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.
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!
Browse our site…particularly reversal cost, success rates and the various blog posts. Then arrange for a free consultation for additional information by using the contact form or by calling our office. Dr. McHugh will give you a call an afternoon that suits you.
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!
The above picture shows the vas deferens isolated and one can see the clips and a small area of swelling of the vasectomy site. If there is swelling here, a sperm granuloma, then the potential for success is higher. A sperm granuloma is a “pop-off” valve of sorts and protects the sperm producing process of the testicle.
The presence of a sperm granuloma explains why a patient 10 years out from a vasectomy might have a better chance than a patient 5 years out who doesn’t have one. This is a random occurrence and can’t be predicted who or who will not have a sperm granuloma. They are only beneficial for the vasectomy patient who is to have a reversal.