Vasectomy Reversal Center of North Carolina

 What You Need to Know

• I perform Vasectomy reversal surgery in my surgery facility on an outpatient basis under local anesthesia with heavy oral sedation. I have a very professional office and surgical facility that is very comfortable for this procedure. I use the finest microsurgical instruments available for this procedure, optimizing your potential for  fertility restoration and pregnancy. I will perform your  vasectomy reversal entirely myself. I am a board certified and licensed doctor who specializes in this procedure. I will not have assistants or associate physicians perform any part of this most important procedure for you. Most patients  tell me how easy the process and the procedure were for them and I appreciate your feedback. My surgical facility is located in Burlington, NC and is equipped with the latest, state-of-the-art  technology including a Carl Zeiss operating microscope and LED surgical lighting.
  
  
  
• You will be asked to arrive at our surgical facility approximately one hour prior to your vasectomy reversal surgery or as directed by my staff or I. You can usually leave shortly after the procedure. The surgery itself takes me about two hours to perform on average. You should plan to eat light on the day of surgery.  Food in the stomach can slow the absorption of the oral medications used to assist with your relaxation. Aspirin, coumadin,  and ibuprofen should be discontinued 7 days prior to any surgical procedure as these medications may act as anticoagulants and lead to an increase in bleeding during surgery. If you are taking blood pressure or other medications routinely, please bring these to our attention. You should continue to take any blood pressure medications before the surgery.  After the surgery, aspirin, ibuprofen, and other anticoagulant medications may be resumed.

• Two marks will be made over the cord, one on each side, with a surgical marking pen. Some of the diagrams on the procedure itself can be confusing.  Above are anatomical renderings which will be used during the consultation to better explain exactly what is going to take place.  The first diagram shows the anatomy of the cord structures.  I will be operating on both sides. There is not an extra charge for bilateral repair, that is my routine. The skin and cord structures will be injected with a local anesthetic after the oral sedation has begun to take effect. Incisions will then be made in the skin. The lower diagram shows the anatomy of the vas and the testicle itself. The vas may have been divided anywhere along its length. Sometimes, significant sections will have been removed.  It should be divided in the area labeled ductus deferens, which is the straight portion.  If this is the case, this will usually require only a direct vasovasostomy to be performed. When we talk about bypass procedures, we are really talking about taking the portion labeled ductus deferens and swinging it over to the portion of the epididymis where the silver grasper is holding the epididymal head. This procedure is called a vasoepididymostomy. With vasoepididymostomy, the vas is sewn directly into one of the smaller tubules in the epididymis. If the union is made closer to the tail of the epidymis, this will usually result in simply connecting one larger tube to one smaller tube and the results will be similar to those obtained with the simpler vasovasostomy procedure.
  
  
  
• I have been performing vasectomy reversal procedures for over 20 years. As such, I am able to reverse a vasectomy more quickly than some doctors / surgeons after the initial setup and preparation. I refuse to compromise anyone's procedure and only the most precise techniques will be utilized. Your reproductive success is very important to me as well as your satisfaction with your decision to trust me to help you achieve your desires to have more children.

• You will be amazed at how comfortable this procedure is going to be for you. The prescription medications you will be receiving prior to the procedure provide for an extremely pleasant degree of relaxation or sleep. To date I have never had a patient tell me that the procedure itself was worse than the vasectomy.  Most tell me the vasectomy reversal was far more comfortable for them than the vasectomy, although  the reversal will take longer to perform. Most men fall asleep soon after being positioned on the operating room table. The premise that vasectomy reversal is better performed under general anesthesia is simply not true.  Vasectomy reversal is safe and very comfortable under local anesthesia with the addition of the relaxing medications provided. This is an area many people have concerns about that I assure you are completely unnecessary.

• Everyone acknowledges that the risks associated with a general anesthetic are far greater than with a local plus sedation. The sedation you will receive in addition to the local however is the key to truly making the procedure comfortable and allowing you to simply relax.  The scrotum is injected with local anesthesia much like it was with the original vasectomy procedure. This causes a brief burning sensation that goes away after about a second. After this, there should be little additional discomfort.  All of the pain medication you will need after the surgery will be prescribed before the surgery. Many people elect to use only ibuprofen and ice, although a narcotic will also be provided if needed. Please inform me if you have any allergies or drug sensitivities that might be important.

About the Surgeon

• As a surgeon specializing in vasectomy reversal surgery, I perform all surgery personally placing every stitch myself. This is the same thing as a reverse vasectomy doctor, just a more common way of saying the same thing. I will be personally caring for you before, during and after your surgery and can be reached for emergencies or postoperative questions most any time. I take great pride in our successes and feel it is my great privilege to care for each couple going through the challenges and emotions of starting or extending a family. Helping to create life is such a blessing. I appreciate greatly receiving photographs of your future children as well as comments about your experience here. Your comments provide ideas for improving the experience for future patients. I am board certified by the American Board of Urology.

