El Camino Urologist Offers "Second Chances" to Dads

Business Wire, May 28, 2008

Technology Makes Father's Day A Realistic Prospect

MOUNTAIN VIEW, Calif. -- More than 500,000 men annually make the decision to have vasectomies, the most permanent and effective form of birth control. But up to 35,000 change their minds after undergoing the procedure. What are their options--and prospects--of successfully fathering a child?

"Well over 95 percent of vasectomies can be successfully reversed through microsurgery," says Dr. Edward Karpman, a member of the El Camino Urology Medical Group (affiliated with nonprofit El Camino Hospital in Mountain View, CA) and head of the California Vasectomy & Reversal Center (www.californiavasectomyreversalcenter.com). He is one of only a handful of board-certified and fellowship-trained microsurgeons who specialize in vasectomy reversals. "It's important to erase common misconceptions that reversals are difficult, expensive, and often unsuccessful," he says. "In fact, it is by far the most cost-effective method of getting pregnant after a vasectomy, better than often-recommended sperm retrieval and IVF."

Vasectomies are minor surgical procedures that cut the tubes (vas deferens) that deliver sperm from the testes, usually performed to provide permanent contraception. The most common reason for wanting a reversal is divorce and remarriage, followed by a change of heart regarding the desire for more children or the death of a child.

"Changing societal patterns of marriage and fatherhood mean more men are having children later in life and vasectomy reversals are growing in popularity each year," Karpman says.

A prevalent misconception is that the success of the reversal procedure declines the longer a man waits to have the reversal.

"The key factor affecting success is correct identification of the appropriate procedure necessary for reversal," says Karpman. "Historically, surgeons have relied only on the standard vasovasostomy to reconnect the vas deferens. However, sometimes a secondary obstruction develops in the epididymal, a long, narrow tube that connects the testicle to the vas deferens. This requires a more complicated procedure, called an epididymovasostomy. It must be performed microsurgically and is considered one of the most technically challenging operations in urology."

The good news, however, is that this complex surgical procedure can increase successful vasectomy reversal outcomes dramatically. "Regardless of the time lapse from vasectomy to reversal, the average success rate for this complex procedure is 75 percent, and 96 percent with the more common vasovasostomy," Karpman says.

Because it is seldom possible to determine preoperatively which procedure will be required, the American Society of Reproductive Medicine has issued practice guidelines recommending that only surgeons skilled in both perform vasectomy reversals. Patients seeking a vasectomy should make sure their surgeon has the appropriate training and experience in both types.

"The operating microscope has revolutionized surgery for male reproductive disorders and made vasectomy reversals faster and more successful," Karpman says. "The vas deferens is about the size of a strand of spaghetti--2-3 millimeters external diameter--and requires powerful magnification to reapproximate the edges in two to three separate layers. We use a suture half the size of a human hair that is barely visible to the naked eye."

Both procedures can be performed as outpatient surgery with the patient immediately ambulatory.

"The most rewarding part of my practice is seeing patients realize their dreams of fatherhood," said Karpman. "I'm incredibly lucky to be in a field that helps create such happy outcomes."

Dr. Karpman will deliver a talk on vasectomy reversals on June 18 from 7 to 8 pm at El Camino Hospital. To register, call 800-216-5556.