Category Archives: vas reversal cost

How long after microscopic vasectomy reversal can a couple have sex?

IMG_4505

Answer: One month is the usual recommendation however, I have had couples tell me (I am not making this up) that they had sex the evening of the procedure and that the reversal resulted in a baby.

The microscopic reversal is watertight from the microscopic sutures (meaning conceivably that tube is patent from the get go and that sperm can traverse the reversal without leakage) however there are other areas of the procedure that need to heal as well. So the one month of waiting is for everything to heal properly- from the skin incision, to the vessels that surround the vas deferens and the repair itself.

 

Northeast Georgia Urological Surgery Center Reaches 100 Vasectomy Reversals Milestone

image2 improved

Earlier this year Dr. McHugh performed his hundredth microscopic vasectomy reversal in the Northeast Georgia Urological Surgery Center. Thanks to all the patients and the dedicated staff that helped make this possible. Here’s to the next one hundred!

Does it matter what type of vasectomy you had if you are considering a vas reversal?

10383986_10152782559125700_5498945221001238244_n

No. All vasectomies involve removing a segment and then closing both ends of the vas defens tube. Whether the vasectomy was no needle, no scalpel, or whether the ends were closed with suture, electrocautery, or staples it doesn’t matter.  What is seen at the time of the reversal is a scarred area of vas between the testicle and body side of the tube. This segment is removed, the ends resected to clean and pristine tissue and then prepared for the rejoining process. The operative microscope is useful in examining the “freshened” ends of the vas tubes as success rates depend on no residual scar at the point of the repair.

Microscopic Vasectomy Reversal-How big is a micron?

how-big-is-a-micron

So why is an operating microscope necessary for reversing a vasectomy?

Well…

The thickness of a strand of hair is 100 microns.

The outside thickness of the vas deferens is about 2 mm and the lumen of the vas (the part of the vas that is connected with the reversal procedure and the tube that sperm travels) averages about .56 mm.

The suture used used for the procedure is 70 -100 microns, i.e. the suture is about the diameter of the human hair.

So…12 or so sutures the size of hair is used to join a tube that is that is less than a millimeter in diameter.

1000 microns equals a millimeter.

Of note: The suture that is usually be used to close an incision after an abdominal procedure would be bigger than the tube in which sperm travels in the vas deferens.

Very small sutures must be used to connect very small openings if there is going to be enough room after connecting the tubes for sperm to travel in their quest to achieve pregnancy.

And now…you know the rest of the story-and why…size does matter.

Why do Vasectomy Reversals cost more than vasectomies?

th

Cutting the vas deferens in two (a vasectomy) is easier than putting it back together (a vasectomy reversal) and is indeed a horse of a different color.

  • Vasectomies are covered by insurance-vas reversals are not.
  • Because the reversal is not covered by insurance the patient sees, feels, and pays the entire expense of the procedure, the surgeon, the supplies (microscopic suture) and the facility.
  • The surgeon fees are relatively high because very few urologists do reversals often or often enough to do well.
  • Few urologists are comfortable enough to feel they can do the procedure with a high likelihood of patency (presence of sperm after a vasectomy reversal) and this in turn also limits the number of urologists willing to perform the procedure.
  • The identification of the vasectomy site and preparing it for the reversal is something that is comfortable to all urologists. Reanastamosing the inner tubule of the vas deferens by tying microscopic suture while looking through a microscope is not what most urologists are comfortable with and to do efficiently and effectively requires experience and a steep learning curve.
  • Some urologists perform the procedure in an office setting with local anesthesia and because this excludes the hospital and an anesthesiologist, these physicians are able to perform a reversal at a lower price. In other words in this setting the hospital fees, which is usually the highest cost component of any surgery, does not exist.
  • Some urologists work exclusively through a hospital and with general anesthesia and the fees of this physician and associated costs are the highest.
  • Some urologists use general anesthesia and an independent ambulatory surgery center. In this scenario the urologist pays the center for the anesthesia, materials and staffing. The fee of the urologist then is added to this for the all inclusive cost of the procedure.
  • Some urologists own their surgery center and use general anesthesia. In this scenario the surgeon has more options regarding costs. Owning the surgery center cuts out the middle man so to speak of a hospital or an independent surgery center and often results in a lower cumulative price but with the benefits of a hospital. The cost of a reversal in this scenario represents a blend of the most expensive hospital based procedure and the least expensive office based procedure.
  • Just because a surgeon charges more for a reversal doesn’t mean he or she is better qualified to perform the reversal. There may be other costs involved that the surgeon must account for in his pricing that have nothing to do with his fee for the procedure, i.e the facility, the microscope, the suture, anesthesia, and the staffing.
  • Because a reversal is not covered by insurance necessitates the surgeon handling all the fees associated with the procedure so that the patient only has one fee.
  • The above makes the reversal procedure expense noticed more because the patient must pay out of pocket.
  • This in turn highlights why urologists are hesitant to say they can do a reversal despite having little experience do the procedure because the patient and the doctor are both very disappointed when the procedure doesn’t work. It would be somewhat disingenuous for a doctor to charge a patient the fees, put him through a surgical procedure, knowing he has very little experience in the procedure. This thought process also limits urologists agreeing to do a reversal for concerns of doing the procedure poorly and with poor results. In other words, if you take out a ureteral stone, you have taken it out and it is gone.  This is considered a good surgical result. When a reversal is done, the urologist has done the procedure then there is the hopeful expectation of a result, i.e. you just don’t remove something and you are done. With a reversal there is the procedure itself and then there are functional expectations, i.e. the presence of sperm and pregnancy.
  • Just with anything the due diligence and decision making is the responsibility of the patient and his family and all of the factors noted above should be taken into consideration.
  • Patients need to know from the start what they are getting into and that despite everything going just right there is a percentage of patients who don’t achieve pregnancy.
  • And this is why there is variance in the cost of a reversal and why it is harder to perform and more expensive than a vasectomy.

