish’s high success rates and low rate of scarring. It has also minimized the patient’s recovery time. See Dr. Larish perform a vasovasectomy.
In about 30% of Dr. Larish’s vasectomy reversal cases, no fluid can be expressed from the vas deferens or there are no sperm in the fluid. It must then be concluded that there is a blockage in the epididymis closer to the testicle. The blockage will not allow sperm to pass through to the vas deferens. Blockage in the vas deferens may be due to inflammation, high pressure in the epididymis or scarring following the vasectomy. This blockage must be bypassed by connecting the other end of the vas deferens directly to the epididymis. This procedure is called a vasoepididymostomy.
Dr. Larish currently employs the state-of-the-art Microsurgical Longitudinal Intussusception Vasoepdidymostomy technique. This technique is also referred to as the “two-suture longitudinal intussusception” technique and requires two 10-0 or 11-0 sutures. The technique permits a larger opening between the extremely small epididymal tubule and the larger vas deferens tubule permitting the two to be connected.
This procedure is one of the most complex and demanding in all of microsurgery. Only physicians who perform vasoepididymostomies on a regular basis should attempt the surgery. For Dr. Larish , this procedure is routine. His success rates are equivalent to those of the world’s leading male fertility microsurgeons. He has achieved 87% patency rate in his vasoepididymostomy patients. See Dr. Larish perform a vasoepididymostomy.
Regarding Laser Vasectomy ReversalsThis technique was popularized in the 1990s. Laser surgery works well for select blood vessel surgeries in cardiovascular medicine. However, research shows that laser vasectomy reversals have lower success rates. Laser vasectomy reversals may, in fact, cause more complications and damage to the vasectomy reversal site. Dr. Larish does not use this method of reversal.
If you are interested in learning more about vasectomy reversal microsurgery, call Dr. Larish, the most experienced micro-surgeon for vasectomy reversal in NYC.
A vasectomy is a surgical procedure that disrupts the flow of sperm through the vas deferens.
A vasectomy reversal is a surgical procedure that restores the flow of sperm through the vas deferens.
Approximately 5% of men with a vasectomy will choose to have a vasectomy reversal. These include men who remarry and desire to have more children. Others seek vasectomy reversal after the death of a child. A small percentage of men seek reversal for relief of scrotal pain attributed to the vasectomy.
It is advised to have a vasectomy reversal as soon as the decision is made to have more children. The length of time from vasectomy to reversal surgery correlates with success so it is best to perform the surgery as early as possible. Another consideration is the possible extended length of time before viable sperm return to the ejaculate following reversal surgery.
Results of recent studies indicate that following microsurgical vasovasostomy sperm appears in the semen in approximately 85 to 97% of men. Approximately 50 percent of couples subsequently achieve a pregnancy. Following microsurgical vasoepididymostomy, sperm appears in the semen in approximately 65% of men. Approximately 20 percent of couples subsequently achieve a pregnancy. The presence of testicular failure or atrophy negatively impacts the success rate of vasectomy reversal.
A vasectomy reversal procedure is performed on an outpatient basis and takes about three to five hours. Pain medication is prescribed for the first two post-operative days after which over-the-counter analgesics (Tylenol, Motrin, Advil) are enough to minimize discomfort. Most patients return to work within three days unless their occupation involves strenuous physical activity or extended periods of driving.
Vasectomy reversal costs can vary depending on the quality of the original vasectomy and which procedure is required. Most vasectomy reversals are not covered by health insurance, but they are the most effective and least expensive option for achieving pregnancy after a vasectomy. Dr. Larish offers very competitive rates and has assembled a fixed-cost vasectomy reversal fee providing his patients with a clear understanding of their costs up front and eliminating any surprise or hidden fees. Currently, Dr. Larish is offering a reduced fee for 2013 to help couples achieve their dreams of having a child. There are also helpful resources for insurance and financing.
Every surgery entails some risk. However, severe complications are extremely rare. Most patients only experience minor pain, swelling and bruising. Infection and bleeding are uncommon. A delayed complication of vasectomy reversal consists of scarring at the site of reconnection of the vas deferens and occurs in 2% of all patients per year until five years post-operatively.
If you are interested in learning more about vasectomy reversal or would like to schedule a consultation with Dr. Larish, New Yorks top expert on vasectomy reversal, Call us today!
Vasectomy is the most common form of permanent contraception used in the US; almost 500,000 vasectomies are performed each year nationwide. Data collected since the economic downturn since 2008 indicate that the number of vasectomies is on the rise.
It is estimated that 5 % of people who have elected a vasectomy will go on to undergo vasectomy reversal; this is a procedure that I specialize in and has a better than 95% success rate if performed within 15 years of the initial procedure.
People elect vasectomy reversal for reasons such as change of heart regarding children or more children, change in relationship, or loss of a child. Almost everyone surveyed regarding the decision to pursue fertility after vasectomy states that they didn’t anticipate the change in circumstance or change of heart that brought them to this decision.
That being said I always remind patients considering a vasectomy to remember that its an excellent procedure with a low likelihood of complications and that it works! And if people change their mind about their vasectomy, I am always ready to help them with their reversal!
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Check me out as a frequent guest on DoctorRadio SiriusXM Channel 81 Wednesdays at 6PM Eastern on the “Men’s Health Show.” Last show we spoke about Omega 3 Fatty Acids and Prostate Cancer with Dr. Eric Klein of the Cleveland Clinic. We will also had a great interview with award winning musician and producer Nile Rodgers; Nile is a prostate cancer survivor and managed to collaborate on the huge hit single “Get Lucky” with Daft Punk in his SPARE TIME while recovering from cancer. Truly inspirational stuff!
All the best and stay healthy!
Dr. Joe
Vasectomy surgery entails cutting the vas deferens to prevent sperm from entering the ejaculate in order to produce long term sterility. (click to enlarge)
Vasectomy reversal micro-surgery entails reconnecting the two ends of the vas deferens utilizing a surgical microscope, micro-instruments and micro-sutures in order to allow the sperm to enter the ejaculate and regain fertility after vasectomy surgery.
