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Tag Archives: no scalpel vasectomy

Myths about Vasectomy Reversal

The following is from a vasectomy reversal doctor in England. The process is similar to but not exactly the same as at Georgia Vasectomy Reversal, however it is informative and adds to the data base of the couple contemplating a vasectomy reversal.

Vasectomy reversal myths debunked

If you decide to undergo a vasectomy reversal, having accurate information at your fingertips will ensure you are as informed as possible. Here are some of the most popular myths associated with reversing a vasectomy.

If you’re too old, you can’t have a vasectomy reversal

The reality is, a vasectomy reversal can be performed at any age, so long as an individual is healthy enough to undergo the treatment.

A vasectomy reversal rarely works after 10 years

This is a popular misconception and is based on outdated studies. Modern techniques used today have increased the vasectomy reversal success rate even if the original vasectomy was performed years ago. Even after about 20 years, you still stand an 84% chance of success following a vasectomy reversal.

Anti-sperm antibodies cause infertility even after a vasectomy reversal

It is widely believed that anti-sperm antibodies attack healthy sperm following a reversal and can cause infertility. In actual fact, antibodies are present in the blood and not in sperm following a vasectomy reversal, so are normally not responsible for any fertility problems that may arise following the procedure.

IVF is a better option than vasectomy reversal

You will need to weigh up the pros and cons of choosing IVF or vasectomy reversal, but there are many benefits to choosing reversing a vasectomy over IVF. For starters, a vasectomy reversal is a quick, single procedure that has good success rates, enabling you to conceive a baby naturally. In contrast, IVF is a gruelling process that often requires several attempts to increase the chance of success. The cost of a vasectomy reversal is also much lower compared to IVF procedures. Bear in mind also that there is a greater chance of multiple pregnancies when opting for IVF, so if you are only hoping for one baby, a vasectomy reversal is easily a better option.

Vasectomy reversal successes are the same whoever you choose

This is not the case at all. Doctors and standards vary, so if you want to achieve the best results possible choose a surgeon who is specialised in vasectomy reversal and has extensive experience. Mr Harriss has many years of experience and is available to answer any questions that you may have.

 

A Urological Vas Deferens “Hat trick?”

hat-trick

What is a “hat trick?” Click image above to find out!

What is a vas deferns “hat trick?” Well…

I am seeing patients one day and come to a room with a chart in the door which says “Post vasectomy.” I note that the patient had had a vasectomy by me about several years  prior to this visit.

I enter the room and there I see a husband and wife and the husband is holding a newborn baby. Only a urologist can really know how it feels to be told of a possibility of a patient having a child after you did the vasectomy. It is not a good feeling…like all the blood goes to your feet feeling.

I ask, “I did your vasectomy?”

The husband says, “Yes”

I say, “Is that y’all’s baby.”

The couple smiles and beaming in unison say, “Yes”

There is a pause. I don’t know really what to say. I was about to say, “I’m sorry. You know there is a one in 2000  chance of these tubes growing back together.”

The wife says, “We are here for a vasectomy.”

Aside: I have had pregnancies after a vasectomy in career about 5 times. Usually it is because the male did not assure sterility by bringing a specimen to the office to be checked. More commonly the couple will have sex too soon after the vasectomy assuming that “If I had a vasectomy then there are no sperm.” They forget that it takes approximately thirty ejaculations to clear the sperm after a properly performed vasectomy. So sex before the sperms clears can cause pregnancy as the sperm is beyond the vasectomy site of occlusion. So even though the urologist never wants to hear about pregnancy after the vasectomy, most commonly it is not because the vasectomy was not performed properly.

Aside 2: It is also common that when a couple has a child after a vasectomy, for whatever the reason, they are happy or shall I say not disappointed about it. Some will say, “It’s God’s will.” By the tone of the conversation with the referenced couple, I felt that they were happy to have a had a child and that were not angry at me nor blaming me for anything. 

Where was I? Anyway I say, “I am sorry about this. You came to me for the vasectomy because you did not want anymore children. Regardless of the cause I apologize and will happily do the vasectomy at no charge.”

The couple appears surprised and the wife says, “We wanted a baby.”

I am relieved and the blood in body is beginning to circulate to my upper extremities again.

Another pause and now the couple appears confused.

The wife says, “Doctor McHugh, there is no reason for an apology. We are very happy.”

The husband says, “Remember…you did my vasectomy reversal last year. We just had this beautiful baby and now I want a vasectomy.” The nurse had failed to put the most recent note in the chart of this patient which would have let me know this patient had had a reversal.

So…I do the vasectomy.

A vasectomy, a reversal and baby, and then another vasectomy. A urological vas deferns “Hat trick.”

Ta Daaaaaaaaaaaaaaaa!

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Vasectomy reversal more cost effective than IVF?

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Vasectomy Reversal Remains More Cost-Effective Than IVF

Urology – October 30, 2008 – Vol. 24 – No. 11
Vasectomy reversal is more cost-effective than sperm aspiration and in vitro fertilization for obstructive azoospermia.
Article Reviewed: A Decision Analysis of Treatments for Obstructive Azoospermia. Lee R, Li PS, et al: Hum Reprod; 2008;23 (September): 2043-2049.
Background: Management of post-vasectomy obstructive azoospermia is either vasectomy reversal or sperm aspiration with in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI). The cost of IVF and issue of multiples has broad implications for public health policy and allocation of resources. The change in cost of male factor infertility over time with the evolution of new techniques like ICSI has not been studied.

