What To Do About vas reversal before and after | Vas Reversal
Vasectomy Reversal Defined
Vasovasostomy involves a surgical
reversal of a previous vasectomy with the goal of obtaining sperm in the
ejaculate of sufficient quantity and quality to achieve a pregnancy. The
patient usually takes an oral narcotic and muscle relaxant one half an hour
prior to arriving at the office. Then after the surgical area has been washed
with betadine, a long acting local anesthesia is injected. Then, depending on
the length of time since the vasectomy, or the presence of a sperm granuloma, a
small incision is made just over the area of the vasectomy.
The proximal end (the end that
comes from the testicle) is opened and the fluid is checked for sperm under the
high power microscope. The distal end (the end that goes to the prostate and
out) is flushed to make sure it is open. The vas is connected to the vas if 1)
there is sperm found or 2) if the inside diameter is wide open and abundant
fluid runs out. This connection or “anastomosis” is called a vaso-vasostomy.
The operating microscope is used during the entire procedure. I use 10-0 nylon
for the inside diameter to connect the mucosal lining of the vas, and 9-0 nylon
to reinforce the muscular layers of the wall. After placement of the sutures,
the skin is closed with absorbable suture. Then attention is turned to the
other side. After both sides are anastomosed, dressings are placed and the
patient is dismissed.
If during the course of surgery,
no sperm are seen at the level of the vasectomy and the inside diameter is
small and no fluid is expressed, then a search for sperm ensues. Generally, the
incision will be lengthened and the epididymis is exposed. The next step is to
find sperm at the epididymis. Outcomes are better the further away from the
testicle sperm are encountered. When sperm are identified then the vas is connected
to the epididymis in a procedure called a “vaso-epididymostomy” or
“epididymo-vasostomy”, I just call it a VE.
Pursue Fatherhood Once
Again
Due to the increased success of modern surgical techniques,
vasectomy reversals are now more common than ever. Whether you remarried,
suffered the loss of a child, are fulfilling a religious obligation, or simply
changed your mind, you can pursue fatherhood once again by having an
outpatient-performed vasectomy reversal.
The Consultation
Before Treatment
Most patients are seen several days to weeks before surgery
and we get to know each other. I review the historical details and proceed with
a physical examination to get an idea of how long the surgery will last and
what the expected outcome will be. We can also review my personal results since
I have been in Michigan. Usually the couple will take a tour of the room where
the reversals are done.
Safe and Convenient
The Procedure
I generally plan on three hours of surgery, a little more or
a little less. The operating room table is firm so the patient will need to
understand he will need to hold still for that amount of time. Some patients
fall asleep. I sit to the right of the patient, my assistant sits to the left
and there is an attendant to take the vital signs and deliver the supplies as
needed. We almost always play some music.
We'll Take Care of You
Recovery
Healing should be rather quick and fairly easy. Pain after
surgery is most often controlled with pills. About 50 out of 100 men say the
pain after the reversal is like after their vasectomy. Another 25 out of 100
say the pain is less than after the vasectomy, and 25 out of 100 say it’s
greater. Pain bad enough to need medications rarely lasts longer than a few
days to a week.
Most men can return to their normal routine and light work
within a week. We recommend an ice pack to the scrotum for 24 hours, a scrotal
support for ten days, weight restriction for ten days and ten days of sexual
abstinence.
Contact Us Today?
We believe that everyone should have access to affordable
healthcare services, and we are dedicated to keeping our fees as low as
possible. Our physicians participate in the Medicare program and accept
assignment of payment so you can avoid having to wait for reimbursement of
out-of-pocket expenses. In addition, we accept most major health plans and work
with a number of HMO and PPO products.
Vasovasostomy costs around $4,300.00. This fee includes the
procedure, a local anesthesia, and operating room. Dr. Wise performs
approximately 123 procedures a year.
A $500 deposit is required at the time the procedure is
scheduled. Patients that cancel the week of or do not show up to their
appointment will forfeit their deposit. Patients that reschedule at the time of
cancellation will apply the deposit to the new date of service.
As a courtesy, our office staff will verify our participation
in your insurance plan prior to your appointment, and will file your insurance
forms for you after you come in. We will bill you for any remaining charges not
covered by your insurance policy.
Urologic Consultants,
P.C.
25 Michigan Street,
Suite 3300
Grand Rapids, MI 49503
(616) 459-4171
Urologic Consultants,
P.C. of Grand Rapids, Michigan
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