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.
Georgia Vasectomy/ Vasectomy Reversal -John Clay McHugh M.D.
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!
Dr. McHugh is Georgia’s most experienced no needle no scalpel vasectomy and microscopic vasectomy reversal urologist.
We offer all inclusive self-pay pricing and an “absolutely no pain” conscious sedation option for vasectomies.
Email us for more information and consultation!
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 vasectomy takes about 15 minutes and I do them through a single “size of a grain of rice” opening.
A reversal, in my hands, takes about two hours and more commonly uses two incisions (3/4 inch on each side of the upper scrotum over the course of the vas deferens) and requires an operating microscope and microscopic suture.
I tell patients that it is a minor procedure, minimal blood loss or other complications, but it does take two hours to do. Bruising and some scrotal swelling is more common and there is a longer recovery period.
So…to the question…same structure (the vas deferens) different procedure.