Can Urologists Perform Vasectomy Reversals?

Do Urologists perform vasectomy reversals? If men change their minds about a vasectomy after opting for the procedure, surgeons recommend vasectomy reversal. In this procedure, a surgeon reconnects all the tubes (vas deferens). These tubes are responsible for carrying sperm into the semen from testicles. Once a professional successfully performs the procedure, semen will start carrying sperms, and couples can opt to get pregnant.

Pregnancy rates will increase from 30 percent to 90 percent after you are done with vasectomy reversal. However, the pregnancy rate depends mainly on the procedure for the reversal. Moreover, there are other factors that affect the success of reversal and achieving pregnancy. These factors include the age of the partner, time since vasectomy, experience and training of a surgeon, and fertility issues before the vasectomy.

Do Urologists Perform Vasectomy Reversals?
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Normal Conditions Before Vasectomy

Testes are located at the base of the penis inside the scrotum. A coiled tube called epididymis helps sperm to leave the testes. Epididymis connects with the prostate through a long tube known as vas or vas deferens. Vas leads to the inguinal canal starting from the lower region of the scrotum. Then it reaches behind the bladder into the pelvis. At this point, it forms an ejaculatory duct by joining with the seminal vesicle. When you are ejaculating, seminal vesicles and seminal fluids mix with the sperm and form semen. The semen then comes out of your penis, following through the urethra.

Treatment Through Vasectomy Reversal

Reversals are mostly performed by a urologist on come and go basis. Surgeons may perform the reversals in the surgery center or the outpatient area of the hospital. If a urologist is using a surgical microscope, they will perform the surgery after giving you anesthesia. Before performing the surgery, an anesthesiologist and urologist will discuss with you about the choices.

Performing this surgery through microsurgery is the best method. A urologist can examine the small tubes by up to 40 times when using a high powered microscope performing the surgery.

Once you are asleep, the urologist will make tiny cuts on the sides of your scrotum. Then the urologist trims the vas deferens’ ends, which was closed during the process of vasectomy. The urologist will then take some vassal fluid near the testis from the vassal end. They will then test if it includes the sperms or not. After that, the urologist will take any of the two methods for reversal. Here are those two procedures:

1.    Vasovasostomy

If sperm is available in the vassal fluid, this means that the path is now clear between the area of the cut in the vas deferens and testis. Now the urologist can join the ends from the cuts. The term used for connecting the ends is called vasovasostomy. When a surgeon performs the procedure through microsurgery, almost 85 out of 100 male patients find it effective, and there are chances of pregnancy in almost 55 out of 100 couples.

2.    Vasoepididymostomy

If the surgeon cannot find the sperms in the fluid, there are chances that because of vasectomy, a blowout in the epididymal tube is formed. In this case, the urologist will go back to the vas and join them from the upper end to the tube. Vasoepididymostomy has the same purpose as vasovasostomy. However, vasoepididymostomy has more complexity than vasovasostomy, and the results are the same. In some cases, urologist my perform vasoepididymostomy on one side and vasovasostomy on the other.

Urologists & Vasectomy Reversals
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Choosing a Doctor for Vasectomy Reversal

There are various factors that you need to consider before choosing a fertility male health care or urologist. These factors include technology they are using, their support staff, and surgical abilities. As vasectomy reversal is a specialized procedure, the experience and training of a surgeon will have the biggest effect on complete outcomes. Surgeons with training for treating infertility in male patients are urologists. They have received proper training for male fertility and microsurgery.

Even though most vasectomy reversals need surgery only in the scrotum, sometimes the patient requires reconstruction inside the abdomen. This happens when the vas experiences a blockage due to any reason other than that of vasectomy. For instance, after you have gone through a hernia repair. When this case occurs, the urologist will avoid repairing the vas. Instead, they will perform the most complex procedure: robot-assisted intra-abdominal repair. Very few surgeons can perform this and have experience of both robot assistance and traditional microscopic techniques for repairing the vas successfully.

Conclusion

When you are choosing a doctor, you should not hesitate to ask questions about the experience of the urologist and how many reversals they have done, what techniques they are experienced in, and what is the effectiveness rate of pregnancy after they perform vasectomy reversal.

To speak with professional and experienced NYC urologists that perform vasectomy reversals, you can contact us at (646) 862-5500.

Visit our website for information about how we can help you with your condition.

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Yaniv Larish, MD

4 East 76th Street
New York, NY 10021

(646) 862-5500


What is Vasectomy Reversal?

Vasectomy surgery entails cutting the vas deferens to prevent sperm from entering the ejaculate in order to produce long term sterility. (click to enlarge)

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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.

Vasectomy reversal surgeon nyc right column 02

Vasectomy reversal surgeon nyc right column 03

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