Shane T. Russell, MD

My number one recommendation is that, at minimum, make sure that the surgeon you are considering is a UROLOGIST.  I am always surprised to look on the internet and see internal medicine doctors, general surgeons, orthopedic surgeons, and thoracic surgeons among others who claim to be experts in vasectomy reversal.  Unfortunately for people searching on the internet, ANY physician who has completed medical school can claim to be a vasectomy reversal specialist, regardless of their training or experience.  So let’s examine further why you may want to think twice before choosing a non-urologist to perform your reversal.

Non-urologists are physicians who have completed medical school but have had little to no training in the field of urology.  After medical school, these physicians completed their residency (i.e. true clinical training) in another field, such as general surgery or orthopedics.  They typically had a ‘calling’ mid-career to start offering vasectomy reversals.  Some claim microsurgery experience on other body parts like tendons or nerves, which are very different than operating on the vas deferens.  Others claim to be experts as they have taken a few week-long courses in urologic microsurgery.  Contrast this with a fellowship-trained urologist who has completed 4-6 years of specialized training focusing on operative skills on the urologic organ systems, including the genital ducts (which includes the testicles and vas deferens), followed by 1-2 years of additional training in microsurgery on the vas deferens.  If you had a broken arm, would you want to see an orthopedic surgeon or a urologist?  Why then would you choose an orthopedic surgeon to perform one of the most challenging urologic surgeries? 

Another important consideration to make is that our hospital systems in the United States take patient protection very seriously.  Hospitals therefore require that all physicians go through an extensive credentialing process in which a physician’s background and training are carefully scrutinized to make sure that they are qualified to perform certain procedures and can handle potential complications which can be associated with that surgery.  In this manner, an orthopedic surgeon has to prove that he has finished a 4-5 year residency program in orthopedics from an accredited training program before he can start seeing patients with orthopedic problems at that facility.  The credentialing process provides a strong line of protection to patients who seek medical care at that facility by ensuring that the physicians with whom they come into contact there are providing care for which they have actually received adequate training.  Unfortunately, this same degree of protection does not extend to surgery which is performed in a private office setting, as there is no regulatory system in place to monitor this. Non-urologists therefore almost always must perform reversal procedures in their office and without anesthesia.  You will rarely, if ever, find non-urologists who perform vasectomy reversals in accredited hospitals or surgery centers, because the patient protection mechanisms of these institutions would, if functioning properly, not allow procedures by physicians who do not have the proper training.  In the office setting, though, there are no such protections.  From a safety standpoint, the best protection that vasectomy reversal patients can have is to make sure that their surgeon is a board-certified urologist.