Tag Archives: john mchugh md

Did you know this about vasectomies?

About 500,000 vasectomies are performed each year in the U.S. Although the procedure is cheaper, faster, safer, and more reliable than female sterilization (1 pregnancy in 100), only 9% of sexually active men in the United States get vasectomies, while 27% of women get tubal ligations.

Is it worth driving from Atlanta to Gainesville for a vasectomy? You bet!

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No Pain – More Gain!!! 

  • Fair Self Pay Pricing.
  • Pre-Vasectomy medication for pain and anxiety.
  • Dr. McHugh is one of Georgia’s most experienced urologists performing vasectomies and microscopic vasectomy reversals.
  • Conscious sedation in our Ambulatory Surgery Center with an anesthesiologist- i.e No Pain.
  • In most cases (whether you have insurance or not) the cost is the same as if you had a vasectomy in an office setting. 
  • How is it the same price? We waive the facility fees for vasectomies.
  • This means-No Pain – To you or…your pocketbook.
  • Oh yea…Dr. McHugh’s free Ebook on Vasectomy-Click here.

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Anesthesia in an accredited surgery center, no pain vasectomy, essentially the same price as in an office, and 30 years of experience makes the decision to drive 45 minutes to Gainesville for a vasectomy…a no brainer.

Contact us or use the form below to make an appointment 24/7. A pre-vasectomy consultation is preferred, however to make the Atlanta to Gainesville vasectomy even easier, ask about the same day consult/vasectomy option with our vasectomy coordinator.

A good reason why you shouldn’t have a vasectomy.

“It can be reversed, right?”

Well, yes. However, just because you can reverse a vasectomy, doesn’t mean that you will achieve pregnancy.

I have done several thousand vasectomies and  several hundred microscopic vasectomy reversals, so…here are some things to consider “before” you decide to have a vasectomy.

  • We tell patients that they should consider a vasectomy permanent and it is…and it isn’t. It can be reversed but it doing so may or may not result in pregnancy.
  • A reversal is not covered by insurance and costs range between $3,000- $15,000.
  • It is a surgery, there will be an incision on the scrotal area that has to heal and there may or may not be time out of work or cessation of physical activities for a few weeks.
  • If it works, i.e. the opening is reconnected and sperm begins to flow again in the ejaculate, there may not be numbers or quality enough to achieve pregnancy.
  • It is a patient endeavor as it takes 3-6 months for the testicles to begin producing sperm again normally and if pregnancy occurs it usually does between 6-18 months.
  • The longer the period between the vasectomy and the reversal, the lower the chances of success.  Click here for success rates based on the vasectomy interval.
  • One must visualize how it would feel to have gone through the surgery, the recovery, and the expense only to be on the side of the percentages where pregnancy does not occur.

So…you don’t want to have a vasectomy unless you are pretty darn sure you don’t want to have any more children. An option is to bank sperm before the vasectomy. This costs about $200 a year.

Conclusion: If you think there is any possibility that you might want to have more children do not have vasectomy. Depending on a reversal, even in the best scenario of surgeon and time interval from the vasectomy, is a risky endeavor.

On the flip side: If you have had a vasectomy, the chances of achieving pregnancy is essentially zero.  In this setting having a reversal is very reasonable as any chance at pregnancy with a reversal is better than no chance. This is the reasoning most couples have when deciding to pursue a reversal.

Two interesting things about having a vasectomy.

 

First interesting thing: Getting an infection is uncommon. Most urologists do not place a suture in the small opening necessary for doing the procedure and this may be protective.

Second interesting thing: If there is a sperm granuloma or some swelling or tenderness under the scrotal skin, it usually resolves on its own and…is it almost always just on one side. In my experience it is rare to have an issue with both sides of the procedure. Each side is independent of the other. Go figure!

More questions? Go to the vasectomy page and read the eBook.

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Healthgrades Reviews for Dr. McHugh 

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Predictive factors in sperm appearance after vasectomy reversal.

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Patient’s often ask, “What is your success rate?” The successful reversal is heavily influenced by the quality of the fluid at the testicular end at the time of the reversal and the time interval since the vasectomy. JM

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).

 

FAQ about A Vasectomy Reversal.

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Dr. McHugh answers questions about a vasectomy reversal with other urologists across America on Vasectomy.com-Click here-there’s a good chance any question you have you’ll find your answer.

FAQ-Vasectomy Reversal

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Frequently asked questions about a microscopic vasectomy reversal-Vasectomy.com

Does steroids given pre and post vasectomy reversal improve the chances of pregnancy? A good question.

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An antisperm antibody test looks for special proteins (antibodies) that fight against a man’s sperm in blood, vaginal fluids, or semen. The test uses a sample of sperm and adds a substance that binds only to affected sperm. Semen can cause an immune system response in either the man’s or woman’s body.
Br J Urol. 1981 Dec;53(6):654-9.

Reversal of vasectomy: the effects of sperm antibodies on subsequent fertility.

Abstract

Antisperm antibodies were measured in serum and seminal plasma in 130 males before and after vasectomy reversal and the occurrence of pregnancy was analysed in the partners of 77 who were followed for more than one year. Sperm-agglutinating antibodies were found in the serum of 79% of patients; seminal plasma antibodies were present in only 9.5% before reversal and this rose to 26% afterwards. Pregnancies occurred in the partners of 53% of those men who were trying to produce children. A pregnancy was significantly less likely when the pre-operative serum antisperm antibody titre was 512 or more, but no decrease in fertility was seen with titres below this. Several pregnancies were produced by patients with seminal plasma antibodies, but numbers and follow-up are too small to permit detailed analysis.

A randomised controlled trial of peri-operative steroids showed that they produced no benefit.

The antisperm antibodies associated with vasectomy reversal appear to differ fundamentally from those occurring in naturally subfertile males.

Tenderness one month after vasectomy reversal-is this normal?

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Dr. McHugh’s answer on Vasectomy.com