Now you know!!!
You have had your vasectomy…here are some “after the procedure” instructions and a heads up on potential issues that are peculiar to having a vasectomy.
- The small opening at the midline of the upper strotum does not have a suture and will close on its own. A thin film of Neosporin ointment daily is recommended.
- You can shower the day after the procedure, but don’t let water hit the procedure site directly.
- Ice to the scrotum after the procedure helps with swelling and with discomfort. (Lidocaine is used at the opening and along the course of the vas tubes so there is anesthesia for an hour or so after the procedure.)
- You’ll be given something for pain, this is to be used in an “as needed fashion.” If you don’t have pain, don’t take it or use Advil or Aleve. Taking a half a pill is acceptable.
- Try to be off your feet with the scrotum elevated strictly for the first 24 hours and then as much as possible for the next two days. Most patient who have the procedure on a Thursday or Friday take it easy over the weekend and return to work on Monday. If you have a strenuous job, you may want to gradually get back into your routine.
- For the first week after the vasectomy, compression underwear to stabilize the scrotum and elevation of the scrotum with a rolled sheet when sitting can reduce any swelling.
- No sexual activity for one week.
- No unprotected sexual activity until we have evaluated two negative specimens. It takes approximately 25 ejaculations to clear the tube beyond the vasectomy site. (A couple can achieve pregnancy if there is unprotected sexual activity before the sperm has completely cleared.) We recommend evaluation of specimens as a rule at 6-8 weeks. It is not about the time since the vasectomy, it is about the number of ejaculations.
- Even though the opening is in the middle of the upper scrotum, the vasectomy sites are on the left and right underneath the skin. Discomfort, bruising or asymmetrical swelling is not uncommon, but should slowly improve over several days.
- Each patient is given two specimen containers after the procedure and there are several options regarding checking the post-vasectomy specimen. Dr. McHugh examines semen specimens with a microscope at no expense. (The best days for dropping off the specimen is Monday, Wednesday and Friday-but it best to call to be sure he is available to examine.) For out of town patients, specimens can be taken to a local hospital for a “post vasectomy” semen analysis (we can fax an order) or use online test kits such as spermcheck.com.
- It is not unusual, maybe 5-10% of specimens, will have a rare sperm. This just means that more time/ejaculations are necessary to completely clear all of the sperm. We will require two consecutive completely negative evaluations.
- There are no special instructions about the specimen. If you obtain the specimen in the morning and drop off later in the day, this is not a problem. We are not doing a formal count, only the presence of absence of sperm. We will call you back with the results that day.
- If any issues arise that you have questions about, feel free to contact us. We will be happy to speak to you or if you feel necessary examine you in the office at no expense to you.
Thank you for allowing us to participate in your care.
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.
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!”
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The question was- “What are the options for the no scalpel vasectomy?”
- In terms of 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 Ativan/Norco by mouth, or a I.V. injection of similar medications) 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.
- In terms of 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 can be with an in office visit which has the advantage of being able to perform an exam, or with a Telehealth visit. One only has to call the office to arrange.
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.
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.
Great Doctor. Completely helps you understand what issues you have and actually talks to you with great respect. – S.G.
Thank you very much. You are kind!- John McHugh
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!