Scalpel-free technique makes this simple procedure even more so
By Theresa Santoro
Women are the majority shareholders when it comes to deciding about birth control. So, it should come as no surprise that when a couple decides to make a permanent choice in birth control, it is usually the woman who has tubal ligation, known as a tubectomy, or having her “tubes tied,” to close her fallopian tubes so that sperm cannot reach her eggs. This is because following delivery — whether a C-section or natural delivery — women are prime candidates for sterilization, as the invasive procedure can take place immediately. Once a woman ties her tubes though, it is usually permanent because success rates for tubal ligation reversal are low. Statistically, the least invasive and most effective form of permanent birth control today lies with our male counterparts undergoing a vasectomy. According to the American Urological Association, the risk of pregnancy after vasectomy is extremely low at approximately 1 pregnancy in 2,000.
“A vasectomy is considered a minor, in-office surgical procedure that usually takes about 30 minutes,” said Dr. Aaron Spitz, a board certified urologist in Laguna Hills and the Orange County Medical Association’s 2013 Physician of Excellence recipient. Dr. Spitz added, “We clip the vas deferens — the small tube that carries the sperm from the testicles to become part of the semen produced at the time of climax — while the patient is numb from a local anesthesia.” He went on to explain that although many men wince at the thought of having this procedure done, it is one of the safest and most effective forms of birth control with a quick healing process. Also, contrary to the belief of many men, in the aftermath of the procedure, there is absolutely no change in the sexual act or level of satisfaction for the man or his partner.
Will is a doting father of two in Lake Forest who chose to have a vasectomy because his wife was experiencing side effects from her birth control pills. Will stated that the decision was an easy one for him, as he was the one in the relationship that was certain about not wanting more children. He had a traditional open vasectomy with stitches. He said that his recovery was easy, and he has not had any regret about the procedure, and shared that he and his wife enjoy nearly 20 years of marriage, and a great life in the OC with their two kids, and are birth-control free. Will is one of many men to take birth control into their own hands, and as more and more men opt for vasectomies, there are continuing advances to make this procedure an easier one.
Dr. Spitz performs many vasectomies, but what he calls the “Cadillac of procedures,” is the no-needle, no scalpel approach. Also referred to as the NSV method, he says it is becoming the preferred method of doctors and patients alike.
In one of his patient-information videos, Dr. Spitz performs a no-needle, no-scalpal vasectomy. In his narration on the video, he explained that an air injector is used in place of a traditional needle to administer a local anesthetic. The air injector shoots pressure, which sprays the anesthetic beneath the surface of the skin to numb the area. The procedure continues with a very small puncture to the scrotal sack. Dr. Spitz explained his surgical approach step by step. The vas deferens is clipped, and the two ends are closed off. Rather than the usual stitches, only a Band-Aid is required for the scrotal skin, as the small puncture allows for a quick natural close within 24-hours. In addition, Dr. Spitz says he uses gauze, and a scrotal support for pressure to decrease the risk of any delayed bleeding. “For many men, the fear is completely alleviated when they learn that no needle, and no scalpel are involved in this procedure,” said Dr. Spitz.
According to Vasectomy.com, approximately 600,000 vasectomies are performed in the U.S. each year, and as many as five percent of the men who had them will change their mind. For this reason, Dr. Spitz counsels his patients before sterilization to be sure of their choice, as vasectomies are considered permanent and can be costly to reverse. The procedure is not covered by most insurance plans and can cost anywhere between $5,000 and $15,000, and it is imperative to discuss all of the costs with the office before you decide to move forward, especially accounting for the possibility that you will not be a success story.
According to Dr. Spitz, successful vasectomy reversals can be demonstrated in both a technical manner or as a resulting successful pregnancy. A technical success would mean that the vas deferens were successfully reconstructed and the man is producing sperm, but a pregnancy is not achieved. He said that this can be due to low sperm quality as a result of the initial vasectomy, or a reduced sperm count. “Some patients achieve immediate pregnancy, even before their first follow-up appointment,” he shared. Dr. Spitz further explained that every case is different and has to be treated individually. “Ideally, the closer a patient is to having the original vasectomy, the more successful the reversal is likely to be,” he said. Unlike a vasectomy, the reversal is a major surgery and requires a specialist to perform, which is why Dr. Spitz says that patients should look for board certified urologists who specialize in microsurgery.
Dr. Donald Moore was a vasectomy reversal patient of Dr. Spitz. He had a vasectomy at the age of 30, believing that he and his wife had completed their family. However, one year following his vasectomy, Don and his wife divorced. A few years later, he met someone else, and he and his new partner decided that if they were going to get married, he would need a vasectomy reversal so they could start their family together. “It was important to make this decision as a family, so we included my son in the whole process,” said Don. At his first appointment with Dr. Spitz, it was determined — based on a physical examination — that even though 11 years had passed since the vasectomy Dr. Spitz could reverse Don’s vasectomy and restore his fertility.
The reversal is a delicate microsurgery in which the vas deferens is rejoined. This requires scar tissue to be removed and tubes rejoined in a precise manner. The surgery, which requires general anesthesia is approximately five and one half hours. Though not always successful, Dr. Spitz was confident that a positive outcome would be had in Don’s case — and it was. Now in his early forties, Don could not be happier at becoming a father the second time around, adding a daughter to his family. Don shared via e-mail just a few days following mothers’ day that he had some exciting family news. “My wife found out this morning that we are 4 weeks pregnant! So the reversal not only worked once, but again 3 years later!” Don also shared, that another vasectomy would be in his future family planning. “The first vasectomy was so easy, that I have no problem doing it again,” he said.
Whether a couple is seeking to become pregnant, or to permanently prevent pregnancy, it is essential to weigh all of the options.