At this year’s 2010 national American Urologic Association’s meeting in San Francisco, California, Dr. Werthman reported his experience with vasectomy reversals with 45 men with post-vasectomy pain syndrome. 75% of them were cured of their pain and 10% had a >30% improvement.
Bottomline: For those unfortunate men who suffer from post-vasectomy pain syndrome, there is hope. While there is no guarantee, most men will improve after a vasectomy reversal. Seek out a vasectomy reversal specialist who can evaluate whether a state-of-the-art vasectomy reversal can help you with your post-vasectomy pain. 082710

We just had the pleasure of meeting Gwendolyn and James from Nicaragua. Flying in from Central America, they were able to meet with Dr. Kuang the day before their vasectomy reversal. His vasectomy had been 18 years ago. When such a long obstructive interval, we knew the chances of having to do the more complex bypass vasectomy reversal was approximately 45%. Not unexpectedly, there was very little fluid that did not contain any sperm coming from the main pipe (vas deferens). Consequently, we explored the refinery (epididymis) and were excited to find dilated tubes filled with complete sperm. Seeing this, we knew we had to reroute the pipes (vas deferens) and plug them directly into the refinery (epididymis) on both sides. While this type of bypass reversal is definitely a technical challenge, it is satisfying to know that the pipes were hooked up to the right place to give our first international couple a very good chance of getting sperm back in his ejaculate.

We got a message from Jennifer and Melvin from Albuquerque, New Mexico. She had had her tubal reversal after having had a tubal ligation, and we had done a vasectomy reversal for him. He required the more simple connections on both sides (vasovasostomies) after having had his vasectomy 3 yrs ago. Getting pregnant five months after the vasectomy reversal, Jennifer left us a great message that she heard the baby's heartbeat at her ultrasound visit at 7weeks and 5 days into her pregnancy. That's awesome. Jennifer, we are thinking of you both and and will be sending all our positive energy your way. Thanks for sharing. -Dr. K

We are delighted to offer a new service for couples seeking a state-of-the-art microsurgical vasectomy reversal. For men who prefer to not "go under" with general anesthesia, we have made arrangements for "conscious sedation." Conscious sedation is an anesthetic approach where the man remains awake but medications are used to relieve a patient's anxiety and discomfort to make him calm and comfortable. The medications may prevent him from remembering the procedure. For some men, this approach works well. Our last patient and I got to enjoy a nice conversation about green chile enchiladas as we performed his vasectomy reversal. In conjunction with our mini-incision approach, this can be a nice approach for some men. Obviously, "one size doesn't fit all." Some of my men also just want to go to sleep under general anesthesia and wake up when everything is done. Every man's needs are different, and we just wanted to make the experience as comfortable as possible by offering all possible options for our couples.

Something to also consider in making the choice about anesthesia is that depending on how long it has been since the vasectomy, there may be an increased chance that you will require the more complex "bypass" vasectomy reversal on one of both sides ("vasoepididymostomy"). If those patient situations where the chances are high, then general anesthesia may be preferred to ensure that you do not move too much during the surgery to optimize the chances for success in performing the more technically challenging "bypass" vasectomy reversal (this more complex vasectomy reversal requires placing surgical threads that are 1/3 the diameter of an eyelash into a tube that is only a fraction of a millimeter wide) . Make sure you talk with Dr. Kuang about your situation so that he can help you make the best decision to optimize the chances for vasectomy reversal success while maximizing your comfort.

Just got a message from JB and MC from Albuquerque, New Mexico. Great couple and he has to be on of the funniest guys I've met. They wanted to get pregnant naturally. The only problem was that she had had her fallopian tubes tied and he had had a vasectomy. In 2008, she underwent a tubal reanastamosis (where they reconnect the fallopian tubes) by Jim Thompson MD at the Center of Reproductive Medicine (Nice work, Jim!); and in 2009, he had a microsurgical vasectomy reversal after it was confirmed that her operation worked. During the vasectomy reversal, we were excited to find complete sperm coming from the pipes (vas deferens) when we opened them up and took a look at the fluid under the microscope. As a result, we were able to perform the more simple vasectomy reversal on both sides (vasovasostomies). Moving sperm was seen in his ejaculate at 4 weeks and they got pregnant 5 months after the surgery. While the chances of a pregnancy are lower since both the tubal reanastomosis and the vasectomy reversal have to work, it still is possible just like in this case. Pretty neat! As always, it's a joy to see great things happen to great people! Thanks for sharing the great news. -Dr. K