A s a patient, there are many things that you need to consider when making this decision. For one thing, the anatomical area of your body that is to be operated on is not just any area! You should feel confident that the person holding the surgical knife has been adequately trained. Also, your ability to have children and a future family is at stake here - you need a doctor who is committed and qualified to give you the best chance possible. Money is also a factor: medical aids do not pay for this operation and you need to be sure that you are investing wisely. So be sure to ask your Urologist about some of the following issues before deciding:
Microsurgery vs magnification
Ask your Urologist about the exact kind of magnification that he will use.
Vasectomy reversal is a microsurgical procedure – this means that microsurgical instruments and sutures as well as an operating microscope is absolutely essential in all cases.
An operating microscope (24X magnification) is certainly much different from the “loupes” (4X magnification) that most Urologists use. Loupes look like normal glasses that a surgeon puts on but they have special lenses that provide some magnification. An operating microscope on the other hand, is a large instrument that remains in the operating theatre and is positioned above the surgical field. It has eyepieces for the operating Urologist and his assistant and projects a high definition image of the surgical field onto a flatscreen monitor. An accurate vaso-epididymostomy cannot be done without an operating microscope – this is why some Urologists who only use loupe magnification perform vasovasostomy in all their cases, even if it is a completely futile exercise in up to 60% of patients! (See Important Decisions). There are also some Urologists who use no magnification at all…
I use an operating microscope for all vasectomy reversal procedures.
Ask your Urologist whether he has received specific training in microsurgery.
Microsurgery is not part of the standard training that Urologists receive when they do their 5 years of specialization in South Africa.
I completed a course in basic microsurgery in South Africa. I then travelled to the USA where I successfully completed intermediate and advanced speciality oriented microsurgical training at the Cleveland Clinic. A Few years later I visited Weill Cornell Medical School in New York for additional training in infertility microsurgery.
Ask your Urologist about the decisions that need to be made during every vasectomy reversal operation.
There is much more to vasectomy reversal than just “re-connecting the tubes”. During your operation important decisions need to be made which will play a determining role in the eventual success of the operation. The Urologist must have the scientific knowledge to make these judgment calls and also the skill to subsequently proceed with vaso-epididymostomy if indicated (up to 60% of cases). This too, is not part of the standard training of Urologists in South Africa.
I completed observerships in male infertility surgery in the USA at the Cleveland Clinic as well as the Weill Cornell Medical School in New York. My mentors at these institutions have vast experience in microsurgical vasectomy reversal. During my time there I gained valuable insight into the practical technique relating to the surgery itself, and also the more academic issues of making the right decisions during the operation. My tutoring at these world-renowned hospitals has equipped me with the knowledge and skill to provide a quality, comprehensive and evidence based vasectomy reversal service that is on par with leading international Urology centres.
Ask your urologist about his fees for vasectomy reversal, and also about the additional fees for the hospital and anaesthetist.
Cost is an important factor and I am sure many patients will “shop around”. When discussing costs, it is very important to know what exactly you are paying for – so ask the Urologist whether it will be a microsurgical procedure or not, whether he will be able to do vaso-epididymostomy if needed, and whether consultations before- and after the operation are also included.
Market research covering Urologists in most provinces of South Africa has indicated that my fee is appropriate. Because of the enormous amount of additional training and expertise that is required for microsurgical vasectomy reversal, be careful not to try and compare it with non-microsurgical procedures. Find out exact details of the procedure that you are paying for.
Good day Dr Zarrabi I hope you are keeping well. It has been 10 months since we did the Varicocele repair and a lot has happened since then and obviously it’s been quite a journey. But needless to say it was not all in vein. Hence my e-mail to you today. If you recall we went back to the Aevitas about August for one last Invitro (6th). The result was that we had a better count and better mobility due to the Varicocele repair as what we ever had before with the previous 5 Invitros. And I am very pleased to announce that E had a successful/positive result and she is 3 and half months pregnant now. We would just like to express our Sincere Gratitude to you and your staff for all your assistance and prayers through the whole process. Kind regards,
We want to thank you and Dr Zarrabi for being kind and gentle…. There is such a huge difference in patient care, follow-ups and bruising between the previous Dr and Dr Zarrabi’s offices. I thank God that we went to your practice and I will let you know if there is a little heart beat inside of me… Lots of Love.
