You should not have anything to eat
or drink after midnight the night prior to surgery. Aspirin and
ibuprofen should be discontinued 10 days prior to any procedure
as these medicines can thin the blood and lead to an increase in
bleeding during or after surgery.
Dr. Werthman has streamlined and refined the surgical process to
the point where the typical vasovasostomy takes one and one half
hours and a vasoepididymostomy takes about 2 hours to perform. Our
operating room team have been working together since the first reversal
and have encountered and are prepared for every possible situation
and scenario in the operating room when it comes to vasectomy reversals.
We will typically perform only one reversal in a day so you are
our sole focus with no distractions.
2. About Anesthesia
Most patients request a general anesthetic for their comfort but
the procedure can also be performed under regional or local anesthesia
with sedation. Our anesthesiologists are experts in administering
anesthesia on an outpatient basis. Their technique allows patients
to awaken immediately after surgery usually without the groggy,
nauseous or heavily sedated feeling that many patients experience
after a general. This allows you to go home quicker, feeling better.
Rarely a patient will ask for spinal or epidural anesthesia.
From the surgical perspective, a general anesthetic is the choice
because of the nature of the surgery. Microsurgical reconnection
of the vas is an extremely technical and precise surgery. It would
be very difficult to perform and results may be compromised if the
patient was able to move around. I therefore discourage patients
from having the surgery just under local anesthetic even though
it reduces the costs somewhat. This is not an area where you would
want to skimp to save several hundred dollars.
3. About the Surgeon
Dr. Philip Werthman performs all surgery personally and places every
stitch himself. While he teaches medical students and residents,
he does so in the classroom or lecture hall, not in the operating
room. Dr. Werthman personally cares for every patient before, during
and after surgery and can be reached by his post-operative patients
on his cell phone or at home for emergencies or postoperative questions
day or night.
Dr. Werthman feels that treating male infertility is his mission
and takes great pride in his successes and feels it is his great
privilege to care for each couple going through the challenges and
emotions of starting a family.
Dr. Werthman is one of the most experienced male fertility specialists
in the country and has limited his practice to exclusively performing
microsurgical procedures, mostly vasectomy reversals. He does not
perform any general urologic surgery. In the last 8 years, Phil
as he prefers to be addressed by patients and staff alike, has performed
over 1700 microsurgical cases. We have one of the oldest established
vasectomy reversal practices in the country ongoing for more than
30 years. Dr. Rothman was one of the original founders and innovators
of the microsurgical vasectomy reversal in the early 1970’s.
Together we have a combined experience of over 5000 microsurgical
cases.
Phil played college basketball for the State University of New York
at Binghamton and then went on to medical school at Hahnemann University
in Philadelphia where he graduated as the number one student in
his class in all 4 years (Valadictorian). He received 4 separate
scholarships while in medical school and received the award for
attaining the highest score on the national medical board exams,
the licensing exam that all physicians in the United States must
pass in order to practice medicine. Phil completed a six- year urology
residency followed by a one- year male infertility and microsurgical
fellowship. He was then picked and mentored by Dr. Cappy Rothman
to take over his long-standing and famous microsurgical vasectomy
reversal practice.
Dr. Werthman was asked to edit the latest hard-covered periodical
textbook on male infertility for the medical publishing company,
W.B. Saunders. The book was completed in 1999 and is the most up-to-date
textbook on the topic for physicians who practice in the field.
Dr. Werthman is board certified by the American Board of Urology,
Is a Fellow of the American College of Surgeons (FACS), and one
of the few urologists to be elected to the Society of Reproductive
Surgeons. He is a member of the American Society of Reproductive
Medicine, Pacific Coast Fertility Society, American Urologic Association,
American Society of Andrology, and the Society for the Study of
Male Reproduction (SSMR).
4. About the Microscope
We are the one of the few centers in the country using the Zeiss
OPMI surgical microscope to perform vasectomy reversals. This is
the latest in innovative medical technology by Carl Zeiss. The magnification
varies from 1.5X up to 18X high powered strength and is equipped
with a xenon light source as opposed to the standard halogen lamp.
This gives us the best optical advantage in performing the most
precise vasectomy reversal surgery. Our center has invested over
$115,000 to get this brand new technology to better serve our patients.
5. Closer Look at Laser Vasectomy Reversal
Presently, there is no accepted FDA approved technique that allows
the ends of the vas to be “welded” together using laser
energy. We had experimented using laser-welding years ago but found
no improvement in results compared with our 99% success rate with
the multi-layered 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. While this is an important part of the procedure; it usually
takes between 5-10 minutes to do with a scissor and micro-scalpel.
It is conceivable that the laser energy causes more damage to the
vas tissue than a scalpel.
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