Vasectomy Reversal: Patency vs. Pregnancy-A big difference.

 

After a microscopic vasectomy reversal, several factors come into play that determine pregnancy. The technical aspects of the procedure must succeed. The surgeon, by experience and care to assure a watertight and tension free anastamosis, hopefully will give the patient the best chance of “having an open vas tube.”

If the reversal is successful and the tube is open, then it is the patient’s testicles turn to “man up.” The longer interval between the vasectomy and the reversal the less likely the testicles have the ability to “pick up the ball” and begin to produce normal sperm that have the ability to be motile. (No pun intended.) The longer the interval, the longer it takes the testicles to produce sperm that can get the job done. This is an imponderable; as no one knows before the reversal the potential of the testicles ability to produce sperm suitable for pregnancy.

So let’s say the reversal is perfect and sperm produced by the testicles are getting through the old vasectomy site are viable, strong, and very motile. Well then, there are the normal things that hinder pregnancy that normal couples, neither of which have had any procedure, experience.

After all this and surmounting the odds of the procedure, the testicles producing good sperm, the length of time since the reversal and the things that are sometimes difficult in pregnancy in the normal situation, pregnancy occurring is much lower percentage than the presence of sperm in the post reversal ejaculate.

This is why the couple considering a vasectomy reversal, and the attendant inconvenience and expense, need to be aware of the difference between patency and getting pregnant.

Pretty in Pink

Another happy reversal result!

Dr. McHugh is the one you should see. We HIGHLY recommend him! Thank you so much again to him and all of his staff. INCREDIBLE!

image

My husband asked questions ahead of time and from friends that previously had the procedure. He felt confident going in and completely comfortable during the procedure. Highly recommend them.

cropped-img_3111.jpg

Twice as Nice!

With time, prayers and of course a great surgeon we now have a healthy baby boy! Thank you!

We are happy to report that we are pregnant! Thank you to all of you who participated in our care, especially Dr. McHugh. We are so pleased and excited.

My wife and I are happy to announce that we are now expecting in March of 2020. This wouldn’t be possible without Dr. McHugh and his amazing staff! Thank y’all!

Thank you!

I had my vasectomy reversal in February 2018 and my wife got pregnant in May 2018, only 3 months later! The service and attention received before, during and after the procedure was excellent. The team was very warm and super easy to work with.

Fantastic bedside manner, office and surgical staff were top notch. This coming from a nurse of 12 years. I was never nervous or uncomfortable. (Microscopic Vasectomy Reversal)

large loga ngua

Stephen

Dr. McHugh is the best! Our family was also blessed by his surgical expertise.


Thanks for dropping by!

Reversal success story!

What a delightful surprise!

Success!

img_3278

Thank you Dr. McHugh and staff!

img_0386-1

Welcome…Ella Grace.

a vasectomy reversal success

After extensive research, we found that the technique performed by Dr. McHugh was the best fit for us. It was the least invasive, and offered the fastest recovery. Dr. McHugh & his team delivered a high caliber of service & comfort for me, & I am extremely thankful for his practice.

