I had my consult with Dr. P today and wanted to share the answers to my questions. Keep in mind this is to the best of my recollection and not actual quotes from the Doc; it’s not intended as medical advice nor can I guarantee my level of accuracy in relaying it, so please consult with your urologist before making decisions.
Q I’ve heard all reversals fail eventually–is this true?
A Reversals do fail eventually. He has one patient still going 10+ years post reversal, but most end up with their tubes closing.
Q What does this reversal failure entail–do symptoms return?
A The good news is that when a reversal helps with pain or ED, the symptoms do not normally return upon failure. An added bonus is that it is essentially like another vas that could prevent pregnancy (but without the side effects).
Q Wouldn’t this tube blockage lead to possible epi blowouts or painful sperm granuloma formation?
A The sperm is typically absorbed into the body without issue and the the blown out epi hasn’t been an issue with vas to vas reversal
Q I’ve heard that vas to vas is the way to go for a reversal (and not vas to epi)–is this the case then?
A Vas to vas is what he performs to help with pain and other symptoms; vas to epi is used for fertility reasons mostly if a vas to vas can’t be performed
Q There are always risks with surgery–what are the chances of a person without pain developing PVPS or something similar as a result of the reversal?
A Very low
Q The statistic they quote for vasectomy is the 2% chance of chronic pain or major issues–is this similar to the odds of developing long-term pain from the reversal?
A The odds are lower than that; reversals can often times help with pain and very rarely cause increased chronic pain in the long term
Q Can the body’s immune response cause issues at the reversal site or for a person’s overall health?
A We are finding that the immune response doesn’t really have an effect
(note: I personally disagree with the assertion that a constant immune response has no effect; I don’t think we could even begin to understand the possible health issues that could be triggered by an immune system in constant high alert; with that said, the vasectomy itself triggers the permanent immune response, so a reversal might not effect this anyway)
Q Some people take papaya seed daily to reduce sperm production (which might help with avoiding pregnancy or lessening the immune response)–is there any issue with doing this?
A No, you can take papaya seed daily
Q If a person with post vas side effects doesn’t elect for the reversal, what are the chances of improvement?
A Pretty decent. A lot of people with pain or ED see symptoms resolve in the months following vas
Q 3 years is the generally accepted window for when it’s most effective to go the reversal route–do you agree with this and would doing it within, say, 6 months improve results further?
A 3 years or less is the ideal timeframe. He didn’t think it would make any difference if you waited 6 months vs. 2 years.
Q Can you tell me more about the bio wrap option and if there are any potential drawbacks for having a foreign material present?
A The bio wrap is available if you want it, but it’s expensive and he doesn’t recommend it. It sounded promising in theory, but they are not seeing any difference in outcomes with or without it
This is my best recollection of our conversation. I hope this is helpful to others!