Post Vasectomy Pain Forum

Good reversal experience with Dr. Trost in Utah

Hi all,

Three days ago I had a redo-reversal done by Dr. Trost in Utah. His clinic’s website is here. It was a great experience, so I wanted to share.

Dr. Trost was previously the head of infertility and andrology at Mayo Clinic, and his success rate is excellent, so I was not concerned that I would be getting a lesser-quality surgery, even though it was much more affordable than many other clinics.

Scheduling the surgery was very easy, and can be done from the website.

The staff at the clinic was very friendly and Dr. Trost was friendly, easy to communicate with, and very patient in answering all my questions.

I elected for the vasovasostomy-only option, which was $1850. Before the reversal, we discussed what to do depending on what we found. Since my discomfort was mostly on the left side, and my semen analysis numbers were low but not zero, we decided that it would make sense to start on the left side, and if the left side was blocked, repair it, and not touch the right side. I decided not to take a sedative, so that I could remain lucid during the operation, and discuss things with Dr. Trost as they came up.

I was prepped, my testicles were numbed, and Dr. Trost started operating. Due to the numbing, I didn’t experience any pain during the operation. The actual injection of numbing agent was painful, but it was over quickly.

Upon examination, it turned out that the left side was completely blocked, so that side was repaired and the right side was left alone. Unfortunately, no sperm was found in vasal fluid, so it’s likely that there was a blockage in the epididymus lower down. Dr. Trost asked me if I wanted to do a vasoepididymostomy at no extra cost, but I wanted a vasovasostomy, so that’s what we did.

Recovery has been good, post-surgical pain has been minimal, and the wound looks healthy.

Unfortunately, my discomfort hasn’t improved after the reversal. However, given that no sperm was found on the left side, and I elected to get a vasovasostomy instead of a vasoepididymostomy, I don’t think this was due to any fault of Dr. Trost.

In hindsight, I think I should have gotten a vasoepididymostomy, but I was hoping to avoid that, and in the moment I just wasn’t able to make that call, even though no sperm was found on the left side. If things don’t improve, I think my next steps will likely to be to go back to Dr. Trost for a vasoepididymostomy or consider orchiectomy. I’m not considering neurolysis, just because of bad experiences I’ve read about on the forum, and because a couple of doctors that I’ve spoken to and trust haven’t been too positive about it.

Even though the surgery hasn’t reduced my discomfort, I’m still very confident that I made the right choice going to Dr. Trost. In addition to Dr. Trost, Joshua Savage and Klint Brearton also do reversals at the clinic. I believe that one is a physician’s assistant, and one is a registered nurse, both trained by Dr. Trost to do reversals. I talked to Dr. Trost after the surgery about their performance, and he said that their success rates are identical to his own. Reversals done by Dr. Trost, Mr. Savage, and Mr. Brearton are all the same price, but Mr. Savage and Mr. Brearton have more availability. I personally wanted to have my reversal done by a full doctor, but given my conversation with Dr. Trost, I think that anyone at the clinic would be a good choice.

I asked Dr. Trost about why his clinic charged such low prices, he said that being able to provide affordable care was important to him, and that making a lot of money was not a personal priority. He had initially considered running the clinic as a charity, but due to the additional complexity of running a non-profit, ultimately elected to run as a conventional business, and just charge low prices.

I wanted to share all this because I think the low prices might lead some people to believe that it’s a lower quality clinic, but after getting a reversal there, and also comparing with the reversal I had previously with Dr. Marks, I’m pretty sure it’s he’s up there with the best.

If anyone has any questions, feel free to ask!

Best,
Alex

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Do you know if vasoepididymostomy tends to help relative pain in people with an obstruction such as yourself? I assumed this was simply to restore fertility and came with additional discomfort. Sorry to hear it didn’t help you.

I am in the same boat as you. Seeking pain relief.
Did Dr trost spend time cleaning out the scar tissue and trying to repair things? I get the impression his specialty is fertility, not pain reduction. I want to go somewhere that will spend the time needed. Dr trost seems to have very rigid scheduling.

Thank you so much for posting!

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This is where I believe that MRI of scrotum can be most useful. MRI can show these blockages in the epididymus with about 90% accuracy. Ultrasound can’t show them. I think it would be valuable to know this before the surgery, instead of during surgery. If you knew beforehand that vasovasostomy wouldn’t work, and you’d need a vasoepididymostomy to get free flow, it could change what surgery you opted for.
study

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I assume that it would. If discomfort is from congestion, then I think a vasoepididymostomy would help, because it would relieve pressure in the epididymus.

I don’t think he removed any scar tissue, aside from removing the original reversal site from the vas. I’m not sure what that would entail, but for a reversal, I probably wouldn’t want more disruption than necessary to perform the repair.

You bet!

I haven’t gone to see any doctors beyond instacare since my vas 1.5 years ago. Something about the whole experience has caused me to lose all faith in the medical system. ESPECIALLY urologists. There’s a special place in hell for them as far as I am concerned.

Due to my distended vas and swollen testicles I really feel that it’s congestion related. Possibly never damage.

I’m going to try cymbalta first, but after that I am thinking of going for a reversal with doctor trost. I can’t take it anymore. Would any of you recommend something else first? I’m taking so much iborufen and naproxen at this point is probably thrashing my kidneys. Again. I encourage you to get the word out. Help save at least one other man from this misery.

Good luck to all. I appreciate the support from you all!

To be honest, I wish I had done my reversal sooner, since the longer your vas is blocked the greater the chances are that your epididymus will be damaged, and a reversal won’t work.

How is your pain since the reversal? Where did you go, and how long was the recovery?

Reversal didn’t change my level of discomfort at all. However, during the first reversal, the doctor found no motile sperm on the left side, and during the second reversal, the doctor found no sperm on the left side. So I infer that my left side has a blockage in the epididymus, and my left side has always been my bad side, so it makes sense that the reversals didn’t do anything. That’s why I wish I had done the reversal earlier, since an earlier reversal might have prevented the blockage from forming.

The first reversal I did with Dr. Marks in Tucson, and the second with Dr. Trost in Utah. Post-operative pain and recovery was not bad at all in both instances. I was comfortably back on my feet in a couple days with minimal pain.

My right side feels okay, so now I’m thinking of doing an orchidectomy on my left side. Although I’m not enthusiastic about the idea of only having one nut, being pain free would be worth it.

Do you think a vasoepididymostomy works have helped you?

I think it might have helped me. And, in retrospect, I think I should have opted for one. However, going forward, I’m not sure if I should get a vasoepididymostomy or an orchidectomy.

A vasoepididymostomy has a much lower chance of success than a vasovasostomy. I asked Dr. Trost, and he said that the chance of success on a single side is 60%, and since about half of vasoepididymostomies scar down over time, that would make the long-term chance of success 30%. That seems like very low odds.

Since my problem has always felt like congestion, I’m pretty confident that an orchidectomy on the left side would fix things, so that’s what I’m leaning towards.