Bullet points/instructions for the post vasectomy reversal operative period:
You can shower but for the first two to three days, don’t let water hit the operative site directly.
A thin layer of Neosporin over the suture sites daily is recommended.
A formal dressing is not required but one 4×4 gauze between underwear and the sutures may be more comfortable.
The sutures dissolve-but not all at the same time. Some separation of the skin in areas is not uncommon and resolves.
The feeling of a “lump” under the skin above either testicle is not uncommon, this is where the body is reacting to the surgical procedure. (It is not uncommon to have this on one side but not the other.)
Compression underwear for three weeks. (This is preferred to the traditional “jock strap.”
No sexual activity for three weeks. Slowly returning to your normal exercise at that time can resume as well.
The more you can be off your feet the first week following the procedure the less swelling you will have. Some bruising of the skin around the suture sites is common.
Patients can walk and even drive if necessary after 5 days if wearing compression underwear and being careful. Again, the more you are off your feet the better.
The testicles begin producing normal sperm again in 4-6 months, depending on the length of time from the vasectomy. (The longer the interval from the vasectomy, the slower return to sperm production.)
If you desire to have an evaluation of a semen specimen to check for the presence of sperm, one would wait until the 4-6 month period after the reversal. The presence of sperm is a very good sign, however it is not unusual for a longer interval is required for the return of sperm. A specimen can be given to our office and can be quickly evaluated for the presence of sperm. If a formal semen analysis is desired which provides an actual count of sperm, an order can be placed to your local hospital negating having to travel to Gainesville.
If pregnancy occurs, it is usually in the 6-18 month time frame.
If pregnancy occurs…we’d appreciate a picture.
Finally…we appreciate the opportunity to participate in your care.
Georgia’s most experienced No Scalpel Vasectomy and Microscopic Vasectomy Reversal urologist.
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.
The three things…The surgeon, the quality of fluid at the time of the procedure, and the years since the vasectomy…and a little luck.
Time to Sperm Appearance Can Be Predicted After Vasectomy Reversal
Urology – November 30, 2007 – Vol. 23 – No. 08
After vasectomy reversal, motile sperm observed intraoperatively at the testicular vas, undergoing vasovasostomy, and an obstructive interval of <=8 years predict shorter time to appearance of sperm in the ejaculate.
Article Reviewed: The Kinetics of the Return of Motile Sperm to the Ejaculate After Vasectomy Reversal. Yang G, Walsh TJ, et al: J Urol; 2007; 177 (June): 2272-2276.
The Kinetics of the Return of Motile Sperm to the Ejaculate After Vasectomy Reversal.
Yang G, Walsh TJ, et al:
J Urol; 2007; 177 (June): 2272-2276
Objective: To study the time to appearance of sperm in the ejaculate for men undergoing vasectomy reversal. Design: Retrospective chart review of men who had undergone bilateral vasovasostomy, bilateral epididymovasostomy, or a combination of vasovasostomy on 1 side and epididymovasostomy on the other. Participants/Methods: 150 men whose records included intraoperative findings with type of reversal performed, record of sperm presence or absence, and associated fluid findings from each testicular vas deferens. Results: Presence of motile sperm in vasa was associated with a shorter time to postoperative presence of sperm observed in the ejaculate: 95% of men with motile sperm in the intraoperative vasal specimen were observed to have sperm in the ejaculate by 6 months after vasectomy reversal compared to 76% of men without motile sperm in the intraoperative specimen (P =0.04). Features correlated with a shorter onset to the observation of sperm in the ejaculate within the first 3 months after vasectomy reversal included an obstructive interval of <=8 years and vasovasostomy rather than epididymovasostomy. Patient age did not affect time to the observation of sperm in the ejaculate after vasectomy reversal.
Conclusions: Motile sperm observed intraoperatively at the testicular vas, undergoing vasovasostomy, and an obstructive interval of <=8 years predict shorter time to the appearance of sperm in the ejaculate after vasectomy reversal.
Reviewer’s Comments: The similarity with previous studies by other investigators of time to sperm seen in the ejaculate, with an average of 3.2 months for vasovasostomy and 6.3 months for epididymovasostomy, provides excellent counseling information for couples considering vasectomy reversal. (Reviewer–Craig S. Niederberger, MD).