What is a “Urologic Microsurgeon” and Why Does It Matter?
This article, written by international vasectomy reversal author, authority and microsurgeon Sheldon H. F. Marks, MD. about the importance and benefits of selecting a true, trained urologic microsurgeon for a vasectomy reversal to achieve the highest vas reversal success rate in 2023.
A true microsurgeon is exactly that – a surgeon with a surgical practice that specializes in microsurgery. Many urologists have had some microsurgical training and may incorporate some microsurgery into their general urologic practices, but only a very elite group of urologic microsurgeons in the U.S. have strictly dedicated microsurgical practices (Li PS, Ramasamy R, Goldstein M. Male Infertility Microsurgical Training.In: Sandlow JI, editor. Microsurgery for Fertility Specialists New York; Springer; 2012.)
Just as concerning are doctors from other non-urology specialties that think that whatever microsurgical skills they have from their residency and practice in other fields gives them the unique skills and knowledge of complex male fertility issues for urologic microsurgical vas reversals.
Unfortunately, the Internet and the current advertising environment have enticed urologists and other specialists throughout the country to create websites, give themselves “program” names and declare they are “experts” in microsurgical vasectomy reversals. There are no background checks, nocredentialing requirements, and noqualifications required. As with so many things in life, don’t believe everything that is written. It is wise to be an informed and intelligent consumer to be able to make up-to-date, accurate shared decisions.
Ask lots of questions. Be suspicious about bold declarations about anyone being an “expert” in anything – and insist on background information that supports any surgeon’s claims of specialty training or expertise (Akanksha Mehta, Philip S Li. Male infertility microsurgical training Asian J Androl. 2013 Jan; 15(1): 61–66).
Well-meaning general urologists perform the majority of vasectomy reversals in the U.S. today. A growing number of our patients (about 10%) come to us after a failed vasectomy reversal elsewhere, often by general urologists and many of these non-urologists. Disappointed couples are suffering the financial and emotional hardships of a failed vas reversal by a surgeon that was not a true urologic microsurgical specialist. Please do not make this mistake. Choosing to have a vasectomy reversed is a huge financial, physical, and emotional investment. Each person owes it to themselves to take the time do the research to find a true urologic microsurgical specialist that will give each and every patient the highest surgical results the first time. Vas reversal microsurgery is not a skill that anyone can simply decide to do or pick up from watching YouTube videos.
With more than 40 years experience performing many thousands of microsurgical reversals, often 4 to 5 reversals each week, Dr. Sheldon Marks has perfected and fine-tuned his microsurgical skills and expertise – and his impressive track record with success rates up to 99.5% for vas-to-vas connections supports this, using a surgical instrument he invented that was named after him – the Marks Vas Cutting Forceps (Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Angled vas cutter for vasovasostomy: technique and results. Fertility and Sterility.2014;101(3):636-639).
Dr. Peter Burrows trained at USC in Los Angeles, the Cleveland Clinic, Ohio State and additional year of fellowship training in male reproductive medicine and surgery at Baylor, where he was considered the “number 1 draft pick” when Dr. Marks discovered him. Dr. Burrows’ commitment to excellence is seen with his impressive successes, even with difficult salvage redo vas reversals that had failed elsewhere and care for complex post-vasectomy pain patients.
Our microsurgical vasectomy reversal center has earned an outstanding international reputation for top tier care – both surgical and medical. Many patients are referred to us by other vas reversal experts when their local doctor’s initial vasectomy reversal failed. With patients daily from every state in the U.S. and more than 82 countries throughout the world, Dr. Marks and Dr. Burrows have had successful vas reversals with men that are up to 42 years post-vasectomy (the world record), and men that have had one to two or even three failed vas reversals by other surgeons.
When evaluating a “microsurgeon,” take the time to ask questions, and listen to the answers. Ask if she/he does stone surgery? Kidney surgery? Pediatric surgery? Prostate or bladder surgery? incontinence surgery and implants ?If she/he says “yes,” this usually means that she/he is in reality a general urologist who may do an occasional microsurgical procedure. When interviewing any potential vas reversal surgeon, ask these and other questions:
• Does his practice focus primarily on microsurgery? If so, how many microsurgical procedures does he do each week? Each month? Each year? He should do at least 50 to 100 a year or more.
• Does he have a dedicated and consistent surgical team and microsurgical suite?
• Does he have his own state-of-the-art microsurgical instruments?
• Does he perform a multi-layer (3 to 4 layers) closure using the smallest micro sutures (10-0) on the innermost layer designed specifically for vas reversals? Many don’t.
• Does he perform the entire surgery start-to-finish, or does he use physician extenders such as physician assistants, nurse practitioners or doctors-in-training, residents or fellows?
Every patient has the right to know the answers to these questions.
We urge anyone considering a vasectomy reversal to do this research. Choosing a doctor is a major decision and is often a major financial investment as well. It is only logical, then, that it is wise to select a microsurgeon that will give each and every couples the highest opportunity for success. When couples do the research, chances are that like so many others from around the U.S. and internationally, they often choose to have the vasectomy reversal here at the International Center for Vasectomy Reversal.
We are here for one reason and one reason alone – to help couples have children through a state-of-the-art microsurgical vasectomy reversal. We are all dedicated to making this a smooth and positive experience for each and every patient.
We care about our patients and want to be sure that they make an informed, intelligent decision based on current facts and expert opinion, so that each will get the highest chances for vas reversal success, and ultimately get what they want – a healthy baby. Call us today to answer questions and when ready, set up a no-cost office, phone, Zoom, Skype or Face Time consultation with Dr. Burrows or Dr. Marks.
This page was reviewed, edited and updated July 13, 2023 by Sheldon H. F. Marks, MD.