Good day Dr Zarrabi Trust you well. I just wanted to say thanks very much for your professionalism and great help on my husband’s operation. Today I have a very healthy active 9 month old son thanks to you. At one stage we had just given up because nothing happened but then this miracle came along. Keep up the great work. Thanks and regards,
Dear Dr Zarrabi We have the best, if not surprising news, 'M is PREGNANT!!! She been feeling funny in the latter part of August as I was starting my course of prelox. We are overwhelmed and overjoyed. Thank you, thank you so so much.
Good morning Gillian I just want to send you this email to say a big thank you for all your assistance in making our trip a success. We are safely back home and everything with M is going great so far. Dr Zarrabi really is the best! I will keep you posted on any further developments. Thank you kindly and have a blessed day.
Hi Doctor Baby girl YP was born on the 12th of April 2017. You do amazing work and she turns 3 months old tomorrow. See pics attached… Regards
Dear Dr Zarrabi A and I feel truly blessed to have been able to have this reversal done by Dr Zarrabi. The fact that he is able to even perform an operation of this nature is truly amazing and we are fortunate to have somebody in South Africa that has the skillset to perform Micro surgery reversals. I imagine it must be very rewarding to make such a positive difference in people’s lives. In addition to this we found it to be easy and hassle-free to undergo the surgery in spite of the fact that we live more than 1500 kilometres away. Thank you for the professional, efficient and friendly way that you assisted us throughout this process. I will be sure to let you know as soon as A is pregnant (she may already be). Once again thank you.
Good day Dr Zarrabi Thank you so much to You and your Staff. We (my Wife) recently did a blood test; and it came out positive - that she is pregnant. Thank you soo much Dr Zarrabi; thank you for helping us in our journey.
Thank you so much, doc I truly appreciate all your support and valuable information. I hope your stay in the USA is amazing, you have been the most amazing medical professional i have ever dealt with and I'm extremely grateful that you've helped me all along. Kind regards,
Good day Dr Amir / Gillian and Team I hereby would like to thank you all for the excellent and friendly service we received. Everyone on the doctor’s staff was professional and efficient, they made me feel at ease in a stressful situation. I felt that I made a good choice in coming here and, as a group, each of the staff members cared for me and wanted to help me get better. I was thoroughly impressed with the facilities and services at the hospital. Everyone knew what needed to be done, at what time and did it with a smile and compassion. Any questions that myself or wife had was answered quickly and with a friendly disposition. In closing, I would like to thank you for all that you did even after I was dismissed and had a little complication Dr Zarrabi assisted and was ready to take action. It is professionals as yourself and facilities like your hospital that made me decided to use you from the beginning. Regards,
Dear Dr Zarrabi We are not sure you will remember us, amongst all your clients! D and I came to see you in November 2013 for a vasectomy reversal procedure. You were a little concerned that his vasectomy was 15 years in the past and he was 55 at the time. We visited your practice this month while in Cape Town for the first scan of our expected little one - we wanted to share the good news with you! We did conceive within 3 months of the procedure but had an early miscarriage and what with the ups and downs of life over the last 2 years didn't get this far until now. SO - D is in peak condition and our baby is due on Christmas day this year. Thank you so very much for all the microsurgery and D says please send him 1000 business cards to hand out wherever he goes! We will send you a picture of the three of us for your collection when baby is born. With heartfelt gratitude and deepest thanks.
Dear Dr Zarrabi We are writing to you to thank you for your amazing care, concern and professionalism. Since meeting you we have has such a wonderful experience working with you. Thank you for everything!! It is greatly appreciated. Wishing you a good evening. With gratitude,
Hi Amir Hope all's well on your side. I am pleased to announce that L is pregnant - exactly 1 year to the day of the reversal! We had it confirmed with a blood test today. We just thank you for your skill and optimism. Just interested to know... Have we set a new record for length of time between vasectomy and reversal: 18 years ;-) thanks again to you and your team. Cheers D.
Liewe Dr Zarrabi Ons wil u net graag in kennis stel dat die prosedure wat u gedoen het suksesvol was. Ons moes nog gaan vir die sperm analise, maar ons het vroeër uitgevind ons is swanger. Ons is nou 6 weke swanger, en wil u net baie hartlik bedank vir die suksesvolle operasie. Baie Dankie
Hallo Dok, Lyk my jou operasie was ‘n reuse sukses. My vrou is nou 11 weke swanger. Dit het ons dus so 1 jaar en 3 maande geneem om swanger te raak. Groete,
Hi Amir Weereens baie dankie vir jou hulp! Dit was n great ervaring! Baie profesioneel! World Class!! Groete
Dear Dr. Zarrabi, Hope you are well. I just want to say thank you for a fantastic service and care I received. It was nice to chat with you first and it made me feel like I am in the right hands. The staff in the clinic were also great. Warm and kind and understanding. A service that stands out compared to other clinics or hospitals where nobody comes to check on you and you never see anybody around.
