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A Second Chance: Vasectomy Reversals

They’re expensive and complicated, but vasectomy reversals may be worth it for men who want a second lease on fatherhood.

A Tale of 2 Procedures continued...

The chances that a blockage has formed -- and that a VE is necessary -- increase with time. Craig Niederberger, MD, chief of urology at the University of Illinois at Chicago, estimates (based on existing studies) that the chances of needing a VE in both vas deferens tubes increase to 20% for a patient who had a vasectomy more than a decade ago.

And the success rate of a VE is lower. Niederberger, for example, reports that more than 90% of patients in his clinic who undergo ordinary reversals succeed in producing sperm. By contrast, 71% of his VE patients succeed in producing sperm.

But success in producing sperm does not guarantee that a man will get his partner pregnant. The pregnancy rate for Niederberger’s patients, for example, is about two-thirds for patients undergoing ordinary reversals and about 50% for VE patients. This is most often due to fertility problems in the woman, Niederberger says.

Unfortunately, there’s no way of knowing until a patient is on the operating table whether he will need a simple reversal or the more complex VE. That’s why many urologists say it’s important to find a doctor who has a lot of experience in vasectomy reversals.

Taking the Plunge

“Every single urologist” has been trained to perform vasectomy reversals, contends Marks. “But this is a very delicate, technically complex surgery that requires constant practice to get the optimal result. If you’re only doing it a few times, there’s no way you’ll be able to get the same results as full-time doctors.”

Marks suggests that patients seek out a reversal specialist. He contends that some general urologists who merely dabble in reversals may be unwilling or unable to perform the more complicated VE procedure.

But it’s not enough to know that a surgeon has performed a lot of reversals, Sharlip cautions. You should also gauge the surgeon’s reputation among nurses, gynecologists, or fertility specialists who know him or her. Your rapport with the surgeon is another factor to consider, Sharlip says.

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