1. True Experts

These are the doctors best to seek out – respected by other top experts, experienced, trained urologists that are true micro-surgeons who perform vasectomy reversals frequently, stay up-to-date attending fertility and specialty society meetings, publish papers in fertility journals, write textbooks and chapters and teach courses to other vasectomy reversal doctors. These are the doctors that most often give each patient the highest chances for success with the fewest complications. Among this group there are a very small number of elite urologists who have dedicated their entire practice to only vasectomy reversals. It is generally smart to limit one’s choices to a urologist in this “true expert” category.

2. "Wannabe" Experts

These are general urologists who promote themselves as vasectomy reversal experts and want potential patients to think they are the same as the true experts. They hope that if they have an impressive website and claim to be a “trained” microsurgical expert (when they really just had a regular urology residency often with with some training and experience), patients may incorrectly assume that they are a trained expert when they really are not. Many are great doctors though may provide lesser after care, use old, easier techniques and have some successes but possibly with a lower vasectomy reversal success rate with potentially more problems that a true expert. Just because a doctor can do a vasectomy reversal does not mean that he or she should.

3. Hobby Doctor

This category of general urologists will gladly do the vas reversal, explaining that they are “trained” and claiming they can do a great job, but only as small part of a busy general urology practice while they also care for everything else – prostate cancer, prostate enlargement, bladder tumors, erectile dysfunction, infections, stones and kidney issues. These are usually excellent, competent and knowledgeable urologists who are often just down the street, but they may only perform a few vas reversals a year. Some quote the published success rates of true, high-volume experts as if they were their own. But without the specialty training and day-to-day hands on vasectomy reversal experience, some may not have perfected the hard-to-achieve skills and judgment to perform challenging microsurgical vasectomy reversals to give their patients the highest success rates.

4. Non-Urology "Experts"

Yes, these are doctors and surgeons, but they are not urologists. Urologists are the only doctors that have completed 4 years of an intensive urology residency which includes training and experience in male reproduction and urologic microsurgery. There are some self-proclaimed “vas reversal” doctors from many specialties that have no significant training in male fertility, understanding male hormones and the technical skills and challenges, decision-making and aftercare of microsurgical vasectomy reversals. I understand their passion and motivation to perform vas reversals is admirable. However, some of these doctors incorrectly believe the desire alone to perform vas reversals with experience in an unrelated specialty, or from a weekend course or watching a few vas reversals somehow qualifies them to claim to be an expert in urologic microsurgery. It usually does not. Some of these essentially untrained experts have gone on to actually train other non-urologists. Of course, if a doctor does enough vas reversals, even with a lower success then they will have plenty of babies to brag about and happy families to sing their praises.

As one patient asked, would anyone trust an orthopedic surgeon to do their father’s heart surgery or an obstetrician (OB) to do their sister’s brain surgery? We have asked many of our patients who are surgeons in other fields, after experiencing what we have done, if they feel that they could or would it even be appropriate for them to perform vasectomy reversals? Their answer has always been a resounding no! They have consistently told us that there was nothing in their training or practice that would adequately train them to do vas reversals or manage routine and complex vasectomy reversal patients. They all said that vasectomy reversals and aftercare are well outside their scope-of-training and practice.

What these non-urology doctors don’t understand is that there is much more to vasectomy reversal success than throwing a few sutures. Staying up-to-date by attending specialty society meetings on critical aspects and advances in microsurgery, male fertility, medications and supplements that impact on sperm, sperm function and hormones are just as important before, during and after for the very highest success rates. Yet I worry that some of these doctors just don’t get it, and that’s the problem.