Category Archives: Atlanta McHugh Vasectomy Reversal

Atlanta, Ga. Vasectomy Reversal-Cost Revealed.

reversal vasectomy accredited center

Vasectomy Reversal…The sweet spot: Physician owned and accredited facility, best all inclusive price and experience.

Microscopic vasectomy reversals are not covered by insurance, as a result prices can vary dramatically. Certainly the experience and skill of the surgeon is important and has a value, however the price is often influenced significantly by where the procedure is performed and the type of anesthesia utilized. Let me explain.

The cost of vasectomy reversal depends in large part on the location where the procedure is done and on the type of anesthesia given.

Lowest cost scenario: Non accredited facility/Local anesthesia.

The surgeon, regardless of the degree of experience, uses an office setting outfitted for surgical procedures. Magnifying glasses called Loupes or an operating microscope are utilized. The anesthesia is oral medications, and local anesthesia. The patient is awake and aware. The facility is not accredited for general anesthesia. Not having to pay the fees associated with having an accredited facility equipped for general anesthesia or a certified anesthesiologist allow the procedure to be done at the lowest cost.

Middle cost scenario: Non accredited facility/Conscious sedation:

Here again the procedure is performed as above in an upgraded office setting and conscious sedation is given for pain control. As a result this aids in keeping the patient still. A pre-procedure oral medication is given, local anesthesia is used (Lidocaine to the scrotal and vas deferns) and I.V. medicine complements the anesthesia. The patient is not having general anesthesia and can respond to questions, as a result the facility does not have to have general anesthesia accreditation. (If the I.V. sedation is given by a certified anesthesiologist (M.D. or C.N.R.A.) this improves the safety of the 2-3 hour procedure but then adds to the cost. I.V. medicines requires monitoring, ideally administered by an anesthesiologist. The supplies and medications used adds to the cost.

Middle cost scenario: Accredited and Practiced owned surgery center/ Conscious sedation or General anesthesia.

This is the scenario at Northeast Georgia Urological Associates. The best of all scenarios. Why? The facility is state licensed and accredited for conscious sedation or general anesthesia. The facility is practice owned and on site. (You don’t have to go to a hospital or a ambulatory surgery center at another site and with equipment and staff that the surgeon can’t control.) The safety and options are dramatically better than the “outfitted office” setting, and the cost is dramatically less than a hospital. This scenario is the best of both worlds in providing a hospital level oversight while keeping the all inclusive acceptable.

Highest cost scenario: An operating room in a hospital is used:

If the reversal doctor is affiliated with a hospital and performs the procedure there, the expenses go up dramatically. The fees are often times are more about paying the hospital than for the expertise of the physician performing the reversal. If the doctor doesn’t do reversals often and you are paying more for the facility in which it is performed, as a result you lose two ways. You are paying for a more expensive location and for the less experienced reversal physician.

The Sweet Spot?

  • Board Certified Urologist
  • Reversal Experience (Hundreds performed)
  • On site, Accredited/State licensed and Physician owned facility.
  • Experienced staff- R.N.s and Certified anesthesia.
  • Best all-inclusive price in Georgia.
  • The “Reversal Sweet Spot”- Experience, Accredited Facility, General Anesthesia and The best “apples to apples” all-inclusive price.

Middle cost scenario/Accredited facility owned by the reversal urologist: This is our scenario. Our facility is accredited by the State and AAAASF. As a result, we are licensed to provide general an)esthesia and are yearly evaluated by the accrediting agency to assure safety and all of the oversight you’d expect from a hospital. Our facility has a generator, special heating and air, a recovery room, certified anesthesia and registered nurses. This comes with an expense to our practice but allows accredited care. We are in the what I like to refer to as the “sweet spot.” The patient has the benefits of a hospital, but not the costs. As well, there is the convenience of having your procedure in a facility that is on site and I own. (The instrumentation, the nurses, the operating room is geared for reversals. This is opposed to having to be scheduled for your surgery at an off site surgery center with instrumentation and nurses, over which the physician has no control.)

The first step of a microscopic vasectomy reversal.

You’d think that finding the area of a vasectomy done years ago would always be easy. Well…not always. If the urologist used clips to facilitate the vasectomy, this makes finding the area very easy. However, if he removed only a small portion of the vas deferens and cauterized a small segment on either side of the the transection…this can be difficult to find.

