A common question asked is whether the reversal will be harder if clips were used or if the patient was told by the urologist “I took out a section and burned it.”
In the vast majority of cases this has no influence on the microscopic vasectomy procedure.
The procedure is harder if both sides of the vasectomy were done in the vas deferens closest to the testicle-the convoluted vas. This area is smaller in diameter and not straight (convoluted) and this makes the repair a little harder.
Whether clips or burned, there is not difference in how difficult the reversal will be. Having had clips makes the area of the vasectomy easier to locate.
The amount of vas tube removed is usually not an issue unless there is a very large segment removed and this is customarily not done.
Of note, if you have had two vasectomies done, this could be an issue. If you had a complication after the vasectomy, say a large hematoma or infection that had to resolve or be operated on, these may affect the repair. On all unusual issues, be sure to make the reversal doctor aware.
Vasectomy.com Question: “What are the options for the no scalpel vasectomy?”
Ga No Scalpel Vasectomy: Whether the concern about having a no scalpel vasectomy is pain, cost, convenience or safety…we have you covered! Check out the link below-“Everything you’d ever want to know about having a vasectomy” at Northeast Georgia Urological Associates. Dr McHugh does between 30-40 a month, hundreds a year and several thousand in his 30 year urological career in Northeast Georgia.
Overview of a No Scalpel Vasectomy At Northeast Georgia Urological Associates by John C. McHugh M.D.
- Anesthesia (Absolutely no discomfort): we offer conscious sedation by a board certified anesthesiologist on Thursday. In this scenario, you’ll have an I.V., monitored and will sleep through the procedure safely with absolutely no discomfort. The medicine used by the anesthesiologist goes to work quickly and goes away out of your system quickly, so it is ideally suited for this type of procedure.
- Local anesthesia with a pre-med (Usually Valium/Tordol as an oral premedication before the procedure and then local anesthesia with Lidocaine. This method is suited for the patient that has no fear of needles, no anxiety with medical procedures or passes out easily. This is a more streamlined method and is commonly done on Friday.
- Insurance and Self Payment Options: Our office accepts most all insurances and we have relationships with them. This means that we accept what they allow. You may have a deductible and other particular specifics of your plan, but that is what we go by.
- If you are self pay: Our fee is $950.00 and this is all inclusive and can be done on a Thursday or a Friday.
- The Consultation: This is done with an in office visit which has the advantage of being able to perform an exam and assess options for anesthesia.
The procedure itself: All no scalpel vasectomies across America use a small hemostat to spread the skin (i.e. no scalpel), however whether after dividing the vas deferens tube the urologist uses cautery, clips or suture the success rate of 1/2000 is about the same. It becomes about the preference of the urologist. Dr. McHugh uses electrocautery (fulgurate or heat). We have learned over the years that many patients prefer not having the foreign body of the clip left in the scrotum. (See link above for the McHugh Method eBook on Vasectomy)
So the answer to the question is that there are several combinations of how the procedure is billed and options re: how it is performed. We do them all. We have done thousands of vasectomies over the years and perform hundreds a year.
“We know a thing or two about doing vasectomies, because we’ve done a vasectomy or two.”
Dr. McHugh is Georgia’s most experienced no scalpel vasectomy and microscopic vasectomy reversal urologist.
“The office staff was very nice and very informative to me and my wife. The doctor was very personable and made you feel comfortable. He explained everything he was doing and explained it before he did it. I would recommend him to anyone and you don’t find that in many doctors these days.” Z.S.
More concerns or questions? Email us.
As someone who battles anxiety (especially around medical stuff), the idea of a vasectomy was unpleasant to say the least. At my initial consult, Dr. McHugh addressed my anxiety immediately and reassured me with a very clear picture of what to expect as well as options to ease my nerves on the day of the procedure. I ended up electing to receive nitrous (laughing gas) in addition to some anxiety medication to take prior to arriving. From the moment I walked in the door on the day of, the staff were beyond friendly, caring, and efficient. They even let me select music to listen to during the procedure. It was evident that Dr. McHugh and his staff genuinely cared about me and making the procedure as comfortable as possible according to my specific needs. It could not have been a better experience!
Great experience with Dr.McHugh and staff perfectly orchestrated from initial consultation to procedure. Highly recommend.
Staff and procedure went effortless
The Energy Hero
The best doctor for vasectomy in the business! Dr McHugh and his team made this process comfortable from start to finish. They are very caring and professional. I would highly recommend this office when you decide to get the snip snip.
Great experience from beginning to end.
Amazing and professional staff. They provided a lot of information regarding the procedure and recovery. No surprises beforehand or afterwards. I would highly recommend to anyone looking for a vasectomy.
