Why doesn’t the average urologist do vasectomy reversals?

Most urologists do a vasectomy once or twice a week. They can be done in the office and usually take fifteen minutes or so to do. We call that in the business a “bread and butter” procedure. In other words, a vasectomy is something that most urologists do often and well. (I might add that some urologists do a better job than others in this procedure-that is true for most surgical specialties.)

Since only about 1 in 6 men who have had a vasectomy will, at some point due to a change in his circumstances consider a reversal, several factors come into play that dissuades the urologist from agreeing to perform the procedure.

  • Fewer numbers of available men wanting the procedure for the average urologist to become proficient in performing it.
  • The procedure takes around 2-3 hours to perform and done looking through a microscope throughout the procedure.
  • It is not covered by insurance-some patients want a reversal but can’t afford it.
  • There is a steep learning curve in doing the procedure well and in a timely fashion.
  • There are expected results by the patient who will be inconvenienced, undergo a surgical procedure and at an expense not covered by his insurance. (When a general surgeon removes the gallbladder, well he removes it…it is not like some function will be expected beyond that. The reversal couple rightfully expect and hope that there will be sperm in the ejaculate after the reversal. This is a lot for the average urologist who would much rather just send the patient desirous of a reversal to someone “Who does them all the time.” Let him or her deal with all the expectations and potential of having put someone through all this and then no sperm in the ejaculate.)
  • The procedure requires special instruments, an operating microscope, and special suture. The local hospital may or may not have all this and if they do, then the patient has the added expense of the hospital fees making the patient pay at a premium for the “set up” and by a urologist who does the procedure infrequently.
  • Not all physicians are comfortable or have the skills to use microscopic suture and to sew and tie suture under the microscope. Without this skill set, the 2-3 hour procedure can last much longer with less acceptable results.
  • So…that the average urologist doesn’t do this procedure is a good thing and how it should be. If they aren’t comfortable with the procedure and logistics of it they shouldn’t be doing it.

It is a fair question for the patient to ask their doctor, “Do you do this procedure commonly?” “How many have you done?”

At Northeast Georgia Urological Associates we have an accredited surgery center appropriately equipped for this procedure, we are approaching 130 reversals done and our patency rates compares favorably with studies in the medical literature.

On top of that-we enjoy performing the procedure, the hopeful couples, and the happy results.

We look forward to working with  you!