INTRODUCTION

I have been blessed with a rich and varied surgical career.  I received the calling to become a physician when I was in elementary school and it never wavered.  After being accepted at the age of 19, I attended the University of Texas Medical Branch in Galveston, Texas from which I received my medical degree at the age of 23.  I was attracted to surgery and was admitted to the General Surgery Residency at the University of Texas Health Science Center at San Antonio where I trained for five years.  It was during this time I was introduced to microsurgery with the Plastic and Reconstructive surgeons.  I participated in numerous microsurgical reconstructive procedures over a three year period and I was amazed by the surgical miracles that could be achieved with these intricate techniques.  I then had the privilege to spend almost a year in Edinburgh, Scotland as Senior Clinical Fellow of Thoracic (chest) Surgery prior to entering private practice in New Braunfels, Texas in 1988.  The subsequent 22 years have been exciting, fulfilling and never dull!  I was an early pioneer of laparoscopic (minimally invasive telescopic) surgery in South Texas.  I had the honor of serving my country during Operation Desert Shield/Storm as a surgeon aboard the hospital ship USNS Mercy when I was called to active duty as a Navy Reservist.  Upon my return to private practice, I became involved in learning new advanced laparoscopic procedures as well as teaching thoracoscopic (minimally invasive telescopic chest) surgery to other surgeons.  I have invented surgical instruments for which I was awarded a US patent and recognized as a contributor on several other patents.   As a Clinical Professor of Surgery for the University of Texas Health Science Center at San Antonio, I have been extensively involved with the training of 4th year General Surgery residents from the University as well as Willford Hall Air Force Medical Center for the past 18 years.  As for church activities, I have served on the Parish School Council, sing in two choirs and have been extensively involved in the Men’s ACTS Retreat Ministry.  I am currently serving on the Apostolate Board for the North American Province of the Missionaries of the Holy Family.  For the past several years, I have served on the Board of Directors of TIPHER (The Institute for Public Education, Health and Research), a local non-profit organization that serves the community with multiple programs for the disadvantaged such as a soup kitchen, diabetes education and GED classes, charitable Medical/Dental clinic, just to mention a few.

After more than two decades in practice, I thought that I had pretty much experienced all of the change one would expect in a full surgical career. Well, I was mistaken.  Dr. Cary Leverett had been engaged in the private practice of urology upon my arrival to New Braunfels.  Little did I know he was quietly building one of the largest vasectomy reversal practices in the country.  With the announcement of Dr. Leverett’s retirement plans nearly a year ago, this fine Christian gentlemen began to acquaint me with the ministry he had built and I was intrigued.  It didn’t take me long to appreciate the wonderful couples who travel from all over the United States to become patients of Dr. Leverett .  I was offered the opportunity to try to fill Dr. Leverett’s huge shoes upon his retirement.  I have had the honor to have been training with him for nearly a year, drawing upon his experience of over 5000 vasectomy reversals!

In 2008, approximately 527,000 vasectomies, to achieve permanent sterilization, were performed in the United States.  Meanwhile, it is estimated that approximately 5% of these men eventually have a change of heart concerning their fertility.  Remarriage, death of a child and change of life circumstance are but a few of the reasons that lead these men to consider vasectomy reversal.  Advances over the years including microscopic surgical technique have greatly increased the opportunity for these men to re-establish their fertility.  However, with cost for the procedure ranging typically from $5000 to $15,000+, many couples are unable to consider this surgical option based upon financial considerations.   The goal of this ministry is to attempt to make vasectomy reversal affordable to most couples.  The use of a free standing operating room and local anesthesia, thus eliminating surgery center and anesthesia charges, make this end possible.   My total charge for a vasectomy reversal (vasovasostomy) performed under local anesthesia is $3000.00.  After 4 months, if pregnancy is not achieved, a semen analysis should be performed.  If sperm in the ejaculate is not present, I will repeat the procedure with local anesthesia for $3000.00.  This repeat procedure must be done within one year of your initial reversal surgery.  I require a $500.00 deposit to schedule your surgery.  This deposit is non-refundable as I have financial obligations to the vas reversal facility and staff.   This deposit is put on your credit card or debit card at the time of scheduling.  The balance of $2500.00 is due upon your arrival for the surgery.  It is payable by cash, cashier’s check, or money order.  Personal checks are not accepted.  Credit cards and HSA cards are also accepted.  However, if these forms of payment are utilized, the transaction will need to be completed one week prior to your scheduled surgery to allow time for processing .  My operating schedule for vas reversals beginning in March 2010 will typically be on Tuesday and Wednesdays.  Although Christian values are the guiding light of this ministry, it is by no means meant to be restrictive to any couple and is without regard to race, ethnic or religious background.

It is my policy to interview you and your spouse the morning of the surgery.  If you have any questions that have not been previously answered, we will have an opportunity to talk at that time.  I prefer you come as a couple because your spouse will play a significant role in your after surgery care.  However, there are times when the patient must come alone, and this works out satisfactorily.  You will be examined and dismissed the day after surgery; again, however, some choose to return home the same day, and this usually works out well.  Follow up in that case will be by telephone.  The vasectomy reversal on average is a 1.5 - 2 hour procedure.  The surgery is done on a day patient basis under local anesthesia. Preparation for your surgery is simple and is detailed in the PRE-OP INSTRUCTIONS section of this site.

When you underwent a vasectomy for sterilization, you were informed about the potential complications. The same list of complications still exists for the vasectomy reversal.  These complications include, in order of frequency: 1) swelling, 2) pain, 3) hemorrhage/hematoma, 4) infection, 5) testicular atrophy (shrinkage), 6) loss of testicle, 7) loss of life.  Pain and swelling are common, but quickly disappear.  Hemorrhage/hematoma is less common.  This complication may occasionally require surgical attention.  If surgery is required to drain the hematoma, there would be some expenses associated with the trip to the hospital or outpatient surgery center (more medication and additional doctor fees such as anesthesia, etc.).  This is an additional expense to you.  Usually, but not always, this is covered by your medical insurance, if you have it.  Therefore, if time allows, I recommend staying near the vas-reversal center (one day after surgery), so, in the unlikely event this complication occurs, it can be handled in a timely fashion.  Also, if surgical drainage of a hematoma is necessary, the possibility exists that the recent reversal surgery will be jeopardized.  This complication occurs less than 1% of the time.  Infections are also less common, and they usually respond very well to antibiotics.  Loss of testicle and testicular atrophy are very rare. Loss of life is mentioned in the world literature, but only a few cases are documented.

For those couples experiencing infertility due to a man’s vasectomy, there are some other alternatives to having the vasectomy reversed, but restoration of a man’s fertility by reconnecting the tubes at the site of the previous vasectomy appears to provide couples with the most optimal and least expensive option for building a family. If I can be of any further assistance to you, please do not hesitate to contact me.  My office telephone is 830-660-0600, or you may email me at info@micro-vas-reversals.com .  I look forward to meeting you.

Most sincerely,

Mark S. Hickman, MD, FACS 

Microsurgical Vasectomy Reversals