Armor Men's Health Show

Become a Dad Again With a Vasectomy Reversal! Dr. Mistry Explains Fertility Odds and Why You Should Bet on NAU Urology Specialists

June 19, 2021 • Dr. Sandeep Mistry and Donna Lee

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Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Dr. Mistry and Donna Lee explain why some men choose to have vasectomy reversals and what that process looks like at NAU Urology Specialists. A number of factors can influence a couple to have a vasectomy reversed: change in financial situation, the heartbreaking circumstance of child loss, and/or remarriage are just a few reasons men and their partners may decide to become parents again. The success of vasectomy reversals often depends on the age of the original vasectomy. After 7-15 years there is a reduction in the likelihood of successful pregnancies resulting from a vasectomy reversal. The skill and expertise of the surgeon also plays a role in the outcome, and at NAU Urology Specialists, our surgeons are incredibly experienced at these delicate procedures. Another factor to consider is the age of the partner hoping to conceive. In general, after age 34, a woman's chance of conceiving by way of her partner's vasectomy reversal declines. Luckily, the combination of sperm extraction and IVF can help older couples become parents again, too. If you or your partner are interested in learning more about these family planning options, or about fertility in general, please give us a call today!

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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Email: Armormenshealth@gmail.com
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Speaker 1:

Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry:

Hello, welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my cohost, the wonderful Donna Lee.

Donna Lee:

Hello, everybody. Happy day.

Dr. Mistry:

Happy day. This is the Armor Men's Health Hour. I'm Dr. Mistry. That's my real name.

Donna Lee:

M-I-S-T-R-Y.

Dr. Mistry:

This is a men's health show. We all have been doing this show on KLBJ news radio 99.7 FM, 590 AM for the last two years.

Donna Lee:

Yeah, it felt like two minutes...underwater.

Dr. Mistry:

Underwater. It's gone so quick. We started this show in celebration of, of men's health month. We're in the midst of men's health month. That's June. I think it's big it's men's health month because it also includes Father's Day.

Donna Lee:

It's an important month for you. Are you going to celebrate?

Dr. Mistry:

Yeah. All my kids are at camp.

Donna Lee:

Oh. So that's your celebration?

Dr. Mistry:

Yes. For Father's Day this year, I'd be like, I'd like to be left alone.

Donna Lee:

That's more of a Mother's Day thing.

Dr. Mistry:

I've heard that from Mother's Day. It's funny. This show is brought to you by the practice that I started in 2007, NAU Urology Specialists. We have offices all over the place. Donna, tell people how to get ahold of us and make an appointment.

Donna Lee:

That's right. You can call us during the week at(512) 238-0762. We're located in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Our website is armormenshealth.com and our email address where you can send your fabulous questions to, or that we will answer anonymously is armormenshealth@gmail.com. We're getting some incredible feedback, Dr. Mistry, M-I-S-T-R-Y.

Dr. Mistry:

Thank you for that. We have patients that are coming to see us after listening to the show. We love talking to them. It's accomplishing exactly what I wanted. We want people to be kind of primed and knowledgeable about what they should expect from a healthcare provider before they come and see us. We like knowledgeable patients, you know, patients that research their own treatment options and algorithms so that we can give them the best treatment possible. We focus on the nipples to the knees here and here in urology.

Donna Lee:

That's right. Nipples to the knees, forward and backwards.

Dr. Mistry:

But if you're out there and you have a medical condition and you're stuck with it, and you're wondering if we have any recommendations on providers or specialists, please send us an email. We get these emails all the time. We have wonderful partners here in the Austin area, and we're, we'll be more than happy to look for people elsewhere through our connections, with different universities and medical schools. We know our practice is big and robust, and we're here to help you.

Donna Lee:

That's right. So, I wanted to chat about something cause I'm getting a lot of feedback from some patients that are being sent your way: vasectomy reversals. So we talk about vasectomies quite a bit, but I've talked to two people just this week about vasectomy reversals. So we did a podcast in the past about it, but I thought we could do a fresh one and talk about how it's handled, when is, when is it too long to have a reversal? One of the patients was interested because he wanted to have a vasectomy because his wife had some really serious health complications and they thought it would just be easier because they're not ready for kids. But then he said,"Well, you know, if I want to change our mind in a year, can I come back for a vasectomy?" So I wanted to talk about that.

Dr. Mistry:

You know, it reminds me, recently a dad was telling me that his son may get in a little trouble early in his life. Maybe he should get his 19 year old a vasectomy just in case. That is not an appropriate parenting style in case you're wondering, but I've had a number of athletes, young athletes who were playing college football and basketball that have come in for a vasectomy because of their concern that, you know, they would inadvertently get somebody pregnant. But the vasectomy in the simplest sense is to find the tubes that transport the sperm from the testicle to the prostate, that's where it get deposited, and take that tube, the vas deferens, and cut it and then tie them off in some way. We have what's called the Mistry Vasectomy. It's an IV sedation, single visit, no metal clip, and I think, you know, one of the best methods of doing a vasectomy. And all of our providers here do that same technique and it's covered by insurance and we've had very high satisfaction rates. But when a patient wants to have that reversed, that can be for a number of reasons. We've seen patients who, you know, were in a bad economic position, gotten a better economic position, but had the same partner. We've had patients whose children have died and they wanted to have another baby. But the vast majority are men who get remarried and they would like to have more children with their new spouse.

