The Madajet Injector spays the anesthetic into the vas and surrounding tissues under pressure.
There are several reasons why not all urologists use the Madajet “No Needle Vasectomy” technique.
- They weren’t “trained to do this technique as a resident.”
- The system is an expense
- They feel it is all hype and adds no benefit to the procedure or the patient
- There is a learning curve they don’t want to go through
- The staff has to learn to prepare the system
- They will have also buy a ultrasonic sterilizer for the system
- They feel it will take longer than using a needle
- They feel that patients are not “really” that afraid of needles
- They just plain don’t want to change the way they have done for years
I know I have been there. I started using the Madajet about three years ago. And let me tell you by the time you buy all the instruments, teach the staff, and begin to use and learn to efficiently use the device you do begin to question its efficacy. You see, having a nurse fill a syringe with Lidocane and place on the vasectomy tray and doing something the way you have done with success for years is a lot easier than “change.”
So I have been on both sides and this is my assessment. It is better. I am now to the point that placing the 6 Madajet injections (three to each vas) is a much improved way to “deaden” the skin and vas for a vasectomy.
- Less medicine is used so it is easier to identify the vas and to work on it when the actual procedure begins.
- For those patients who are truly “needle phobic” not using a needle and telling them from the start that there will be no needle is indeed helpful in reducing anxiety. Reducing anxiety is important as it makes the procedure easier for both the patient and the doctor.
- Once you learn how to use the Madajet the numbing part of the procedure takes less time.
- The anesthesia is quite good and it is uncommon to need to use a needle for the procedure although this does happen from time to time. This occurs more frequently in patients with thick scrotal skin. (That’s right…not all men’s scrotal tissue is the same and the thicker skin makes it harder for the Madaject to penetrate all the tissue.)
There are YouTube videos of urologists demonstrating the use of the Madajet if it would be of interest to the patient considering a vasectomy.
Summary: Is using the Madajet better? I think so but in the big scheme of things it does not change the basics of the vasectomy (cutting the vas and sealing the ends) but the amount of medicine is less, the anesthesia is good, the vas are easier to work on as a result of the less volume of medicine, and the patient is more relaxed knowing there is no needle.
Posted in a gainesville georgia urologist, a microscopic vas reversal, a no scalpel vasectomy, a northeast georgia urologist, gainesville ga vasectomy, no needle no scalpel vasectomy northeast ga gainesville ga, no scalpel vasectomy gainesville ga, northeast georiga vasectomy | Tagged gainesville ga urologist, john c mchugh m.d., mchugh no needle vasectomy gainesville ga, mchugh vasectomy northeast ga, microscopic vasectomy reversal, no needle vasectomy, no needle vasectomy gainesville ga, no scalpel vasectomy, northeast georgia vasectomy | Leave a Comment »
When I began my urological practice in Gainesville, Georgia 27 years ago the standard surgical procedure for the prostate was a T.U.R.P. (Some patients refer to the procedure as having a “roto rooter.”) This procedure at that time took about an hour, and most patients were admitted to the hospital for 2-3 days. It was often times a bloody procedure and as a result patient’s were advised after the procedure to not do any strenuous activity for about a month because of risk of bleeding.
The GreenLight Laser usually takes about half the time of a T.U.R.P. because there is very little bleeding and there are no chips (shaving of the prostate tissue which a T.U.R.P. results in) to irrigate out of the bladder and there is very little bleeding for which the surgeon to contend. In addition this can be done as an out patient, and the catheter remains usually for only one day. The limitations regarding post operative activity is a lot less with the laser.
The Green Light Laser has been used by the Urologists at the Northeast Georgia Urological Surgery Center for several years. The qualities of the laser demonstrated in the video below make this form of treatment well suited for out patient Ambulatory Surgery. Patients customarily have the procedure done and are in the recovery room less than an hour, go home with a catheter which can be removed in one to two days.
Northeast Georgia Urological Associates use the XPS GreenLight laser which is the latest version of the GreenLight and is associated with less operating time, less bleeding and fewer post operative symptoms.
If you are a male who is having obstructive voiding symptoms of slow stream, hesitancy, or straining to urinate you may benefit from this procedure. Patients with irritative symptoms of an enlarged prostate such as frequency, urgency, or getting up at night may also benefit from this procedure.
“A couple of things, says Dr. McHugh. Most men who undergo the GreenLight laser have been tried on oral medications and for one reason or the other failed. Secondly, like any procedure the results are not always perfect. There are patients whose prostate is not well suited to the GreenLight. There are patients who for whatever reason the laser energy is very aggravating to the prostatic urethra and this results in a longer than usual course of irritative symptoms. I do recommend the GreenLight to my patients, however I want to be sure they have tried the available medications for prostate enlargement and that they understand the potential of the irritative effects of the laser energy on the prostatic urethra.”
Dr. Brent Sharpe, a Northeast Georgia Urological Associates Urologist, has given and will be giving other talks on the GreenLight in Gainesville and the Braselton area.
Posted in a gainesville georgia urologist, a john mchugh md, a microscopic vas reversal, a no scalpel vasectomy | Tagged book on prostate cancer, gainesville ga urologist, GreenLight laser prostate, john c mchugh m.d., microscopic vasectomy reversal, no needle vasectomy | Leave a Comment »
gotta be to do and gotta do to have
The above picture is the before and after of the treatment of a low grade bladder cancer.
The bladder is commonly in the path of the radiation and radiation cystitis occurs commonly.
There is a small incidence of bladder cancer after radiation of the prostate, but it occurs and should be part of the decision making process.
Patient’s will often question getting “a cancer” from having a CT scan (i.e. how much radiation is in this x-ray) and at the same time not think twice about receiving a full course of radiation to treat their prostate cancer. (External beam radiation is 42 treatments.)
In the case of radiation for prostate cancer the primary other organ in the treatment path is the bladder and the colon/rectum.
Not saying not to choose this form of treatment, but just like surgery you need to know all the facts.
Posted in a gainesville georgia urologist, a john mchugh md, a microscopic vas reversal, a no scalpel vasectomy, a northeast georgia urologist, a overactive bladder interstim, a prostate cancer blog, a prostate cancer book | Tagged book on prostate cancer, gainesville ga urologist, john c mchugh m.d., microscopic vasectomy reversal, no needle vasectomy, urologic humor, wife and prostate cancer | 1 Comment »
If nothing is going right….go left.
If you have obstructive voiding symptoms (slow stream, hesitancy, getting up at night, stop start stream, decrease in caliber of stream) and want to do radiation as your treatment of your prostate cancer it is okay to have the prostatic urethra opened by the Greenlight laser before the treatment to prevent exacerbation of your voiding symptoms after radiation. It is not advisable to do any surgical treatment of the prostate after radiation treatment of the prostate. Trust me.
It is better to cure at the beginning than at the end….my friend.
Posted in a gainesville georgia urologist, a john mchugh md, a microscopic vas reversal, a no scalpel vasectomy, a northeast georgia urologist, a prostate cancer blog, a prostate cancer book | Leave a Comment »