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- 'vasectomy reversals' COST AND PAYMENT INFORMATION
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- 'vasectomy reversals' Determination of Prognosis
- 'vasectomy reversals' Re-operable ?
- 'vasectomy reversals' Vasectomy Reversal or IVF ?
- 'vasectomy reversals' How Old A Vasectomy Can Be Successfully Reversed ?
- 'vasectomy reversals' VV or VE ?
- 'vasectomy reversals' What About Anti-Sperm Antibodies ?
- 'vasectomy reversals' How Long Will A Vasectomy Reversal Remain Successful ?
- 'vasectomy reversals' TRAINING / PRACTICE
- 'vasectomy reversals' SURGICAL TECHNIQUE
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- 'vasectomy reversals' DR. POHL
The primary goal of this website is to assist your selection of a quality reversal surgeon and to increase your understanding of the procedure. All patients inquire about cost. However, comparison of surgeons, various surgical techniques, and many other ancillary services can be quite difficult. This website contains frequent warnings, while providing unique guidance in your selection of a vasectomy reversal surgeon.
Vasectomy Reversals have become a fairly common procedure over the past twenty years due to dramatically improved success with microscopic techniques.
vasectomy reversal success rate
Almost all true “vasectomy reversal surgeons” have received formal microsurgical training. Many took a two year fellowship in male infertility after completing their four or five years of urology training.
vasectomy reversal with a ZEISS (West Germany) Model OPMI MDM operating microscope
Only two conditions must be satisfied for sperm to be returned to a patient's semen with vasectomy reversal by vasovasostomy (VV). The first condition is rather obvious. The patient must have sperm available to pass through at least one reconnection. The second condition is that each reconnection must be as watertight as possible. The surgeon's goal is to achieve a very precise reconnection of the sperm canal edges. Many microsurgical sutures (size 10-0) with meticulous placement greatly enhance this goal.
Dr. Pohl strongly believes that a much closer and more precise approximation of the mucosal edges of the vas canal (inner circle) is obtained with a 12 to 14 FT suture technique. Twelve to fourteen FT, very tiny (size 10-0) sutures are precisely placed for each reconnection of a normal size vas. Compare this approximation of the edges of the vas canal to the four sutures with the modified one-layer VV, or the 6 to 8 sutures of the two-layer VV. VV's that leak sperm generally fail due to scarring.
Vasovasostomy Reversal Technique - The Key to Successful Vasectomy Reversal
All potential vasectomy reversal patients ask the cost and this is usually one of the most important factors in their choice of surgeon. Unfortunately, even this is often surprisingly complicated. Is the price given just the surgeon’s fee, or the surgeon and facility charges, or the entire cost including anesthesia? You must ask, if the services included are not clearly described.
The prognosis for each of my patients is determined by my pre-operative examination of his vasectomy sites besides consideration of the time interval between vasectomy and reversal. If a patient has a sperm granuloma at one of his vasectomy sites, the time interval becomes almost unimportant. If there is no granuloma at either vasectomy site, the prognosis is then based completely on the time interval since the vasectomy. I define a sperm granuloma as a hard knot at least the size of a BB-gun BB, often a little larger, at the tip of the lower vas end, which is usually next to the top of the testicle. A local urologist can easily determine whether you have 0, 1, or 2 sperm granulomas by a painless examination of each vasectomy site. This exam can be fairly inexpensive, if you inform his office in advance that this is the only service you wish and you obtain the cost for only this specific examination. If the interval since your vasectomy is less than fifteen years, your prognosis will be 70% or better and this local examination is probably not needed. A sperm granuloma develops from post-vasectomy sperm leakage and somehow it behaves like a safety valve preventing internal pressure build up and ruptures of the delicate epididymis tubules with subsequent obstructive scarring.