Objective: To investigate and compare the economic impact of IVF versus vasectomy reversal for obstructive azoospermia over time using population data and analytic models. Continue reading Vasectomy reversal more cost effective than IVF?

Having a microscopic vasectomy reversal will lower the chances of getting prostate cancer. True or false?

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Answer: False-The vasectomy did not increase the chance of prostate cancer in the first place.

Vasectomy Not Associated With Prostate Cancer

Urology – February 28, 2009 – Vol. 25 – No. 04

There is no association between prostate cancer and age at vasectomy or years since vasectomy.

Article Reviewed: Vasectomy and the Risk of Prostate Cancer. Holt SK, Salinas CA, Stanford JL: J Urol; 2008;180 (December): 2565-2568.

Background: The majority of the literature now has shown no association between vasectomy and prostate cancer. The effect of vasectomy on men with a family history of prostate cancer or on those who underwent a vasectomy at a young age or had an extended period of time since the procedure has been poorly studied due to small sample sizes and short study follow-up.

Objective: To assess the risk of prostate cancer in men by age and length of time to exposure from vasectomy to disease.

Design: Population-based, prostate cancer case-controlled study.

Participants: 1327 men aged 35 to 74 years residing in King County, Washington, with a diagnosis of prostate cancer.

Methods: Cases of prostate cancer were identified from the SEER database for this population. Structured in-person interviews were conducted. Eligible controls were identified by random digit telephone dialing. Analysis based on prostate cancer Gleason score and stage was performed. Analysis was also performed based on demographics, age, prostate cancer screening history (within the last 5 years), family history of prostate cancer, and vasectomy parameters.

Results: 1327 men were eligible for study from the SEER database; 1001 completed the personal questionnaire. In total, 1340 controls were identified, of which 942 were interviewed. The control population showed that men who had undergone vasectomy were older, white, married, non-smokers with higher income and education, and had undergone PSA screening. Of men with prostate cancer and controls, 36% had undergone a vasectomy. Mean number of years since vasectomy in cases and controls was 21.1 years. No significant association was seen between prostate cancer and vasectomy status, age at vasectomy, years since vasectomy, or year of vasectomy. There was no evidence of risk estimates across vasectomy parameters. Risk did not change if men with prostate cancer within 2 years of vasectomy and controls with no PSA screening within 5 years (n=136) were excluded.

Conclusions:

No association was found between prostate cancer and vasectomy, even in men who had a vasectomy performed at a young age or had an extended period of time since vasectomy.

Reviewer’s Comments: This paper is a well-conducted, large case-control study that answers the concern about possible limitations of previous work that reported the lack of association between prostate cancer and vasectomy. This criticism often indicated inadequate follow-up since vasectomy to make this claim. In this study, average time since vasectomy in cases of prostate cancer and controls was 21 years. Multiple variables were looked at including vasectomy in the face of prostate cancer family history and screening. This large study should end the criticism on previous work that did not answer the question of prostate cancer and time from vasectomy. (Reviewer–Ajay K. Nangia, MBBS).

The most cost effective vasectomy reversal in Georgia.

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Cost-Effectiveness Analysis of Vasovasostomy Techniques

Urology – September 30, 2016 – Vol. 34 – No. 7

The authors found decreased costs without compromises to surgical outcomes with the modified 1-layer vasovasostomy technique.

Article Reviewed: Comparative Cost-Effectiveness Analysis of Modified 1-Layer Versus Formal 2-Layer Vasovasostomy Technique. Nyame YA, Babbar P, et al: J Urol; 2016;195 (February): 434-438.

Continue reading The most cost effective vasectomy reversal in Georgia.

All about a vasectomy…an animation by Dr. McHugh

Is the No Scalpel Vasectomy a gimmick? Yes and No.

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The very first vasectomy ever performed probably isolated the vas deferens, cut out a section and then destroyed the cut ends. This has the effect of a double whammy to assure sterility. How the ends are destroyed or closed is myriad-clips, suture, fulguration, folding the vas on itself and tying- doesn’t really matter in terms of the long-term success rates.

When I learned to do a vasectomy as a resident in the 1980’s, we made a fourth of an inch midline scrotal incision and brought the vas to the surface with a instrument called a towel clip. It had two fine pointed ends and was used to hold towels in place to isolate the surgical field. This instrument was adapted to many functions in surgery and in urology was the device of choice for a vasectomy.

The China Method or the No scalpel method introduced two instruments. One is the fine pointed hemostat which is used to spread the skin for the vasectomy opening. (So there is still an opening but you did not use a scalpel to make it-whoopee do.)

The fine pointed hemostat is also used to open the vas sheathing without having to incise it with a knife once the vas has been isolated and brought to the skin.

This is where the grasper is used. The opening is smaller-a grain of rice in length- and the grasper allows for the urologist to easily grasp and bring the vas to the skin to perform the procedure.

The story line goes that the procedure has a smaller opening, that the opening heals better because the skin has been spread and not cut, the procedure can be done quicker  because of these instruments, and that the patients do better with less heal time and fewer complications.

So is it a gimmick? Well it is a better procedure now because of these instruments, but we still identify, cut and destroy. You can decide if all this fuss in nomenclature warrants “spreading” is better than “cutting” an opening that is less than a centimeter in length.

No Scalpel does have a ring to it I must admit. The No Needle vasectomy is another story; I’ll do that at another time.

Of note, these same two instruments are also very useful in preparing the post vasectomy vas for the microscopic vasectomy reversal.

Helping couples achieve the new addition to their lives with microscopic vasectomy reversal.

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