Buyer Beware or "The Big Lie"

At a recent meeting of most of the world's leading vasectomy reversal experts, there were a few moments of heated discussion about microsurgery courses offered to general urologists. The purpose of the course is to improve the level of care they provide. Makes sense. The question that was debated - does taking an introductory weekend course in microsurgery really qualify the doctor to be able to perform microsurgical vasectomy reversal procedures? Just as important, does it qualify the doctor to be able to advertise that he had formal microsurgery training and is therefore an expert?

If the doctor was being honest with you and himself, he would have to answer no. Yet the internet is filled with dozens of doctors who say yes, they can and will gladly do your reversal, promising the success rates of the experts. Just as scary, they proudly promote on their website that they have had "advanced training in microsurgery". Really? This is without a doubt a huge distortion of what they were taught and unprofessional abuse of what was intended. What these doctors fail to tell you is what the course really consisted of and just as important, what the real trained microsurgery doctors go through to be able to say they have advanced training. Being a top vasectomy reversal expert means many years and thousands of patients with the highest level of documented success.

Advanced training - this can mean anything, literally anything, from a half-day class on up. For those few who choose to do it the right way, advanced training in microsurgery in 2011 is a 6 to 24 month competitive, full-time fellowship program after residency in male fertility and microsurgery. These doctors are truly trained. Of course, being trained doesn't mean you are skilled at vasectomy reversals nor does it mean that you are using those skills daily. A quarter century ago these fellowships did not exist, so us senior guys earned our stripes in the trenches, performing many thousands of reversals. Mix this with skill and years under their belt and your will have a top vasectomy reversal expert.

Weekend course. Then there are those that take a short, one day or weekend course. I know what these courses consist of, as I have helped teach a few of these over the years. They are not designed or intended to be able to take a general urologist and make him a vasectomy reversal expert overnight. Likewise, they are definitely not intended to have him boldly advertise and portray himself to the world as a trained microsurgery expert. Rather, these are good, useful courses intended as a sort of a "booster shot" to help general urologists 1. do a better job when they choose to do a microsurgical vasectomy reversal, and 2. better understand their own skill and limitations to know when the patient would be best served by referring him to a top vasectomy reversal expert.

Dishonesty. Why would these doctors be dishonest? The answer is obvious. If they can convince you that they are in fact a highly trained expert (when they are far from it), then you are more likely to select them for your vasectomy reversal. It's all about the money. Sadly, there is no ethics oversight, and these guys know it. They realize they can claim anything, distorting the facts to create a false image to essentially trick prospective patients into believing that they are something they are not.

What to do? This is where the "buyer beware" concept is so important. Take the time to seriously look at any doctors you are considering. How long have they been performing vasectomy reversals? How many do they do a week? Has it been decades or just since the economy crashed? What else do they do? Do they really dedicate themselves to vasectomy reversals? If you seriously read between the lines, chances are good you will find that great reversal doctor who can give you the highest chances for success and your baby.