Vasectomy Reversal Clinic

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Covid-19 Update about our services

Despite the pandemic, we can continue providing an excellent vasectomy reversal service bolstered by stringent COVID-19 safety measures and regulations. Many have felt that these reduced months aligned well with the prospect and planning of surgery and recovery.  We are proud to announce that throughout 2020, we were able to operate on 115 men and start them on their journey to fatherhood again.

 

Welcome to the Best Life Microsurgery Clinic

Here at Best Life Microsurgery, we endeavour to give you the best possible information to aid you in your choice. The techniques we use are highly advanced and set us apart from most other centres in the UK. Please take the time to read through the information on this site and do your own research. We offer a no-obligation free telephone/video consultation followed by a written summary and information leaflet to help you further. After this consultation, we will never contact you and entirely leave it to you to decide if the reversal is right for you and come back to us if you think we are the right team to do that for you. 

What is a Vasectomy Reversal?

A vasectomy reversal (snip reversal or reversal of male sterilisation) is an operation to identify the cut ends of the vas (which has a minute diameter of 0.2 - 0.4 mm) and reconnect them to enable fertility. The vas is a tube that carries sperm from the testis to the penis.

The main principles of this operation include:

  1. To achieve the best possible alignment of the minute vas lumens, even if the cut ends are different diameters.

  2. Connect them in a leak-proof manner. Any leakage can cause a blockage of the tube.

  3. Preserve the blood supply to the vas throughout the procedure. Over-handling can compromise the blood supply and cause scarring & blockage.

Our advanced microsurgery techniques can achieve the above consistently, irrespective of the variable and potentially challenging situation in each procedure. If these principles are not adhered to, the operation will likely fail due to blockage at the connection.

What are the types of Reversal Operations & How the procedure is chosen during the operation?

Two types of procedures are available to deal with the intentional blockage caused by vasectomy. Suppose your surgeon or clinic do not have the skills/resources to do both types of procedures. In that case, the reversal will be incomplete in a proportion of men who had late consequences of vasectomy, such as blow-out or blockage upstream at the epididymis level.

Vasovasostomy:  This means connecting the cut ends (segments) of the vas. Vasovasostomy is the most common reversal procedure needed that carries the best possible outcome.

Vaso-Epididymostomy: If there is blockage upstream at the epididymis level due to damage by back pressure (called blow-out), simply connecting the cut ends will not be helpful. The vas will need to be connected directly to an even more minute tube, the epididymis. This is called Vaso-epididymostomy. Very few surgeons in the UK take steps to diagnose the blowout and carry out a vasoepididymostomy if necessary. You should always check that the surgeon can carry out this service. The risk of blow-out goes up with every passing year since the vasectomy. One in five men who come to Best Life clinic for their reversals requires and gets vasoepididymostomy at least on one side due to the blowout condition mentioned above.

How are Vasectomy Reversals performed in the UK?

Unfortunately, there is no standardised way of doing a vasectomy reversal in the UK. The various methods of carrying out this operation are listed below. Limitations often govern the type of procedure chosen in the surgeon's experience, resources, need to limit the operation time and the need to offer the procedure cost-effectively. This means that the patient's interest is not always at the centre of a clinics decision on which technique they provide. That is why you must carry out your own research and choose your clinic and surgeon diligently. 

The reversal operations are done in the following ways. 

Reversal without Microscope and using larger stitches with bigger needles (substandard currently, don't even consider this option)

Surgeons use magnifying loupes that give a maximum of 2-3 times magnification and 6-0 stitches that contain a needle that is as thick as half of the lumen of the vas. This is an elementary version of the procedure. The tube ends are joined with 6 stitches on a single layer. It may take 60 to 90 minutes to do this procedure. This is a no-go if you want to have a predictable result.