Donna Lee:

So the older guy with the hot young wife and the question is how much money does he have? That guy?

Dr. Mistry:

When, when I learned how to do these back in Houston with Larry Lipshultz, he's like the king of male fertility, it would be the case that these people would fly in from other states and they would put the wife in like a limo to go shopping at the Galleria, and the poor guy would be doing his vasectomy reversal with us. It was, it was a pretty funny sight. But interestingly enough, over the years, what has happened is that second wives have gotten older.

Donna Lee:

Oh, right. And that's okay.

Dr. Mistry:

And so it's changed, it's changed the calculus of what is the right way to go about having a child when you remarry. It may seem obvious to some people that if you've had a vasectomy and the tubes are cut, that you just tie the tubes together and you can have a baby again. But it's not just a simple act of plumbing. If you go to an appropriately trained micro surgeon, and not all urologists are appropriately trained in microsurgery, where I trained at Baylor College of Medicine, the best place on earth to train as a physician, you, we actually spent quite a bit of time sewing the vas deferens of rats together and the arteries of rats together--I mean, this is, it requires incredible hand-eye coordination, ability to work under a microscope, and practice. And a lot of people just don't have it. So make sure your surgeon does vasectomy reversals, but usually it's a self-selective kind of group. The vas reversal in my hands takes me about an hour and 15 minutes. I do it in the operating room. It costs about$6,300 for the surgeon's fee, anesthesia, and the fee for the surgery center and all the instruments. The most expensive thing are the sutures that we use. They're so small that they're about maybe a quarter of the thickness of the human hair. They're super small. You can't even see them.

Donna Lee:

How does it stay together?

Dr. Mistry:

Because you use a lot of them and they're super strong and made of nylon. It's an amazing, it's an amazing case. It's something that I love to do. And I help a lot of the guys in town do them when their own patients would like a vasectomy reversal. I do help a lot of people in town when they themselves would like a vasectomy reversal. We know if their patients want it. So the procedure, the success of it depends on how long it's been since your vasectomy. Generally, we think of people below between, you know, seven years from their vasectomy as being the ideal candidates, oftentimes over 85% success rates. The rates can drop significantly between 7, 15 and 15 years. And then over 15 years, the rates drop even further. And that's because when you cut the, when you tie the tube off, it causes changes in the testicle and the epididymis and where the sperm are getting stored and all those dead sperm there, they're just kind of cause inflammation and blockage and it just doesn't reverse. And so if you've had a vasectomy that's older, you can just get the sperm and not reverse it. It's called a sperm extraction.

Donna Lee:

Oh. That makes sense.

Dr. Mistry:

And nowadays, so 20 years ago we would do 15 vas reversals to every one sperm extraction. And now it's the opposite. And that's mainly because of the second wife age issue. So when, when the spouse was in her twenties, the likelihood of getting pregnant was very high and so doing a vas reversal made a lot of sense. It was the cheaper way to do it. And, you know, you could have more than one kid. Now when people are remarrying and your spouse is 38. Now you're running into just female related age issues when it comes to having a baby. So in our literature, when the woman is over the age of 34, the likelihood of walking out with a baby or actually getting pregnant, having a child is much better by doing a sperm extraction along with in vitro fertilization. So if you're in that boat, sometimes patients come to us assuming that the vas reversal is the only way, but ultimately the goal for some patients is just to kind of see what happens--reverse it, and let's see what God has in store for us. But other people, they really want to come out of the experience with the baby and are willing to spend the money and the time and the effort to do IVF. And so there are options for that, for those of you interested in a vasectomy reversal, however, there's very little testing needed. Even if it's been a long time, but it's something you want, then we're more than happy to accommodate. There are people in this area and people in all areas of the United States that will do the procedure in the office under like a light sedative. But oftentimes those people are not urologists, believe it or not.

Donna Lee:

What are they?

Dr. Mistry:

They're something else. They're another, I mean, surgeons are surgeons, but...

Donna Lee:

Like when Cardi B got her butt implants in a basement. No these are doctors...

Dr. Mistry:

No, these are doctors, but, but not necessarily urologists. But more importantly, and, and, and, and we have this in this area, surgeons who do vasectomy reversals, but don't treat male fertility. And that's always backwards to me. It's the same thing like when you go to a shockwave treatment clinic and they don't treat impotence. You know, you're, you're like, it doesn't even cognitively make sense. They're not really physicians trained to help you have a baby. They're just physicians trained to tie two tubes together. And, and, if you're looking really to restore your fertility, to be a dad again, as we celebrate father's day and...

Donna Lee:

Don't we have a special running for Father's Day, a vasectomy reversal...it's free!

Dr. Mistry:

No, we don't have that. And, and the, and the, the special we're running is the 10% off your gin and vodka if you get a vasectomy for Father's Day. Donna, how do people get ahold of us if they're interested in being a dad again?

Donna Lee:

You can be a dad again by calling(512) 238-0762, and check out our website and our podcast at armormenshealth.com.

Speaker 1:

The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.