Vasectomy Reversals

Avant Specializes in Vasectomy Reversals!

Within the first three years of having a vasectomy, a vasectomy reversal generally restores sperm to the semen in 97+% of cases. And even when the time period between vasectomy and a vasectomy reversal is 15+ years, sperm recovery rates generally remain around 70%!

A vasectomy reversal is a highly technical procedure in which blocked ends of the vas deferens (following a vasectomy, of course) are cut open and microsurgically reconnected. To dive a little deeper, after a vasectomy, there are sperm still made by the testes; however, since the vas deferens tubes have been blocked, the sperm is unable to exit in the traditional way.

To further illustrate, on each side, sperm can still enter the epididymis as well as the lowermost portion of the vas tube upstream from the obstruction imposed by the vasectomy. After a vasectomy, the very fine tubes of the epididymis can become obstructed due to scarring of the epididymis or increased pressure from the vasectomy site that results in sperm leakage and eventual blockage of the epididymis.

At Avant Concierge Urology – the first and only office-based microsurgical center in the United States – vasectomy reversals are offered within our medical office building, which allows our team to more cost-effectively perform the surgery with little downtime for patients. In fact, for a vasectomy reversal using intravenous sedation, Avant Concierge Urology offers a worry-free, fixed-price rate for a vasectomy reversal.

What to Expect with a Vasectomy Reversal

When a patient comes to Avant Concierge Urology for a vasectomy reversal, he can expect to spend approximately 3 hours at our office. Continuity of both vas tubes can be restored through a very small incision. 

Avant utilizes best-in-class high-definition magnification not available in other urology office settings. The medical team at Avant also uses the Erbe VIO® 3 cauterization device as well as other custom-made microsurgical instruments to minimize bleeding and damage to tissue. 

Patients who undergo a vasectomy reversal can generally expect to be able to return to completing non-strenuous work within 4 – 5 days, but it is suggested that they avoid all sports and lifting activities of more than 20 pounds for an additional two weeks. 

More detailed instructions for before and after the vasectomy reversal will be provided by your Avant medical team.

Why Choose Avant for Your Vasectomy Reversal?

When you’ve made the decision to move forward with a vasectomy reversal, you want a surgeon who is known around the globe as an industry leader. Long considered an expert in microsurgical urology procedures, Dr. Sijo J. Parekattil has vast experience in the field of male infertility. Having personally performed well over a thousand of vasectomy reversals throughout his career, Dr. Parekattil uses cutting-edge microsurgical techniques to perform reversals, which result in less downtime and a more comfortable experience.

In most cases, at the time of the reversal, the two ends of the vas may be simply reconnected if there is sperm found on the vas end from the testicle. This is called a vasovasostomy. In some cases, however, sperm may not be found from the vas end coming from the testicle. This may indicate that there is scarring and a blockage in the epididymis (storage container for the sperm behind the testicle). In this situation, a bypass procedure is performed from the distal vas to the epididymis above the level of the obstruction. This is called a vasoepididymostomy. 

There are not many microsurgeons who are fellowship-trained in performing this more complex reversal. Dr. Parekattil is one of the only dual board-certified microsurgeons (completed his fellowships at the Cleveland Clinic, Ohio) in microsurgery and minimally invasive/robotic surgery. He has performed well over 3,000 such complex reconstructions. The Avant Concierge Urology advantage is that we perform this complex reconstruction if deemed necessary at the time of surgery at no additional charge. Unfortunately, we are not able to tell with 100% certainty which type of reversal would be needed until the time of the surgery. However, Dr. Parekattil has developed predictive models to try to predict the likelihood of the more complex type of reversal, but these are not 100% accurate.

Below are some videos that illustrate the various reversal techniques utilized at Avant Concierge Urology.

Dr. Parekattil is one of the founding Board members of the Robotic Assisted Microsurgical & Endoscopic Society (RAMSES). In addition, he holds active membership in the American Society of Andrology, the American Society for Reproductive Medicine, the American Urologic Association, and the Society for the Study of Male Reproduction. He also serves on the Executive Board for the Florida Urological Society.

Lastly, because Avant Concierge Urology is the first and only office-based microsurgical center in the United States, we are able to perform best-in-class surgical procedures at a lower cost to our patients.