{"id":3229,"date":"2026-09-21T07:08:24","date_gmt":"2026-09-21T07:08:24","guid":{"rendered":"https:\/\/www.malereproduction.com\/blog\/?p=3229"},"modified":"2026-09-21T07:08:24","modified_gmt":"2026-09-21T07:08:24","slug":"dr-philip-werthman-vasectomy-reversal-my-35-year-experience","status":"publish","type":"post","link":"https:\/\/www.malereproduction.com\/blog\/dr-philip-werthman-vasectomy-reversal-my-35-year-experience\/","title":{"rendered":"Dr. Philip Werthman | Vasectomy Reversal: My 35-Year Experience"},"content":{"rendered":"\n

By Philip Werthman, MD, MMH<\/a><\/p>\n\n\n\n

After more than 35 years performing vasectomy reversals<\/a> and helping thousands of men regain their fertility, I have learned something important: there is still an enormous amount of misinformation about vasectomy reversal. I regularly meet patients who have been told that vasectomies<\/a> are not really reversible or that reversal stops working after 10 years. Those statements are simply not true as general rules.<\/p>\n\n\n\n

A properly performed microsurgical vasectomy reversal can be highly successful even many years after the original procedure. I have treated men well over a decade after vasectomy who had sperm return and later had children. For me, that remains one of the greatest joys of my professional life: giving men and couples another opportunity to have a family naturally.<\/p>\n\n\n\n

Vasectomy Reversal Is True Microsurgery<\/h2>\n\n\n\n

Patients should understand just how small the structures are. The vas deferens is a small tube, but the channel inside it – the lumen through which sperm travel – is only about 0.3 millimeters in diameter, roughly the size of a tiny pen dot.<\/p>\n\n\n\n

That is the scale at which a reversal surgeon operates. The goal is to reconnect these microscopic channels precisely enough for sperm to travel again. I believe the best way to do that is with a high-powered operating microscope and extremely fine sutures. I use 10-0 microsutures, far finer than a human hair, to align the tissues as precisely as possible.<\/p>\n\n\n\n

This is not simply sewing two tubes back together. It is delicate reconstructive microsurgery, and at this scale tiny technical differences matter.<\/p>\n\n\n\n

Microsurgery Is Not a Focus of My Practice – It Is the Focus<\/h2>\n\n\n\n

This distinction is important when choosing a surgeon. Male reproductive microsurgery is not one part of a broad general urology practice for me. It has been the central focus of my professional career. For more than three decades, I have concentrated on male infertility<\/a> and the microsurgical procedures<\/a> used to treat it, including vasectomy reversal, vasoepididymostomy, varicocele repair<\/a> and sperm retrieval<\/a>.<\/p>\n\n\n\n

That makes this level of experience increasingly unusual. When I trained and began practice, vasectomy reversal was a much larger part of male infertility treatment. Over the past 10 to 15 years, IVF and ICSI<\/a> have become increasingly available, and many younger urologists coming out of training simply have not had the opportunity to accumulate the same volume of reversals. That is not a criticism of younger surgeons; it is a reflection of how fertility treatment has evolved.<\/p>\n\n\n\n

Microsurgery is a skill built through repetition. Over my career, I have performed thousands of vasectomy reversals. That experience includes straightforward anatomy, long vasectomy intervals, scarring, previous failed reversals and the difficult reconstructions that become familiar only after years of high-volume work.<\/p>\n\n\n\n

The Surgeon Must Be Prepared for More Than a Simple Reconnection<\/h2>\n\n\n\n

Sometimes the correct operation is a vasovasostomy, reconnecting the two ends of the vas. In other cases, a secondary blockage has developed closer to the testicle and the proper operation is a vasoepididymostomy, connecting the vas directly to an extremely small epididymal tubule.<\/p>\n\n\n\n

The surgeon may not know which operation is required until the procedure is underway. In my view, anyone performing vasectomy reversal should be fully comfortable with both techniques, because the patient should not discover during surgery that the reconstruction he really needs is beyond the surgeon’s usual experience.<\/p>\n\n\n\n

Vasoepididymostomy is one of the most technically demanding operations in urologic microsurgery. I developed the mini-incision microsurgical vasoepididymostomy, a technique that allows this complex reconstruction to be performed through a much smaller incision than the traditional operation, without having to widely open the scrotum and fully deliver the testicle. The goal was to make the surgery less invasive, with less postoperative discomfort and an easier recovery, while preserving the precision required for the microsurgical connection. The technique was published in the journal Urology and was subsequently recognized at the American Urological Association<\/a> annual meeting as one of the top advances in fertility-related microsurgery. Developing and refining techniques like this is part of what it means for microsurgery to be the focus of my practice rather than an occasional procedure.<\/p>\n\n\n\n