Reversal using Operating Microscope but larger needles and stitches (Not the current Best Standard)

Surgeons use similar material as above but with the help of an operating microscope. Here, the operating microscope provides a bit more magnification. However, the magnification is not fully used as the surgeons choose the easier and less demanding method of larger sutures (with larger needles) and conventional instruments. The operation is done in one layer of 6 - 8 stitches and will take around 90 minutes. This technique is widely used in the UK to drive down costs by limiting the expensive operating theatre and surgeon time while claiming it to be microsurgery (arguably incorrect in our opinion). This procedure will only work if the quality and dimension of the tubes are uniform and straightforward. The issue here is that neither patient nor the surgeon can assure this until the operation occurs. Please see the pictures below from one of our patients who came to us for a redo-reversal surgery after a failed reversal from another high volume centre in the UK. They used 6-0 stitches (bluish coloured) in the previous centre, which are thick stitches with thicker needles that unfortunately blocked up the tube. The second photo below shows the 10-0 black sutures used in our redo-procedure and the finished product showing the correctly aligned vas. 

              

Reversal using operating Microscope and Advanced Multilayer Microsurgery (Current Gold Standard)

The tubes' best possible alignment can be only achieved by a multilayer microsurgery reversal using very minute 10-0 or 9-0 stitches. It is essential to connect the inner layers (mucosal layer) of the vas separately. This ensures that the connection site (anastomosis) can stay open and patent. In real life, during the operation, the inner layer can look very collapsed, with the opening's diameter varying from 0.2-0.4mm. That is the reason multilayer surgery carries a distinct advantage. This method using two layers was initially described by two different surgeons (Silber and Owen) in 1977. They described a two-layer technique which raised the successful outcomes from over 40% to more than 90%. Professor Goldstein's further development at New York’s Cornell University was called Microdot Multilayer Microsurgical Vasovasostomy (MMMV), which is the world’s gold standard procedure. This involves using three or more layers to reconnect the tubes. This helps to realign the tubes of varying diameters even in the midst of challenging situations, such as extremely thin tubes.

Also, see our Blog, "Does the technique and the type of sutures matter in vasectomy reversals?"

 

What do we offer in Best Life Clinic? Only the Current Best Standard.

We offer the same advanced Microdot Multilayer Microsurgical Vasovasostomy (MMMV). This service is unique in the UK. We pride ourselves on being reasonable and cost-effective, often placing us below even some of the clinics offering basic procedures. You can easily identify surgery quality from how long the actual operation takes and what size stitches the surgeons are using. Please do not hesitate to ask that question. We have not come across any other surgeon in the UK who transparently carries out this multilayered procedure, even though this is the standard of care in most male-infertility centres in the United States. This operation usually takes four hours using expensive purpose made sutures. The full magnification power of the operating microscope will have to be used during the procedure's difficult and minute steps. 

We also perform Vaso-Epididymostomy in the event of a Blow-out diagnosed at the time of the operation. So there is hope even if there is a blow-out. At the time of the procedure, we check the fluid from the testicular end of the vas multiple times. This is to ensure that the procedure we are doing carries the highest possible chances of success. 

Which procedure should you choose?

Please do your own research and read through the material on our website. Based on that, you will be able to make an informed decision. The surgeons using basic techniques will claim that their techniques are working. There is truth to these claims, nature's inherent healing mechanism is remarkable, and there is even a chance of a spontaneous natural reversal in one out of 2400 men undergoing vasectomy. All the procedures outlined here carry the possibility of success. The difference between them and the current best standard is best defined like this. If the surgeon can do only one type of basic reversal procedure, your outcome is left to the chance of you being the right patient for that surgeon. We propose that it should be other way round. The surgeon should possess specialist fine skills and resources to make the procedure right for you as per the operation's needs. These needs can be incredibly challenging, such as the loss or damage of long segments of the vas, extremely thin vas, varying diameters of the vas' cut-ends, the vas is cut very close to the epididymis and blowouts. 

We can assure you that we are capable and resourced to deal with all of these Challenging situations because of the unique factors and resources mentioned below.

