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Tag Archives: vas reversal atlanta

After the Vasectomy Bullet Points

You have had your vasectomy…here are some “after the procedure” instructions and a heads up on potential issues that are peculiar to  having a vasectomy.

  • The small opening at the midline of the upper strotum does not have a suture and will close on its own.  A thin film of Neosporin ointment daily is recommended.
  • You can shower the day after the procedure, but don’t let water hit the procedure site directly.
  • Ice to the scrotum after the procedure helps with swelling and with discomfort. (Lidocaine is used at the opening and along the course of the vas tubes so there is anesthesia for an hour or so after the procedure.)
  • You’ll be given something for pain, this is to be used in an “as needed fashion.” If you don’t have pain, don’t take it or use Advil or Aleve. Taking a half a pill is acceptable.
  • Try to be off your feet with the scrotum elevated strictly for the first 24 hours and then as much as possible for the next two days. Most patient who have the procedure on a Thursday or Friday take it easy over the weekend and return to work on Monday. If you have a strenuous job, you may want to gradually get back into your routine.
  • For the first week after the vasectomy, compression underwear to stabilize the scrotum and elevation of the scrotum with a rolled sheet when sitting can reduce any swelling.
  • No sexual activity for one week.
  • No unprotected sexual activity until we have evaluated two negative specimens. It takes approximately 25 ejaculations to clear the tube beyond the vasectomy site. (A couple can achieve pregnancy if there is unprotected sexual activity before the sperm has completely cleared.) We recommend evaluation of specimens as a rule at 6-8 weeks.  It is not about the time since the vasectomy, it is about the number of ejaculations.
  • Even though the opening is in the middle of the upper scrotum, the vasectomy sites are on the left and right underneath the skin. Discomfort, bruising or asymmetrical swelling is not uncommon, but should slowly improve over several days.
  • Each patient is given two specimen containers after the procedure and there are several options regarding checking the post-vasectomy specimen.  Dr. McHugh examines semen specimens with a microscope at no expense. (The best days for dropping off the specimen is Monday, Wednesday and Friday-but it best to call to be sure he is available to examine.) For out of town patients, specimens can be taken to a local hospital for a “post vasectomy” semen analysis (we can fax an order) or use online test kits such as spermcheck.com.
  • It is not unusual, maybe 5-10% of specimens, will have a rare sperm. This just means that more time/ejaculations are necessary to completely clear all of the sperm. We will require two consecutive completely negative evaluations.
  • There are no special instructions about the specimen. If you obtain the specimen in the morning and drop off later in the day, this is not a problem. We are not doing a formal count, only the presence of absence of sperm. We will call you back with the results that day.
  • If any issues arise that you have questions about, feel free to contact us using the form below.  We will be happy to speak to you or if you feel necessary examine you in the office at no expense to you.
  • You also can utilize our text to email option. (You text your comment/concern and it comes immediately to our email.  We check our email numerous times a day and on weekends.)  The response comes back to you as a text. Here’s the number: 770-376-5616

Thank you for allowing us to participate in your care.

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.

 

Vasectomy reversal-Loupes vs. Microscope?

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Atlanta—If you’re going to perform a vasectomy reversal, use a microscope. Despite the additional time and cost involved, microsurgical vasovasostomy is superior to the loupe-assisted macroscopic technique, findings from a recent study from Korea confirm.
In the retrospective study from Bundang CHA Hospital in Sungnam, researchers found a 24% higher patency rate in patients who underwent microsurgical vasovasostomy using 9-0 nylon compared with those who underwent a loupe-assisted technique using 8-0 nylon. However, the improved patency rate of the microsurgical technique did come at the expense of a significantly longer operation time than that of the loupe-assisted approach. Read More…

Dr. McHugh uses a Zeiss operating microscope in our accredited ambulatory surgery center. Contact us for a free consultation.

Request an appointment 24/7-We’ll return your call the next business day.

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First Vasectomy in America? 1897

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Click on Image to Visit Northeast Georgia’s Vasectomy Page

Interesting Facts about a Vasectomy and Vasectomy Reversals

The First Microscopic Vasectomy Reversal?

Technical advances in vasectomy reversal mirror those in microsurgery over the past 100 years. As a discipline, microsurgery was first performed by Carl Nylen in Sweden for middle ear surgery in 1910, but grew most rapidly as a discipline in the 20th century stimulated by its success in microvascular reconstruction of war-injured soldiers.

The first microsurgical vasectomy reversal was performed by Earl Owen in 1971.

Why do you wait 3-4 months to check for sperm atfter a vasectomy reversal?

