The suture is the size of hair and the vas opening is the size of the O in God on a penny.
Also…12-15 sutures are placed on each side.
And now you know!
It’s your move!!!
Tag Archives: microscopic vasectomy reversal atlanta
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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
A little Birdie told you what?!!!
Vasectomy Reversal? A patient journey.
- It all starts with the decision to begin the journey that is a vasectomy reversal.
- The procedure is not covered by insurance.
- Success can’t be guaranteed.
- Once the procedure is performed, it takes the testicles about three months to begin producing sperm again.
- If pregnancy occurs, it is usually six to eighteen months after the procedure.
- A lot of things have to come in to place and in many ways a pregnancy is “miracle.”
Many times I have said to the vasectomy reversal couple that you have to begin with the procedure to start the clock. Then live your life… as this is a “patient journey.”
Next generation of urologists! Our surgery center was happy to provide the “uniforms.”
If it was easy to get pregnant before the vasectomy…will it be easy to get pregnant after the reversal? Well…it depends.
So…I hike a trail most every evening after work and on the weekends that takes about an hour. My vasectomy reversal coordinator Kathy get several calls a day about scheduling either a reversal or a free consultation about arranging for a reversal. Many of our patient live a long way away and ask, “Can I speak to the doctor by phone?”
Kathy routinely says, “Can he call you between 5 and 6 tonight?”
The interested couple most commonly says, “Yes. Perfect.”
So last night Kathy gives me two people to call who have an interest in reversing their vasectomy. The second patient I call asked the question, “My wife and I got pregnant very quickly. I mean one the first try. Does this mean that we’ll get pregnant just as quickly after the reversal?”
Good question and very similar to this common question, “Will the reversal surgery be like the vasectomy?”
Regarding the latter, the reversal takes approximately two and half hours, a vasectomy less than 15 minutes. So no a vasectomy is not like a reversal.
Regarding the former question: the issue is not that you and your partner are very fertile, the success of the reversal depends on the experience of the surgeon and the time interval since the vasectomy.
The perfect scenario? A short time since the vasectomy and a urologist who does reversals microscopically often. It does not hurt that the wife was fertile, that is good. For the male however the production of good sperm suitable for pregnancy decrease as time elapses since the vasectomy.
It was a good question and I hope this helps you understand the nuances of a microscopic vasectomy reversal. You might check out this internal site link.
Reversal consults are free. Leave a number or email and we’ll schedule an in office consultation or Dr. McHugh will call you while on his walk!
GA Vasectomy Reversal FAQ -The Nitty Gritty
Vasectomy Reversal FAQ-The Nitty Gritty…
- The cost is all-inclusive-$7,2000.
- The pre reversal consultation is free.
- Performed in a practice owned and accredited surgery center.
- General anesthesia performed by board certified anesthesiologist.
- 600 reversals have been performed.
- Overnight accommodation is free.
- Usually takes two hours or less to perform.
- Out patient.
- Operating microscope and microscopic sutures and instruments utilized.
- Success rates mirror national studies. (See success rates page.)
- Safety record has been impeccable.
Vasectomy Reversal Consult Overview PDF
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How long to pregnancy after vasectomy reversal?
Although vasectomies should be viewed as a permanent form of birth control, there may be certain circumstances in which a man desires to have his vasectomy reversed. If this is the case, questions might arise about how long it takes for a vasectomy reversal to result in pregnancy.
There are no definitive answers. Research indicates that, if a reversal is successful, it can take anywhere from three months to several years for couples to get pregnant. Up to 75 percent of all vasectomy reversals ultimately lead to natural pregnancies, with over half occurring in the first two years.
However, there are several factors that impact whether conception will occur and how quickly:
- Type of vasectomy reversal procedure: The type of vasectomy reversal procedure a man has will impact reversal success and pregnancy outcomes. Men who have a vasovasostomy — the shorter and simpler of the two types of reversal procedures — tend to have higher success rates than those who have undergone a vasoepididymostomy. The vasoepididymostomy is a more complicated procedure, and is performed when a surgeon believes that the vas deferens tube is blocked closer to the testicle, in a coiled part of the vas deferens known as the epididymis. Because patients who have had a vasoepididymostomy tend to have longer periods of impaired sperm motility, it tends to take longer for their partner to conceive.