  • Ability to offer Advanced Multilayer reversal - This is a time consuming and very delicate but worthwhile procedure that will give you the best opportunity to have the desired outcome
  • Allocation of four operating hours - We will book you into an entire session of four hours instead of one slot in a session.
  • Resources & skills to do vasoepididymostomy in the same sitting  - one in five men who come for a reversal to our clinic needs and gets the bypass procedure (Vasoepididymostomy) for the blockage at the epididymis (blow-out) 

We are here to help. We can assure you that the Best Life Clinic always offers the current Best standard of service and try our best to make the procedure right for you. 

Call us today Tel: 01642 939798 or Text us on 07984448243

Our Mission

At Best Life Clinic, our style and philosophy of care put you at the centre of our attention whilst striving to achieve higher levels of excellence. We fully appreciate that our customers (patients) come from all walks of lives and backgrounds. They all, however, share the unifying dream of having a baby. Whatever situation you are coming from, we are here to welcome you and accept the privilege of helping you achieve your dream of becoming a parent again. We will put to full use our: Efforts, Expertise, Equipment and Experience for your care. 

Vasectomy Reversals Service

To find out more about our reversal service and its potential suitability, click on the links below or contact us for a free telephone or video consultation. You will receive a free consultation document with personalised chances of an outcome to help you make your decision.

Telephone Consultation

Many of our patients travel from different parts of UK, Ireland and abroad and  prior face to face consultation is not usually  feasible for them. Therefore telephone consultation is the norm for most of our patients. You will have the opportunity to speak to the surgeon Mr Jesuraj directly who will take you through an indepth consultation about your medical back ground to assess your needs and give you a personalised reommendation.  Following the Telephone consultation, you will receive a detailed summary of what was discussed including the personalised chances of success, risks, alternatives and uncertainties. After this you will be able to make a fully informed choice of if and when and where you would want to have your reversal.There is absolutely no obligation to book for the procedure with us and this service is totally free. If you decide to have this consultation, please fill the detailed questionnaire at the link 'Consultation Questionnaire'  that is mandatory prior to the consultation. This will save time during the phone call and also ensure the accuracy of information you are providing to us.

 

Face to Face Consultation

Those would would like to come for face to face consultation or those patients with complex history especially those patients who desire reversal for pain, we encourage to come for face to face consultation. This will give the surgeon opportunity to  check the length and quality of the remaining  tubes and identify the potential  challenges such as insufficient tubes, blowouts etc.  As Mr Jesuraj performs  both Vaso-vasostomy and Vaso-epididymostomy, he is capable of dealing with these challenges and manage to complete  the reversal on both sides on more than 95% of our patients. The cost of face to face consultation will be £240, though this will be reduced from the procedure cost if you go ahead with the procedure in our clinic. If you decide to have this consultation, please fill the detailed questionnaire that is mandatory prior to the consultation. This will save time during the consultation and also ensure the accuracy of information you are providing to us.

 

FEES

One fee covers all aspects of the procedure.  We provide Multilayer Vaso-vasostomy or Vaso Epididymostomy or combination of both according to the need at the time of the operation. Fees includes any follow up and advice upto One year. See full details in  'Cost' link.


 

 

Contact us today  Tel:  01642 939798 
Text:  07984448243
Email:  contact@bestlifeclinic.org

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6th May 2019

Mr Jesuraj attending American Urological Association’s Annual meeting at Chicago. A great educational and networkin… https://t.co/XM2L2s2dwk

4th September 2018

Why is the type of surgical Technique important in Vasectomy Reversal? Not all microsurgical Reversals the same. In… https://t.co/JzukiouiCM

27th August 2018

Blowout or previous failure of reversal is not a problem. Thanks to advanced Microsurgery to revers the vasectomy b… https://t.co/9YfxMvVuRT

What is Blow out?  Blow out is a rupture and blockage of the very thin epididymis tube (only 0.2 mm in diameter) situated on top of the ...

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Fortunately, most are suitable for vasectomy reversals (approximately 95%), but it’s important to have an initial consultation beforehand. The ...

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Face to Face Consultation When it’s possible, we  always encourages consultations and this is because it gives our team the opportunity ...

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