Vasectomy Reversal

Vasectomy Reversal Overview

A Complete Guide to Vasectomy Reversal Surgery from Martin Bastuba, MD, FACS

For many men considering undergoing a vasectomy reversal, they already have the benefit of understanding what the experience will largely entail because of their original vasectomy. Much of the preparation and recovery between the two procedures is similar, though there are some differences. This being said, it’s often the case that years or even decades have passed since the vasectomy was completed, and men can be understandably wary of taking steps toward a reversal.

In order to help relieve any concerns you may be having, I’ve outlined what men thinking about reversing their vasectomy need to know based on some of the most common questions that I hear during my consultations. In addition to the following information, one of the best ways to fully prepare for the procedure is to schedule a consultation with me, your vasectomy surgeon, so we can walk through your individual questions one-on-one.

Why Dr. Martin Bastuba?

Dr. Bastuba cares about all of his patients and provides expert care while eliminating financial barriers. His vasectomy reversal success rate of 98% is among the highest in the nation. Learn more about the specific reasons why you should choose Dr. Bastuba, California's leading vasectomy reversal surgeon. Dr. Bastuba is specially trained for this surgery. While most urologists might attempt 2 – 3 cases a year, Dr. Bastuba performs 2 - 5 per week.

Vasectomy FAQ

  • The average patency success rate of a vasectomy reversal is 70%, and the average pregnancy success rate of a vasectomy reversal is 55%. Dr. Martin Bastuba is proud to provide patients with a vasectomy reversal patency success rate of 98%, and a vasectomy reversal pregnancy success rate of between 65-75%.

  • The greatest remedy to being nervous is a clear understanding of what is going to happen, how it will take place and the risks and benefits of each option provided by an experienced surgeon in open conversations with the patient and his partner. Dr. Bastuba has been performing this surgery for over 27 years and is the go to 2nd opinion physician for many of the insurance carriers when other cases have not been successful. Ask lots of questions. Know that you will have Dr. Bastuba’s cell number for direct access, and a patient navigator will be in contact with your information for up to a year after the vasectomy reversal.

  • Dr. Bastuba performs the vasectomy reversal at a surgery center or hospital. The procedure is done on an outpatient basis — without an overnight stay. General anesthesia is provided to keep you pain free and motionless while Dr. Bastuba is under the microscope working with surgical thread that is thinner than a strand of your hair. Vasectomy reversal is more difficult than a vasectomy. It requires specialized skills and expertise. The duration of the case is 3-4 hours long.

  • The surgeon usually will re-attach the vas deferens in one of two ways depending on where sperm is found:

    • Vasovasostomy (vas-o-vay-ZOS-tuh-me). With this procedure1 (Goldstein et al. 1998. Journal of Urology), the surgeon reconnects the ends of the vas deferens after removing the blockage of each tube that carries sperm (vas deferens).
    • Vasoepididymostomy (vas-o-ep-ih-did-ih-MOS-tuh-me). This surgery attaches the vas deferens directly to the small organ at the back of each testicle that holds sperm (epididymis). A vasoepididymostomy is more complicated than a vasovasostomy and is generally chosen if a vasovasostomy will not work or sperm is not present. Dr. Bastuba utilizes the state-of-the-art techniques as described by Dr. Marc Goldstein2 (Berger 1993. Journal of Urology).

    In most cases, the patient will not know ahead of time which technique is required. Dr. Bastuba determines during the operation which procedure will work best and provide the best chance for a successful pregnancy.

  • Vasectomy reversals sometimes fail if there is an underlying issue with the testicle, which cannot be recognized during surgery, or if a blockage develops sometime after surgery. Up to 10% of patients can scar down following a successful vasectomy reversal3 (Sharlip et al. 2015. AUA). Dr. Bastuba encourages all patients to recover sperm at the time of the vasectomy reversal, which can be frozen and used as a backup if there is a failure.

References

  1. Goldstein M, Shihua P, Matthews G. 1998. Microsurgical vasovasostomy: the microdot technique of precision suture placement. Journal of Urology. Volume 159(1):188-190. auajournals.org/doi/abs/10.1016/S0022-5347%2801%2964053-9
  2. Berger RE. 1998. Triangulation end-to-side vasoepididymostomy. Journal of Urology. Volume 159(6):1951-3. ncbi.nlm.nih.gov/pubmed/9598495
  3. Sharlip I, Belker A, Honig S, Labrecque M, Marmar J, Ross L, Sandlow J, Sokal D. 2015. Vasectomy Guideline. American Urological Association. pubmed.ncbi.nlm.nih.gov/23098786
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