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  • The time from the vasectomy to the reversal is one of the most important factors in the reversal’s success.
  • The longer the interval the more effect of the vasectomy obstructing the natural course of things in the testicle has on sperm quality.
  • Determining how much negative effect has occurred as result of the vasectomy on the quality and quantity is variable and usually based on the time interval.
  • Assuming that because a vasectomy can potentially “shut down” production of normal sperm, the testicles, after a reversal, have to readjust and begin to produce sperm again.
  • The chart above shows the maturation of sperm in the testicle.
  • This process usually takes about three months.
  • So, if the testicles have stopped producing sperm and the obstruction of the vasectomy is corrected by the reversal, then it would take about three months for normal sperm to complete the maturation process and be seen in the ejaculate.
  • So this is why many reversal doctors tell their patients not to consider submitting a specimen for the presence of sperm after a reversal for at least 3-4 months.
  • It you submit a specimen at three months and there are no sperm, that is disappointing, but in many patients it may take up to a year for the testicles to resume their normal activity.
  • I have had patients with no sperm in the ejaculate at six months and achieved pregnancy at one year.

Overview of a Vasectomy Reversal

Adobe Voice Video of Beginning the Vasectomy Reversal Process

The first step is making the decision to have one and the next is scheduling a free consultation to learn all about the procedure and how factors specific to you affect the success rates.

770-535-0001 ext. 112 and we  will guide you through the process.

After a vasectomy reversal…What type of scrotal support?

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Well you might think this is an odd question. Well…it is probably the most commonly asked and the first question in the post-op area asked by the wife. Tighty whities or  boxer briefs are the most common “supports” mentioned as potentially being suitable for the post-reversal male.

The problem with the traditional “jock strap” and the above mentioned supports is that they just don’t add the compression and lack of movement of the testicles necessary to facilitate immobilizing the newly repaired vas deferens.

Nothing fits the bill better than a pair of athletic compression shorts as seen above. The male can begin wearing the day after the procedure and throughout the 3-4 week post-operative non sexual activity period necessary to allow the vasectomy reversal to heal appropriately.

Okay…you think this was an odd thing to spend a post on, but just wait…it will be on your mind as the first question after the surgery…that is after, ” When can we have sex?”

As a side note-this type of compression shorts are excellent for the post-vasectomy patient as well.

Are vasectomies reversible?

Yes…but that doesn’t mean it will work!

This is a common question by the person wanting a vasectomy. I often explain that yes they are reversible but that is not the entire issue. As explained elsewhere, there are many factors involved in a “successful” reversal to include the health of the couple, who does the reversal and the time between the reversal and the vasectomy.

Urologists always tell the vasectomy couple that they should consider the procedure permanent. We mention that it can be reversed but the success rates vary and that they should not depend on that.

If there is any doubt  about wanting another child you probably are not ready to nor should you have a vasectomy.

A good option for some is to bank sperm. The fee for this varies but is around $300 a year.

A funny memory for me… awaiting our third child my wife informed me that she did not want anymore children and that she had arranged for her tubes to be tied after the delivery. I asked, “What if you change your mind and we do want another one in a few years.” (I was one of five boys and had always wanted a large family.)

“John we can adopt. My body is done with having babies.”

Well…there you go. Having three children now all over the age of thirty I understand the wisdom of her decision.

Microscopic Vasectomy Reversal-How big is a micron?

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So why is an operating microscope necessary for reversing a vasectomy?

Well…

The thickness of a strand of hair is 100 microns.

The outside thickness of the vas deferens is about 2 mm and the lumen of the vas (the part of the vas that is connected with the reversal procedure and the tube that sperm travels) averages about .56 mm.

The suture used used for the procedure is 70 -100 microns, i.e. the suture is about the diameter of the human hair.

So…12 or so sutures the size of hair is used to join a tube that is that is less than a millimeter in diameter.

1000 microns equals a millimeter.

Of note: The suture that is usually be used to close an incision after an abdominal procedure would be bigger than the tube in which sperm travels in the vas deferens.

Very small sutures must be used to connect very small openings if there is going to be enough room after connecting the tubes for sperm to travel in their quest to achieve pregnancy.

And now…you know the rest of the story-and why…size does matter.

Can a vasectomy be reversed?

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Yes a vasectomy  can be reversed…but that really isn’t the issue. The real question is if a vasectomy is reversed what are the chances that it will be successful?

The answer is multifactorial and dependent on the age of the male and female, how long ago was the vasectomy done, the reproductive health of the female, the surgical reconnection of the vas deferens staying open after they are rejoined, and finally the quality of the semen produced after the reversal. All of these factors explain why the patency of the procedure (presence of sperm) and the pregnancy (it worked) of the procedure differ.

Yes you can send a boy to college but you can’t make him think

and yes you can lead a horse to water but you can’t make him drink.

Yes you can reverse a vasectomy but that don’t guarantee no baby

It’s about if it will result in success and that my friend is a big maybe!

Reversal Rates Based on the Time Since Vasectomy

Less than 3 years  Patency 97% Pregnancy 76%

3-8 years             Patency 88% Pregnancy 53%

9-14 years           Patency 79% Pregancy 44%

Greater than 15 years Patency 71% Pregancy 30%

Belker AM, et al. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. Journal of Urology 1991; 145(3):505-11.

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

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