Sounds great, doesn’t it? A reversal operation for only $3000 and the website is quoting success rates equivalent to reversals performed by more expensive fertility microsurgical specialists. It almost sounds too good to be true, but you really want to believe it. Unfortunately, as with most things associated with advertising, if it sounds too good to be true, it most likely is.
The age of the internet has revolutionized the field of medicine, providing patients with powerful tools to educate themselves on their medical options. In general, this trend is quite good. However, it also provides the opportunity for distributing misinformation as well. As described in the previous section, ANY physician can set up a nice website and claim to be a ‘microsurgical specialist’ with no control as to the accuracy of their claims. These websites claim wonderful outcomes equivalent to the latest microsurgical techniques, despite spending typically half the operating time felt necessary by leading fellowship trained specialists. Bargain surgeons typically quote large numbers of cases that they have performed, made possible by doing multiple quick procedures daily, typically in their office under local anesthesia. What they all have in common is an attractive selling tactic of promoting that their inexpensive quick surgery is really as successful as a careful 2.5-3 hour reversal by a fellowship trained specialist, with the knowledge that it is impossible to verify these claims.
Almost all bargain reversal sites have a few things in common: they are typically offered by non-urologists who perform these procedures in their office under local anesthesia and typically take about one and a half hours to perform. A nice website and impossible-to-verify success rate claims do not substitute for a lack of training, and an outdated surgical technique performed thousands of times is still not going to provide optimal outcomes. Microsurgical vasectomy reversals are one of the most demanding technical procedures if performed with optimal technique. It is very telling that, to my knowledge, no fellowship trained microsurgical specialist offers discount reversals under local anesthesia. During their fellowship training, true microsurgical specialists learn the latest, most successful vasectomy reversal techniques that take at least 2.5 to 3 hours of actual operating time. General anesthesia is very important, as the patient must remain completely motionless for these 2.5 to 3 hours, which is virtually impossible to do if they are under just local anesthesia. Any movement by the patient under the operating microscope literally looks like an earthquake, which is certainly not conducive with the precision needed for optimal outcomes. To the credit of my fellowship-trained community of vasectomy reversal specialists, none of these true specialists have chosen to put marketing above their professional obligations by shortening their operative times and eliminating anesthesia for their patients. Their fellowship training has shown them that the latest microsurgical techniques cannot be rushed in 1-2 hour time blocks just so that multiple reversals can be squeezed into a day of surgery, but that a meticulous, methodical approach under anesthesia has the best chance for reversal success.