Hallo Dokter Zarrabi Ekt gister met my sussie en swear ‘n koffietjie gedrink en hierdie ‘great’ storie gehoor van hoe u hulle hanteer en versorg het. (eintlik gebless het!) My mond het oopgehang, want mens hoor dit min. Dankie Dokter, ek eer en respekteer jou daarvoor. Alle sukses met jou praktyk en drome vorentoe. Vriendelike groete
Hello Dr. Zarrabi, It has been a hectic couple of months. I have great news, M is 11 weeks pregnant and to top it off I didn’t even go for the sperm test. We found out the week that the test was scheduled. Thank you! You have worked miracles we never in our wildest dreams thought that it would happen so soon. We will keep you updated as the pregnancy progresses and might even come introduce the little one next time we are in Cape Town. Regards
Dear Dr Zarrabi, Many thanks to you and the gift that you have given to me. I really wish that I were in Cape Town to celebrate with you. Thanks once again for your great skill and miraculous hands.
Hi Doc, Just a quick email to share our wonderful news - we are pregnant!!! We can't thank you enough for all you have done, and not giving up when most doctors probably would have just shrugged their shoulders. I know you were a tool in the Great Healer's hands, but nonetheless, a BIG thank you!! Can't wait to send our updated family picture. Have a wonderful, blessed day!
Dear all, After much soul searching, S and I decided to reverse his vasectomy and try naturally before resorting to other options. S had his vasectomy reversal done by Dr Amir Zarrabi. We never got to do the 6 month sperm test as I had fallen pregnant. The pregnancy was uneventful and our son was delivered at 39 weeks.
Hi Dr, Thank you so much for this report!! I am in tears right now, I did not even realize how much I was stressing about this until I got your e-mail!! You really have made this year the best one ever and we will highly recommend you to anyone we can. Your support and complete handling of our case including your after service has been so amazing! We are both so grateful to you. Kind regards,
Dear Dr Zarrabi This letter is long overdue…but for a very happy reason. My wife and I would like to express our heartfelt appreciation for the efforts you made and the application of your considerable skill in reversing my previous vasectomy done 13 years ago. Before proceeding with the surgery you fully explained what we could expect in terms of a timeline, and we complied with all the steps along the post-surgical way. As per your instruction we were supposed to have a sperm analysis done 3 months after the operation but when my wife missed her date we knew something was going on and I didn’t even have to go for the sperm test. We were ecstatic to learn that the surgery was successful and that I was once again delivering viable “swimmers”! We are now 12 weeks pregnant and all thanks goes to you. Doctor we are so blessed to came across your information on the website just when we were at our lowest. We have been through ICSI twice, as we thought it would have a better chance of success. With even everything as normal and positive as could be both sessions was unsuccessful. It costed us a fortune and we didn’t realize that if we did our homework properly the first time, we could had our baby in our arms right now. That is why we are extremely thankful that you have done such a great job. We never doubted you once…we just knew this was it. Words are a poor conveyance of the gratitude we feel, but please accept them with the knowledge that you have made us very happy as a result of your outstanding skill and diligence. Warmest regards,
Hi Doctor Amir, We hope that you and your family had a wonderful Christmas and new year. We have some wonderful news, D is pregnant!! This miracle was conceived naturally!! She is just over five weeks today and we are both over the moon. We would like to thank you again for all that you have done for us to make this miracle happen! We will keep you updated. Kind regards,
Dear Dr Zarrabi, As you can see from the attached pics, our 2015 started off extremely well, all thanks to you... KL was delivered via c-section at 08:31am on Friday the 2nd Jan 2015. Weighing 3.22kg and measuring 51cm. She is gorgeous! I'd like to extend a very big thank you to you and your staff for making our dream come true. A is thrilled to be a big sister. Take care and best regards,
Good day Dr Zarrabi We are happy to announce the birth of our baby girl TH. She was born on the 4th of February 2015 weighing 3.350kg. This was a miracle to us. We would like to thank you for making our dream come true by resulting in a successful vasectomy reversal on my husband G in October 2013. Thank you so much doctor!