Why I Prefer General Anesthesia<\/h2>\n\n\n\n

Patients sometimes ask whether reversal can be performed under local anesthesia or sedation. Technically, it can. My goal, however, is the most precise reconstruction possible. When I am placing microscopic sutures around an opening measured in fractions of a millimeter, movement matters. General anesthesia keeps the patient completely still and comfortable while I concentrate entirely on the microsurgery.<\/p>\n\n\n\n

The Myth of the 10-Year Limit<\/h2>\n\n\n\n

One misconception I would most like patients to forget is that vasectomy reversal stops working after 10 years. There is no magical expiration date. Success can decline as time passes because secondary obstruction may develop, but men many years and even decades after vasectomy can still be excellent candidates.<\/p>\n\n\n\n

The important issue is not simply how much time has passed. It is what is found during surgery, what reconstruction is required, and whether the surgeon has the microsurgical experience to perform it.<\/p>\n\n\n\n

Why Patients Travel to See Me<\/h2>\n\n\n\n

Patients often ask whether it is really worth traveling to see a surgeon who specializes in vasectomy reversal rather than simply choosing a urologist close to home. For many men, I believe it is.<\/p>\n\n\n\n

A vasectomy reversal is something you hope to have performed once. The inconvenience of traveling for surgery is relatively small compared with the importance of getting the reconstruction right the first time. An unsuccessful reversal may mean another operation, additional expense, or ultimately moving on to assisted reproduction.<\/p>\n\n\n\n

Patients have traveled to my Los Angeles practice from across the United States and other countries. They are not traveling because the surgery cannot be done elsewhere. They travel because this is a tiny, unforgiving reconstruction and they want a surgeon whose career has been devoted to male reproductive microsurgery and who has performed thousands of these procedures.<\/p>\n\n\n\n

When choosing a surgeon, look beyond geography. Ask how many reversals the surgeon has performed, how frequently he performs microsurgery, whether a true operating microscope is used, whether he routinely performs both vasovasostomy and vasoepididymostomy, and whether male reproductive microsurgery is the focus of his practice or something he performs only occasionally.<\/p>\n\n\n\n

One Operation. A Potentially Life-Changing Result.<\/h2>\n\n\n\n

I have performed thousands of these operations, but for the man on the operating table this is never simply another procedure. It may mean having a child with a new wife or partner, having another child years after believing his family was complete, or regaining the opportunity to conceive naturally.<\/p>\n\n\n\n

That is why, even after 35 years, I still approach these operations with tremendous respect for the anatomy and attention to detail. The technical part of the surgery may be measured in fractions of a millimeter, but the result can change the course of a family’s life.<\/p>\n\n\n\n

Helping a man regain the possibility of fatherhood has been one of the greatest privileges of my professional career. But some of the moments that have meant the most to me have come long after the surgery was over. Over the years, patients have sent me hundreds of baby photographs, many of which cover the walls of my office. Others have stopped by months or even years later to introduce me to the children they were able to have after their reversal. Those moments never become routine.<\/p>\n\n\n\n

They are a reminder that vasectomy reversal is not simply about reconnecting a tiny tube. It is about giving men and couples another opportunity to experience the extraordinary joy of parenthood. That has always been the real goal of my practice: to give people the best possible chance to build the family they dreamed of.<\/p>\n\n\n\n

Philip Werthman, MD, MMH
Director, Center for Male Reproductive Medicine and Vasectomy Reversal<\/a>
Los Angeles, California<\/strong><\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

By Philip Werthman, MD, MMH After more than 35 years performing vasectomy reversals and helping thousands of men regain their fertility, I have learned something important: there is still an enormous amount of misinformation about vasectomy reversal. I regularly meet patients who have been told that vasectomies are not really reversible or that reversal stops … Continue reading Dr. Philip Werthman | Vasectomy Reversal: My 35-Year Experience<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3229","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/posts\/3229","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/comments?post=3229"}],"version-history":[{"count":1,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/posts\/3229\/revisions"}],"predecessor-version":[{"id":3230,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/posts\/3229\/revisions\/3230"}],"wp:attachment":[{"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/media?parent=3229"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/categories?post=3229"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.malereproduction.com\/blog\/wp-json\/wp\/v2\/tags?post=3229"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}