Simply amazing, very professional ,friendly and sincere.The procedure was painless and very fast.Thank you for an awesome experience.
Would definitely recommend to anyone needing a vasectomy or vasectomy reversal. Dr. McHugh and his staff are very professional and take the utmost care of their patients. After my surgery I was contacted twice by Dr. McHugh’s office just checking in on me. I am thankful for the opportunity to be able to have more children, and I look forward to sharing pictures of a successful vasectomy reversal.
My experience was great, every step was quick and easy. The entire staff was very friendly and helpful, made the process much smoother. I would definitely recommend anyone considering a vasectomy to chose to go here.
I give the whole experience a 10/10. Everything from start to finish was excellent, and the whole staff is comforting. I wouldn't recommend anyone else other than Dr. McHugh and his team.
Great Doctor. Completely helps you understand what issues you have and actually talks to you with great respect. – S.G.
Georgia Vasectomy/ Vasectomy Reversal -John Clay McHugh M.D.
Thank you very much. You are kind!- John McHugh
Rev Hosp Clin Fac Med Sao Paulo. 2004 Oct;59(5):312-5. Epub 2004 Oct 29.
The best infertility treatment for vasectomized men: assisted reproduction or vasectomy reversal?
In men with prior vasectomy, microsurgical reconstruction of the reproductive tract is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if the obstructive interval is less than 15 years and no female fertility risk factors are present. If epididymal obstruction is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
A Microscopic Vasectomy Reversal Podcast by Dr. McHugh
You can schedule your free reversal consultation 24/7 by giving us your phone number and our reversal coordinator will call you with an appointment.
There are two areas that have to heal after a vasectomy reversal procedure.
- The subcutaneous tissues and the skin which have been incised to reach the vas tubes has to heal.
- What the patient sees is the skin sutures. These sutures dissolve and go away in about two weeks.
- Although the skin will appear healed on the surface, microscopically full healing occurs at approximately six weeks.
- The scrotum is not like an abdominal incision where excessive straining prior to complete healing could cause extrusion bowel or create a hernia.
- The skin of scrotum healing is independent of straining but excessive activity and motion could delay the healing process.
- Sometimes the sutures dissolve prior to complete healing of the skin. Some areas of the suture line may open minimally and this is of no concern and will close over (epithelialize) within a week.
- In regards to the skin healing process, a patient can shower in a few days with care for water not to hit the site directly, and one should place Neosporin ointment on the site daily.
The Reversal Site
- The repair is done with 12-14 permanent sutures in a tension-free and water-tight fashion.
- Compression shorts are recommended for approximately three weeks.
- This allows for the inner and out layers of the repair to heal without the undue stress of the testicles and hence the vas deferens moving up and down and potentially delaying the healing process.
So although the two primary areas that need to heal before strenuous physical activity or sexual activity are different in character, the magic number of time is around three weeks-four weeks.
Anecdotally, I have had a patient present to my office the day after a reversal stating that he was having bleeding at the incision site. He confessed that he had had sex the night of the procedure. I reassured him the bleeding was from the skin edge and nothing to be concerned about.
This couple had a baby almost 9 months later to the day. Go figure!
I saw a patient recently on whom I performed a reversal around a year ago. He and his wife have not achieved pregnancy. He showed me the report of a semen analysis which showed around 50 million sperm with a motility of over 50%. Although 60-150 million sperm is considered normal, most urologists feel that any count above 20 million is suitable to achieve pregnancy. Motility should be over 45% (i.e. 45% of the sperm under the microscope are observed to be moving forward). Other parameters such as morphology (how the sperm look) are less important.
From the perspective of the surgeon who performed the procedure, any sperm in the ejaculate indicates that the reversal was successful and now it is up the the male to begin to produce the quality of sperm necessary to achieve pregnancy. As well, there is the added dynamics of the female ability to have a child. As a rule, when there is no pregnancy between a couple without the history of a vasectomy, the problem is about 50/50 male to female. The point is that even if the post reversal male has adequate sperm, pregnancy still requires other factors to be in place as well.
In the above scenario, the good sperm count and motility is a very good start and indicates a good reversal. And it makes the point about couples understanding the difference between patency (presence of sperm after a reversal) and pregnancy. There is usually a 10-15% differential between the two.
Pregnancy is a many splendored thing-Pregnancy after a reversal is a multi-factorial thing.
- The age of the male.
- The age of the female.
- The time since the vasectomy.
- The quality of the sperm from the testicular end of the transected vas at the time of the reversal procedure.
- The technical quality of the reversal procedure itself and the experience of surgeon.
- Some degree of luck for all of these factors to come together and result in pregnancy.