First of all, I have been a big fan of this continuation of the prior support site. I think those few that have worked so hard to educate so many deserve a real thanks.
Why I am here now after all these years. I have always kept a distance from being involved as I felt that this site was best served by those men with PVPS and those that had PVPS to be able to talk and share honest thoughts. It concerned me that if doctors had a presence, you might not want to be honest or that it might motivate us to want to try and sell ourselves to readers. But over the past and especially recently, with Victor asking specifically, I think it would be reasonable to include a series of articles on relevant and timely topics that we (Dr. Burrows and I) talk about with our PVPS patients- before, at reversal and when I go by and do my post-op house calls in the hotels while recovering and afterwards.
First a little bit about who we are and why I think we are qualified to be able to say these things (sadly so many are self declared experts, doctors and non-physicians).
About us. We have the International Center for Vasectomy Reversal (ICVR) located here in Tucson, Arizona. This is unique in that it is a full-time, reversal only center. We have almost 6000 reversals under our belt. I did my general surgery at the Mayo Clinic and my urology training in Boston at Tufts/New England Medical Center. I started my practice in 1987. Dr. Peter Burrows did his undergraduate world at UCLA, then his medical school at Ohio State/Cleveland Clinic, then his urology at USC in Los Angeles and his fellowship at Baylor in male reproductive medicine and surgery. We perform reversals Monday through Friday, on average 7 to 9 week on patients from every state in the US and more than 68 countries around the world. Though we are very busy, Dr. Burrows and I choose to limit our practice each to just one reversal each day. That way we know the each patient gets our full and undivided attention - we are not rushing off to do a second or third case nor we fatigued from an earlier reversal. I truly believe that our practice really offers a level of care, service and attention to detail unsurpassed in the world. About 10% of our practice our reversals on men with PVPS, though just this week we had four consecutive PVPS patients.
There are a few other things that make our practice unique. Every year at the annual international urology conference, I am honored to be the doctor gives the postgraduate course on state-of-the-art microsurgical vasectomy reversals. Plus to be certified in andrology by the American Society of reproductive medicine (ASRM) I wrote the module on the vasectomy reversals. And recently we had two major papers accepted for publication – one on the high success of reversals in men more than 15 years after vasectomy and the other showing a 99.5 % success using the Marks Vas Cutting Forceps (they named it and sadly I don’t get any money for sales of these). The point of this is not to brag but to show that at least in our little world of reversal doctors I am able to carry my weight and that my thoughts and comments on reversals and PVPS are not from a wannabe expert. Let me also say that of course there are many many excellent reversal doctors throughout the country. If you are talking with one of the top-tier reputable experts and you will get good care and good results. But remember to take everything with a grain of salt. I have my biases, as we all do, and of course as a reversal doctor to me that's the smartest solution. But it's not the only solution.
At this point these are the topics I would like to address. If anyone has any other suggested topics please let me know. If I don't feel like I can speak to any points with truly expert knowledge then I might suggest others in our community who may be a better resource.
- My thoughts on PVPS and why does it affect some people but not others?
- Signs and symptoms, and why everyone is the same yet in a different way
- The variable and inconsistent natural history of PVPS
- Causes and myths of PVPS
- Conservative treatment options, including alternative therapies
- Aggressive and invasive treatment options
- Your own path and decision-making
- Pros and cons of doing your own healthcare research on PVPS (yes there are cons) and the dreaded analysis paralysis
- Why I think a correctly performed microsurgical multilayer vasectomy reversal makes sense for chronic refractory PVPS (bias alert)
- Recovery after treatment, short-term and long-term