In the picture above you can see on the left side the vas tube is slightly smaller than the right and that the right seems to have groves in it as well increased vascularity. The groove indicated that this is the portion closest to the testicle and is called the convoluted portion of the vas. In the middle of the two yellow things (penrose drains) is the scar from the vasectomy.

This scar will be removed, the fresh ends unaffected by the vasectomy scar isolated and approximated, and then the microscope will be brought into the surgical field to accomplish the microscopic repair with microscopic suture the size of hair.

Often times, whether this step is easy or difficult will predict the how easy or difficult the rest of the procedure will be.

It’s a “patient journey.”

But…it’s worth it!

Give us a call and let us help you achieve that new addition to your family!

What a microscopic vasectomy reversal “technical” success looks like!

Microscopic vasectomy reversal semen analysis specifics.

  • Year vasectomy performed-2012
  • Date of Vasectomy Reversal by Dr. McHugh – May 2021
  • Date of post reversal semen analysis- December 2021
  • Number of sperm seen-98 million
  • Number of sperm necessary for pregnancy-20 million
  • Motility-65%

Assessment-A good start!

The road to a successful pregnancy after a vasectomy reversal is convoluted journey. The above semen analysis is a wonderful start and confirms that the procedure was successful and that the patient’s testicles adapted to being obstructed for the 11 years. Now the normal impediments to pregnancy common to all couples becomes a factor. Considering all the factors, this is very favorable in culminating in a successful pregnancy. We wish the couple a happy outcome and appreciate the opportunity in participating by way of a microscopic vasectomy reversal.

Vasectomy and Lewis and Clark-Today in history.

The Lewis and Clark expedition took 2 years, 4 months and ten days, but it should not take you that long to figure out where you should have your vasectomy or microscopic vasectomy done.

Board certified anesthesia, board certified urologist, practice owned accredited urological surgery center and over 30 years of experience are all good reasons help you “Discover” your urologist.

No scalpel vasectomy:  Dr. McHugh’s eBook on vasectomies-Everything you’d want to know.

Microscopic Vasectomy Reversal: Common questions Dr. McHugh addresses in his complimentary reversal phone conversations.

Let us help you on your “Journey!”

Let’s get started!

It’s a “patient journey.”

But…it’s worth it!

Give us a call and let us help you achieve that new addition to your family!

Instructions after the Vasectomy Reversal

Bullet points/instructions for the post vasectomy reversal operative period:

  • You can shower but for the first two to three days, don’t let water hit the operative site directly.
  • A thin layer of Neosporin over the suture sites daily is recommended.
  • A formal dressing is not required but one 4×4 gauze between underwear and the sutures may be more comfortable.
  • The sutures dissolve-but not all at the same time. Some separation of the skin in areas is not uncommon and resolves.
  • The feeling of a “lump” under the skin above either testicle is not uncommon, this is where the body is reacting to the surgical procedure. (It is not uncommon to have this on one side but not the other.)
  • Compression underwear for three weeks. (This is preferred to the traditional “jock strap.”)
  • No sexual activity for three weeks. Slowly returning to your normal exercise at that time can resume as well.
  • The more you can be off your feet the first week following the procedure the less swelling you will have. Some bruising of the skin around the suture sites is common.
  • Patients can walk and even drive if necessary after 5 days if wearing compression underwear and being careful. Again, the more you are off your feet the better.
  • The testicles begin producing normal sperm again in 4-6 months, depending on the length of time from the vasectomy. (The longer the interval from the vasectomy, the slower return to sperm production.)
  • If you desire to have an evaluation of a semen specimen to check for the presence of sperm, one would wait until the 4-6 month period after the reversal. The presence of sperm is a very good sign, however it is not unusual for a longer interval is required for the return of sperm.  A specimen can be given to our office and can be quickly evaluated for the presence of sperm. If a formal semen analysis is desired which provides an actual count of sperm, an order can be placed to your local hospital negating having to travel to Gainesville.
  • If pregnancy occurs, it is usually in the 6-18 month time frame.
  • If pregnancy occurs…we’d appreciate a picture.
  • Finally…we appreciate the opportunity to participate in your care.
Georgia’s most experienced No Scalpel Vasectomy and Microscopic Vasectomy Reversal urologist.