About the Microscope

• We utilize a Carl Zeiss Surgical microscope, recognized as being the best optics available for surgical purposes. This microscope allows for accurate suture placement to be performed during the vasectomy reversal procedure. We do not use surgical loupes which are essentially small binoculars affixed to a pair of glasses. These do not offer the same degree of magnification and are not powerful enough to accurately place sutures which can barely be seen without magnification. If a lower fee than mine is offered at another facility, this is probably the first question you should be asking. Personally, I cannot imagine having loupes hanging from my face every day, much less trying to do this work with them.

• Presently, there is no accepted FDA approved technique that allows the ends of the vas to be “welded” together using laser energy. There does not appear to be any improvement in results compared with our success rate with the microsurgical technique we currently use. If you examine the ads for laser vasectomy reversal closely, one realizes that the laser is not used to put the vas back together but just used to free the vas from surrounding tissue and to remove the vasectomy scar.

Ÿ  Do not try to resume normal activity for at least 2 weeks! Do not expect your reversal procedure to be anything like your original vasectomy procedure. Take it easy! You’ve just been through a two hour surgery. You’re body needs time to heal.

Ÿ  After your procedure expect some swelling, bruising and discomfort. This is normal. The use of an icepack can help limit the amount of swelling you experience. We recommend 20 minutes of ice per side for the first 24-48 hours after your procedure. You may alternate sides if that is more comfortable for you. After the first 48 hours you may switch to heat therapy. Some patients find that if they sit in a warm tub of water for about 20 minutes at a time, like a sitz bath, this helps with the swelling and discomfort. (a sitz bath is different from a tub bath because it is a warm tub of water 3-4 inches deep without soap) If you see bruising along your penis or abdomen, do not be alarmed. This is normal as well.

Ÿ  After your procedure, you may eat and drink as you feel like. 

Ÿ  After returning home or back to the hotel you may feel like taking a nap. This too is perfectly normal.

Ÿ  You may remove the gauze placed on your scrotum after you get home or back to the hotel. You may notice clear or blood tinged drainage coming from your incision. This is normal and usually consists of local anesthetic primarily. If it becomes thick, yellow, or has a foul odor, please contact our office. Old blood smells bad. Clean with peroxide if this is noted. You may also notice that your incision has small gaps between the suture threads. This is to allow for your incisions to drain and is normal as well.

Ÿ  You may shower after your procedure. Do not take a tub bath, go swimming, play in the ocean, lake or pond after your procedure until your incisions are completely healed. If you do, bacteria can enter into your body and cause infection. 

Ÿ  Do not resume exercise for at least 4 weeks. This includes NO SEX for the next 30 days as well. If you lift weights, run, or participate in other strenuous activities do not resume for at least 6 weeks. Examples of strenuous activities are horseback riding, water or snow skiing, rock climbing, racing, parachuting, bicycling etc.

Ÿ  Do not apply any type of ointment to your incisions. This includes Neosporin, Polysporin and A&D ointment. Application of these or other ointments can slow down the healing process and the suture absorption by your body. Instead use hydrogen peroxide 2-3 times a day to clean your incisions. Try to keep them clean and dry.

Ÿ  Do not pick at the incisions. This includes the sutures and the glue. They are there for a reason! The glue usually will come off on its own within a couple of days. If it does not you may use alcohol on a cotton ball or q-tip to dissolve and remove it. The sutures will dissolve within 3-4 weeks. If the suture becomes bothersome in a certain area you may take small scissors and clip the suture as close to the skin as possible. Do not pull or tug at it.

Ÿ  Do not ejaculate for any reason during the next 30 days as this may potentially result in  irreparable damage to the vas as it heals. It is recommended that you abstain from sexual contact of any kind. There are no exceptions! If you have a special occasion planned during this 30 day period (like a birthday, or an anniversary) you may want to make arrangements to reschedule celebrating. Please do not call us to ask permission to break this rule! The answer is going to be NO!  

Ÿ  If you think you are having complications related to your reversal procedure please do not go to the Emergency Room, your primary care physician, or another urologist until you have contacted us. Please call us first! Most doctors do not have experience or knowledge about your procedure. If you need to see a local physician, we will be glad to discuss your procedure with them if they wish to call Dr. Daniel. You have been provided all of our contact information and Dr. Daniel’s cell phone number and email address. Please do not hesitate to contact us during or after business hours if you have questions or concerns. We are here to help! Problems are unusual but they do occur. We want you to succeed in your goals regarding this procedure and we want to be of any assistance we can be to help you achieve those goals. 

Contact us for more info

BURLINGTON OFFICE
1041 KIRKPATRICK ROAD, SUITE 250, BURLINGTON, NC 27215
Phone (336) 584-1010