Naomi  was born just 12 months after having my surgery, & we couldn’t be happier with our newest addition! 

R.P.

 

Two for the price of one!

dcaa384245311610c4713ec09f1d0c5a

20180727_112100

img_2402-4

3

eb955c744a627e39362ecb27f16de78f (1)

Thank you!

Review - 3 - Social Post

“You were very professional!”

Thank you!

Even after a miscarriage, with time, prayers and of course a great surgeon we now have a healthy 7lbs 2oz  baby boy! Thank you.

Hannah M.

I appreciate everyone’s friendliness and kindness during the multiple office visits and surgery center procedure. Thank you for the good care you gave me!

P.H.

Blessing after ten year successful vasectomy reversal!

“You and your staff were wonderful! I love the relaxed and laid back atmosphere that y’all provided especially the Music! Definitely helped my anxiety. Thank you.”

Thank you back!

Dr. McHugh and his wonderful staff are without a doubt the best in the industry.

Happy result in Tennessee!

This is Shawn and Jayna Porter. We are writing to let you all know that surgery was a success and we’d like to send you all pictures of our new addition! Harper Quinn Porter.

We try to make it “fun!”

“Dr. McHugh is loads of fun. Really nice guy. Excellent staff. Easy, short, and (mostly) painless procedure. Great practice here.”  D.D.
Georgia Vasectomy/ Vasectomy Reversal -John Clay McHugh M.D.
Thank you so much for the positive feedback. Enjoyed comparing “Beatles Trivia!” I hope you do well. John McHugh

Reversal success times two!

Reversal easier than the vasectomy? Thank you!

Vasectomy Reversal: 0 Sperm to 66 Million!

Thank you for the 5 Star Vasectomy Reviews.

“A beautiful gift from God”

Thankful for Dr. McHugh’s talent and the whole experience!

vasectomy reversal baby

Dr. McHugh is very thorough and answered any questions we had prior to surgery. His team was very kind and thorough post surgery as well, following up via phone and email to be sure my husband had the best recovery he could. Our chances for conceiving were less than 50% and we just had our daughter a month before the one year mark from surgery. Leanna T.     September  2022

 

Wonderful Addition!

Vasectomy Reversal

Thank you so much for my husband’s successful reversal that you performed in October 2021. We found out we were expecting in the beginning of January and our son was born on September 7th.

Jen and Kristafur

 

Our little Pumpkin!

Vasectomy reversal baby.

Dr. McHugh, my husband had his vasectomy reversed 10/7/21 and we had our sweet baby girl 9/29/22!! Here’s some pictures of our beautiful girl.   H.S.

Vasectomy reversal baby
jordan voss
jordan voss
2023-01-16
I had a great experience getting my reversal done here. The whole team was great and worked with me to make me feel as comfortable as possible. Dr. McHugh is very personable and is one of the most experienced doctors in the area so it was an easy choice. I would recommend to anyone who wants a vasectomy or reversal done.
Matt Dyer
Matt Dyer
2023-01-06
Dr. McHugh and his team were great, any questions that may be brought up he had an answer to. I would recommend Dr. McHugh to everyone.
Dylan McClellan
Dylan McClellan
2022-12-31
Dr. John McHugh and staff were so friendly and made the whole process super simple and smooth. I will be recommending all of my friends interested in a vasectomy to come straight to him and his team. Don’t hesitate to call them first
LauSte
LauSte
2022-12-16
I highly recommend Dr McHugh for a vasectomy. He explained the whole procedure throughly and made me feel as comfortable as possible.
Creek Hunt
Creek Hunt
2022-12-13
Hands down the best 😃
Jennifer Hayes
Jennifer Hayes
2022-12-01
Excellent Doctor and Staff! Office is orderly and efficient. The nursing care and surgical services are top notch!
Erik Krause
Erik Krause
2022-11-19
Fantastic experience. The staff are friendly friendly and professional. Dr. McHugh walks you through the entire process step by step and his staff did a wonderful job of making sure I was informed about insurance and the procedure along the way. The operation itself was painless and quick. I can't recommend Dr. McHugh enough!
D.J. Kerns
D.J. Kerns
2022-11-19
The procedure was quick and the anesthesia was perfectly executed. The best part of the procedure is that they let me pick one of my favorite bands to play over the speakers while drifting off.
Brett Lee
Brett Lee
2022-11-12
Dr. McHugh and his team were very professional, efficient, friendly, and they made the procedure as comfortable as possible. I’d highly recommend going here for your procedure!