- Time since the vasectomy procedure: The amount of time between the original vasectomy procedure and the vasectomy reversal also affects the length of time it will take to conceive. In general, higher success rates have been reported when the reversal is performed closer to the original vasectomy procedure, especially if less than five years. After 10 years of a vasectomy, pressure within the vas deferens can cause a rupture or blockage in the epididymis. This blockage requires the micro-surgeon to perform a more difficult vas-to-epididymis reconstruction, which causes the success rate to decrease.
- Maternal and Paternal Age: If a woman is over 35, her hormone levels and ovulation cycles may be harder to predict; if a man is over 50, the quality or concentration of his sperm may slightly decrease. Both of these can increase the amount of time to conception. Talk to your urologist about which alternative methods for conception, such as in vitro fertilization, might be an option.
What It Boils Down To
There is no perfect way to predict when, or if, a couple will be able to get pregnant after a vasectomy reversal. But talking to a doctor can help couples understand their own personal chances of success, which obstacles may stand in the way of conception, and whether a reversal is the right choice.
Reviewed December 4, 2012, by Larry Lipshultz, MD – Urologist
References:
Busato, W.F. (2009). Vasectomy reversal: A seven year experience. Urologia Internationalis, 82(2), 170-174.
Graham, S.D., & Keane, T.E. (2009). Glenn’s urologic surgery. Philadelphia, PA: Lippincott Williams and Wilkins.
Labrecque, M., Durfresne, C., Baone, M.A., & St-Hilaire, K. (2004). Vasectomy surgical techniques: A systematic review. BMC Medicine, 2, 21-32.
Palkhivala, A. (2006). Vasectomy reversal: Data point to choice of technique. Urology Times, 43(2), 23, 41.
Vasectomy Reversal-What a Woman Wants to Know.
From Vasectomy.com
The decision to reverse a vasectomy should be considered carefully by each couple. As a woman, you may have special concerns that are difficult to express.
Vasectomy reversal (and the microsurgery involved) raises questions for both men and women. Although men need to be forthcoming about any questions, concerns and fears they share with their physician, it is just as important for women to be informed and reassured about the procedure. You may be surprised to know that many women share the apprehensions about reversal surgery that you may have.
Candid questions, correct information, and the assurance of an experienced urologist are the keys to feeling more comfortable and sure about the decision you and your spouse have made to have a vasectomy reversal. Make a list of the questions that concern you most before meeting with your doctor.
Here are some of the questions women commonly ask:
“This is my first marriage– and his second. Will my spouse’s older age affect the health of his sperm or our babies born after his reversal?”
Generally speaking, a man who has healthy sperm can reasonably expect to father a healthy child. A man’s age does not affect fetal development the way a woman’s does. But time does have an impact on successful conception.
The longer the amount of time between a man’s vasectomy and his reversal, the less potent he may become. This is why: After a vasectomy, unreleased sperm collect in the testicles before being absorbed by the body. The body responds to the unspent sperm with a reaction that can affect, to some degree, sperm quality and health. Over time, this reaction can gradually reduce the mans sperm count, and impair sperm motility.
A successful reversal that results in pregnancy is proof that the man has a healthy, adequate sperm count. The course of pregnancy that follows a vasectomy reversal should be as normal as any other pregnancy. A vasectomy reversal merely restores sperm to the seminal fluid. It should not affect the health of an unborn baby in any way, no matter how old the man is at the time of his reversal.
“Will a vasectomy reversal affect a man’s ejaculation?”
Sperm is only a tiny portion of the seminal fluid that is released at ejaculation. Just as a vasectomy does not change the volume, color, or consistency of the ejaculate, neither does a vasectomy reversal. Sperm are impossible to detect in seminal fluid without the use of a microscope. The quality, intensity and duration of a mans orgasm and ejaculate will not change after a reversal.
“How long will it be until my spouse and I can resume sex?”
Physicians usually advise that it is best to wait three or four weeks following the reversal procedure before returning to sexual activity. It will take additional time before sperm returns to the ejaculate.
“Does the vasectomy reversal procedure leave scars?”
Despite the greater complexity and time involved in a vasectomy reversal procedure, there is usually no lasting or noticeable difference to the feel or appearance of the scrotum.
“How soon can I expect to get pregnant?”
If reversal is successful and healthy sperm rejoin the seminal fluid, it may take 12 months, on average, to achieve pregnancy. The range, from reversal to conception, is between one and 82 months. Most couples achieve pregnancy within a year.
“Can I and should I be examined and tested for fertility first, before we decide on a reversal?”
Since many couples consider reversal surgery a costly matter, women often do choose to consult with their own physicians or fertility specialists first, to determine whether there is any question or doubt about the woman’s ability to conceive and complete a healthy pregnancy.
