Dr. McHugh participates in hundreds of vasectomy reversal phone consultations a year. The following are the top questions that are asked and discussed during these visits with patients from all over the Southeast.
What is the success rate? This depends on the interval of time between the vasectomy and the reversal. The shorter the interval the better the chances of success. Success rates-Click here.
How many microscopic vasectomy reversals has Dr. McHugh done? Over 400 in our accredited Urological Surgery Center.
What is the cost? $6,500, which is all-inclusive. ( Please note that this rate is subject to change beginning January 2021.)
Do you have a payment program? No but we accept CareCredit. (See CareCredit.com)
Will I have any pain? No, we provide anesthesia by a board certified anesthesiologist. Our safety record has been impeccable. The pain after the procedure is slightly more than you may have experienced during the vasectomy.
Is it like having a vasectomy? No, a vasectomy takes 15 minutes and done through a “size of rice” opening. A vasectomy reversal takes our team approximately 2 hours. As a result one can expect a bit more swelling and bruising. “The procedure involves the same tube… but it’s a different operation!”
Is the age of my wife important? Yes. Success rates begin to decline as the female’s age goes above 39. The male is less age dependent.
What if I have to travel a long distance to go home? Most couples will arrive the day of the procedure and then spend the night afterwards in a local hotel. Hotel accommodations if necessary is complimentary for one night. (As a rule, couples within a few hours drive from our facility prefer to go home after the procedure and this is acceptable.)
How long before I can drive? Usually within a week. If the surgery is on a Thursday, for instance, the longer you can be off your feet with the scrotum elevated the less swelling you will experience. The complete healing doesn’t occur until around a month, but patients can be active but careful during that time. Tight compression exercise underwear is better than the traditional “jock support.”
When can I resume sexual activity? In three weeks.
When can I return to work? Desk work, with caution and being careful, in one week. If one has a strenuous job usually three weeks, however a lot of patients go back in one week but they have made arrangements to gradually get back to their normal work routine. (With the help of their co-workers.)
How long does it take for the testicles to produce sperm again? Usually 4-6 months depending on when the vasectomy was done. (The shorter the interval between the reversal and vasectomy, the sooner the vesicles begin to produce sperm.)
If pregnancy occurs, what is the most common time frame? 6-18 months. This is important to remember this as achieving pregnancy after a vasectomy reversal is a patient process.
Are birth defects more common after a vasectomy reversal? No.
Which is better in vitro methods or a vasectomy reversal? This is a decision which the couple should research and based on what is best for them. Proponents of a reversal state cost, the ability to have more than one pregnancy, less requirements by the female, and a more streamlined process from the decision to having the procedure.
How soon can I schedule the procedure? It is unusual not to be able to schedule within a month of inquiring. Our practice owns our surgery center, so it is not uncommon to open another operative day and perform two reversals on the same day to accommodate demand.
Is it necessary to have an in person consultation visit? In most cases no. The anesthesia doctors do not require new blood work or EKG if the patient is less than 50 and not on certain medications. The only thing that can’t be done ahead of the procedure is the exam of the testicles.
Is there a safety risk of the procedure or of the anesthesia? It is rare to have any injury to the testicles. Infections are uncommon, bruising is common. There is no change in the male sexuality. The anesthesia is very safe and to date we have had no issues/complication related to this. Our anesthesiologists are all board certified.
Well, that is a start. After reading the above, you still can call( see the contact page) to arrange a phone consultation. Dr. McHugh does them every day of the week. All we need is a time frame that accommodates your schedule to arrange.
We look forward to speaking to you and helping you with the new addition to your family!
This is a common question and maybe more common for me than other urologists. Why?
I make one mid-line opening using the no scalpel instrument. This is done at the peno-scrotal junction (upper aspect of the scrotum in the middle.) Through this opening the right side vas deferens is brought to the surface and the vasectomy is performed. This vas then returns to the right. Same thing is done on the left. (Many urologists make two openings, one on each side.)
What can be confusing to the patient is that days or weeks later he notes the mid-opening that is healed, but he feels a small knot on the left or right. What is going on? Something must be wrong.
