March 04, 2011
|Sean, 40, said he’s wanted kids all of his life. He had a vasectomy in January 2006 and life’s changes led to a divorce. But he’s now engaged and he and fiancée Haylee want to expand their fledgling family.
“I met my fiancée and she has two kids,” Sean said. “I basically decided I’m not done, even at my age, with my desire to have children.”
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Bob, 43, was in a similar situation. He had a vasectomy when he was married, got divorced and now wants children. “My girlfriend and I are looking at making this a permanent relationship,” Bob said. “We want children.”
What’s a man to do? Both opted for a vasectomy reversal, and also chose Dr. Tom Walsh
, UW assistant professor of urology, to perform the procedure.
Walsh is currently the only surgeon on the West Coast performing vasectomy reversals using the da Vinci robot—which is the route taken by both patients. Why go robotic with this procedure?
“You can reduce the time of surgery, which leads to increased speed in the healing process for patients, and it’s also less taxing on the patient and surgeon,” said Walsh. Using the robot also removes all human tremors.
Physicians across the country perform 600,000 to 700,000 vasectomies each year. Up to seven percent of those men will want the procedure reversed, said Walsh. Rates of success—defined by viable sperm count—are remarkable with the robotics procedure, coming close to 100 percent.
Sean said that he considered two academic medical centers for his care while researching the procedures. Walsh shared statistics from UW Medicine showing viable sperm counts above 90 percent.
“The other institution’s procedures were in the mid-60s,” Sean said. “That was the decision-maker, the efficacy combined with Dr. Walsh’s very personable approach. It became a no-brainer. And when I reviewed this with my fiancée, who has a nursing background, she said the same thing – we’re going to UW Medical Center.”
Bob was Walsh’s first patient using the robotics approach to vasectomy reversal.
“Dr. Walsh said, ‘The risks appear to be low, precision is high, and you understand robotics.’ I said, ‘Absolutely.’ I’m all about precision in the first place, but I also make a living in process improvement. So if I could help someone create a best-in-class procedure, I didn’t mind being the test patient or early patient.”
Healing time after the procedure varied between the two patients. Bob described the recovery as “very smooth, relatively painless, and there wasn’t a lot of discomfort.” Within one week, he was taking long walks and went back to normal activities shortly after that. “I get a sense after talking with others that I was probably ahead of the curve in terms of recovery,” he said.
Robotic surgery made a difference, too. “With the precision, cleanliness of incisions, and small sutures, I get a sense that it was far less invasive,” he said. “Recovery was that much easier. I can’t help but believe a fully manual procedure would have been a bit more disruptive.”
Sean said he only took one day off work—the day of the procedure—and used very little of the painkillers after surgery. His healing time was just a bit more than Bob’s experience. “More than anything, it was uncomfortable,” he said. “The swelling was substantial and it was uncomfortable for about two weeks. After that, there was pretty much a very level decrease in swelling.”
Moving forward, to the “success” question, Sean said after six weeks, his post-operative check-up showed a viable sperm count of 94 percent. Bob said his numbers were also way above what was expected at the six-week point.
What advice would they offer to others considering vasectomy reversal?
Bob said patients should consider the robotics approach. “Any time that you can leverage technology to improve precision and enhance a surgeon’s inherent abilities, you’re improving your chances of success,” he said. “To me, it’s like stacking the deck in your favor.”
Sean said in addition to connecting with the surgeon, patients should conduct research and, yes, even shop around before making this big decision.
“Do your research on what type of procedure you’re having done,” he said. “If you are trying to have a family, and there’s a difference between the mid-60s to mid-90s on the success rate, you’ll see that it is worth every penny to come to UW Medicine.”
The hopeful father-in-the-making found it hard to contain his excitement at what lies ahead.
“This is a really important journey to me,” Sean said. “None of these decisions have been made lightly. I’m 40 years old and hopefully will become a parent to my own child this year, which will be beyond beyond beyond exciting.”
Patient Sean Poppoff is an administrator in the department of pediatrics, division of neonatology, at UW Medical Center.