“How long will my husband be in pain, and what can I do to help?”
You can expect your husband to experience some degree of discomfort and swelling in the first three to five days following reversal surgery. A gradually decreasing ache in the scrotal region will follow and may last for three to four weeks. His attention to doctors orders during the recovery process, lots of ice and rest, and your tender loving care will be the best medicine for your husband.
“Does a vasectomy reversal make you more, or less, susceptible to sexually transmitted diseases?”
Vasectomy and vasectomy reversal surgery do not protect couples from the risk of transmitting or contracting a sexually transmitted disease. These diseases are transferred in body fluids, such as saliva or semen. Both men and women should use condoms if any potential risk of sexually transmitted disease exists.
“How old is ‘too old’ for a couple considering vasectomy reversal?”
All women lose the ability to conceive by late middle age. Women over the age of 40 may experience difficulty conceiving with assisted reproductive techniques (ART).
Men can remain potent and father children even after the age of 70. However, a man may not want or be able to parent a new child at a later stage of life. The older you are, the fewer the years that you have left in which to raise an infant to adulthood. And older couples often have more health problems as they age.
“My husband does not want more surgery-he says that sperm aspiration is easier and just as effective as vasectomy reversal. Is it?”
A vasectomy reversal, performed under general anesthesia, is virtually painless, more natural and more likely to result in pregnancy than an assisted reproductive technique (ART) that begin with sperm aspiration as the first step. Besides a lower rate of success, ARTs have much higher costs, involve a greater number of complex, uncomfortable procedures, and take considerably more time than that required to perform a comparatively simple and safe reversal.
In a straight comparison, reversal surgery is preferable to ART and should be considered first, unless conception and pregnancy cannot be achieved any other way.
“What if we just want one child. Would not sperm retrieval and in vitro fertility be more efficient?”
Not necessarily. The rate of multiple order births–twins or triplets–is several times higher with in vitro fertility than with natural conception following a vasectomy reversal. The risk of having twins with IVF is 20 to 50 percent depending on which IVF center one is treated at.
In Summary:
- A vasectomy should be considered permanent, so have reasonable expectations about the success of reversal surgery. Be informed and discuss all your options with your spouse and your physician.
- Some men or couples may not be well suited or economically prepared for a vasectomy reversal or second family, particularly if either partner is over the age of 40 or in poor health. Vasectomy reversal microsurgery is often evaluated as a first course option; generally preferable to assisted reproductive techniques for many couples.
Does it matter where the vasectomy site is if having a microscopic vasectomy reversal?
The vas deferens closest to the testicle and just before the epididymis is the convoluted portion of the vas. As you see above the vas then “straightens out” the further you get away from the testicle.
Above you see the “old vasectomy” site marked and it is in the mid scrotal area and in the straight not convoluted portion of the vas. This is the ideal location for the reversal doctor because it is away from the inguinal area and up from the smaller and more difficult to isolated convoluted portion.
Although you can feel the vasectomy site through the scrotal skin preoperatively, you really cannot tell where in the course of the vas it actually is.
Recently I performed a reversal and both sides of the vasectomy site were in the convoluted portion of the vas and close to the epididymis. This required more dissection to reach and it is tricky to get a portion of the convoluted vas to reconnect that is straight (as opposed to curved away from the other side of the vas).
So yes if the person who did the vasectomy happened to do it in the middle, that is away from the inguinal area as well as away from the convoluted portion of the vas then the procedure is much easier to locate, to prepare for the reversal, and to perform the reversal.
You might ask, “Why wouldn’t every urologist make a point to do the vasectomy in the best position in case a reversal has to be done years later.”
Well a reasonable enough question but there are two factors to consider as to why urologists don’t think this way.
- Vasectomies are usually done in the office under local anesthesia and depending on the patient and the patient’s scrotal anatomy…he gets the vas where he can get it…i.e. sometimes you can’t pick and choose a site the patient’s anatomy dictates that.
- Also, the vasectomy is supposed to be considered permanent and the primary goal is a good vasectomy and prevention of pregnancy. Vasectomies are not and probably should not be done with the idea in mind that the patient will reverse it.
- In my practice if I were asked to do the vasectomy so it could be more easily reversed, I’d probably tell the couple to re consider a vasectomy until they felt it was permanent and they had no plans for further children.
- Having said that, a urologist can try to make a point to be “in the middle” but as I mentioned sometimes you take the vasectomy site where the patient’s scrotum gives it to you.
Reversals Are What We Do.