The knot is where the body has begun the healing process. This varies from left to right, so that one patient may feel something on the right another the left. Because the opening is in the middle the assumption is that the swelling should be in the middle.
Now you know why it is left or right. The middle is where we access the left and right vas deferens but then it returns to its normal location and the healing process then begins.
If it is a small area and minimal discomfort, then this is the normal healing process and no need to call your doctor.
We offer vasectomy conscious sedation, fair all inclusive pricing for self pay patients and accept most all insurances. Call us when you’re ready to consider a vasectomy. We’ve done thousands.
Before the vasectomy patient can be released by the urologist to have unprotected sex, there must be two consecutive semen specimens with no sperm. It takes about 25 ejaculations to achieve this. We customarily give two specimen containers at the time of the vasectomy and recommend dropping off the specimens at approximately six and eight weeks. Dr. McHugh personally examines all of the specimens with a microscope.
After the initial clearance to proceed with unprotected sex, the chances of the the vasectomy “growing back together” is 1/2000.
In the diagram above you can see why. When Dr. McHugh performs a vasectomy a section of the vas is removed (red), both ends are cauterized (green) and then an absorbable suture (yellow) is placed on both ends as well.
The diagram above also answers another very common question about vasectomies: Does it affect the patient’s sex life?
The answer there is no. As you see, the only thing “tied off” is the vas deferens and this is where the sperm travels. Testosterone, which is responsible for the male’s sex drive, is produced in the testicle, but leaves the testicle in the blood stream not the vas deferens.
So there is a vas deferens between where the sperm exits and how the testosterone exits the testicle!
A handful of studies have tried to pinpoint a number of children that maximizes parents’ happiness. One study from the mid-2000s indicated that a second child or a third didn’t make parents happier. “If you want to maximize your subjective well-being, you should stop at one child,” the study’s author told Psychology Today. A more recent study, from Europe, found that two was the magic number; having more children didn’t bring parents more joy.
In the United States, nearly half of adults consider two to be the ideal number of children, according to Gallup polls, with three as the next most popular option, preferred by 26 percent. Two is the favorite across Europe, too.
Ashley Larsen Gibby, a Ph.D. student in sociology and demography at Penn State, notes that these numbers come with some disclaimers. “While a lot of [the] evidence points to two children being optimal, I would be hesitant to make that claim or generalize it past Western populations,” she wrote to me in an email. “Having the ‘normative’ number of children is likely met with more support both socially and institutionally. Therefore, perhaps two is optimal in places where two is considered the norm. However, if the norm changed, I think the answer to your question would change as well.”
About 500,000 vasectomies are performed each year in the U.S. Although the procedure is cheaper, faster, safer, and more reliable than female sterilization (1 pregnancy in 100), only 9% of sexually active men in the United States get vasectomies, while 27% of women get tubal ligations.
One must visualize how it would feel to have gone through the surgery, the recovery, and the expense only to be on the side of the percentages where pregnancy does not occur.
So…you don’t want to have a vasectomy unless you are pretty darn sure you don’t want to have any more children. An option is to bank sperm before the vasectomy. This costs about $200 a year.
Conclusion: If you think there is any possibility that you might want to have more children do not have vasectomy. Depending on a reversal, even in the best scenario of surgeon and time interval from the vasectomy, is a risky endeavor.
On the flip side: If you have had a vasectomy, the chances of achieving pregnancy is essentially zero. In this setting having a reversal is very reasonable as any chance at pregnancy with a reversal is better than no chance. This is the reasoning most couples have when deciding to pursue a reversal.
The above picture shows the vas deferens isolated and one can see the clips and a small area of swelling of the vasectomy site. If there is swelling here, a sperm granuloma, then the potential for success is higher. A sperm granuloma is a “pop-off” valve of sorts and protects the sperm producing process of the testicle.
The presence of a sperm granuloma explains why a patient 10 years out from a vasectomy might have a better chance than a patient 5 years out who doesn’t have one. This is a random occurrence and can’t be predicted who or who will not have a sperm granuloma. They are only beneficial for the vasectomy patient who is to have a reversal.