Post Vasectomy Pain Forum

Dr. Sijo Parekattil's new office & cost-effective technology in Winter Garden, Florida

Dear all,
Just wanted to let everyone know about our new office in Winter Garden, Florida. At my previous clinic, PUR Clinic, we were hospital employed and I decided to become independent and start our own new clinic: Avant Concierge Urology. Over the last several years, health care costs have really risen quite dramatically and many of our patients even with insurance are being priced out. I have really become frustrated with the rising costs at larger healthcare systems and decided that the only way to try to reduce costs is by trying to do more of our treatment options in office and ambulatory surgery type settings to try to control our overhead costs. We have partnered with Karl Storz from Germany and are building the first ever office based micro-surgical suites in the US. This new technology provides unparalleled microsurgical optical magnification and allows the surgeon 3D visualization on 55" digital high definition screens in an ergonomic fashion to allow for greater surgical ease during complex microsurgical procedures. This technology allows us to perform microsurgical cases in an office based setting with IV sedation or nitrous sedation, thus significantly reducing our overhead costs. I really believe in giving patients the financial benefit of lower overhead costs and thus, we have reduced the pricing on a number of our procedures:

Below is a listing of our new self pay pricing at Avant:
a) Vasectomy Reversal - total out of pocket charge is $3600 - includes surgery & IV sedation (we also offer nitrous sedation now for patients who do not want IV anesthesia)
b) Targeted blocks & cord blocks - usually covered by insurance, but if pt desires self pay pricing - $500 total out of pocket charge (includes nitrous sedation)
c) Targeted peri-cord or nerve cryoablation - usually covered by insurance, but if pt desires self pay pricing - $2600 total out of pocket charge (includes IV sedation), there is an additional $500 charge for the optional allogen injection
d) Targeted microsurgical denervation of the spermatic cord - usually covered by insurance, but if pt desires self pay pricing - $2750 total out of pocket charge (includes IV sedation), there is an additional $1000 charge for the optional cord bio-wrap

Our new clinic will be up & running 11/2/2020. However, we are offering telehealth consultations currently and I would be glad to talk to anyone interested in a telehealth consult. Hope this info is helpful.
Feel free to contact me directly at: sijo@avantconciergeurol.com
with any questions or at: info@avantconciergeurol.com to setup a telehealth consult

Thank you

Sijo Parekattil, M.D.
Director, Avant Concierge Urology
15548 W. Colonial Drive, Winter Garden, FL 34787

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@S_Parekattil_MD

Your dedication to patients and your specialty is unquestionable. This clinic will become the new standard for treating PVPS and a beacon of hope to all that suffer from urological conditions. Thank you for your continued support and work on our behalf.

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Thank you for your support. Grateful that you let us take care of you.

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Thank you for what you’re doing! I can’t think of anyone I’ve ever felt more comfortable with than you and, of course, Dr. Thomas, for my condition (thankfully nearly 2 years without pain).

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Dear all,
Had to make some minor corrections for pricing - I had made a mistake with the prior posting with some of the IV sedation costs.
Below is a listing of our new self pay pricing at Avant:
a) Vasectomy Reversal - total out of pocket charge is $3950 - includes surgery, IV sedation (we also offer nitrous sedation now for patients who do not want IV anesthesia) & first post-op phone f/u,
b) Targeted blocks & cord blocks - usually covered by insurance, but if pt desires self pay pricing - $500 total out of pocket charge (includes nitrous sedation)
c) Targeted peri-cord or nerve cryoablation - usually covered by insurance, but if pt desires self pay pricing - $2600 total out of pocket charge (includes IV sedation), there is an additional $500 charge for the optional allogen injection
d) Targeted microsurgical denervation of the spermatic cord - usually covered by insurance, but if pt desires self pay pricing - $3400 total out of pocket charge (includes IV sedation & first post-op phone f/u), there is an additional $1000 charge for the optional cord bio-wrap
Thank you for letting us take care of you

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Hi @S_Parekattil_MD thank you for keeping us posted .

Two questions:

  1. The cost of the vasectomy reversal its the same for vasovasostomy than for vasoepididymostomy?

  2. I´ve read somewhere here in the forum that for PVPS you do or prefer the vasovasostomy option. Is that correct? And in that case, why?

Thank you very much for been here.
Ary N. from Argentina
(We spoke by the phone 5 or 6 time last year)

The cost for the vasovasostomy is the same as vasoepididymostomy. Cannot discuss medical issues via forums like this with patients - please call our office at 407-547-1654 to setup a phone/whatsapp call with me. I would be glad to go over options and answer all your questions.

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I have to say, Dr. P’s. new clinic is nothing short of amazing! Everyone on his staff treated me so well. The surgery was precise and we are hopeful it will be successful in reducing my pain. (I’ll post updates about that part in my own thread in the future as I’m still healing.) His clinic set me up with a butler for the day, Jeff. Super nice guy and happy to have him since I was on my own. Aside from superior surgical skills and a great patient experience, Dr. P. makes things affordable. I cannot recommend his clinic enough.

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What is optional cord bio-wrap

This is great news. Not surprising from my standpoint. While I have no complaints about my local PVPS treatment at the Cleveland Clinic (Drs. Thomas back in the mid-2000s, Dr. Sabanegh, and Dr. Shoskes), I found myself going to Dr. P. back in the 2017-18 timeframe because he offered a ladder approach of therapies and, specifically, a therapeutic cord block with steroid and botox that wasn’t available here at home. First class treatment all the way, and every single nurse expressed their love and enjoyment in working for Dr. P.

Ironically, Dr. P. did his fellowship under Dr. Thomas (who did my reversal in 2006) just before I developed PVPS in late 2005 and was on staff there while I was being treated by Dr. Thomas. Didn’t meet Dr. P. while being treated then, but he’s the closest I’ve found to Dr. Thomas in terms of bedside manner, compassion, and respect from the nursing staff.

Dear all,
Thank you for the feedback. Starting the new clinic in these times has been a challenge and we tried to incorporate a lot of features to try to make it more comfortable and welcoming. I really just want to treat every patient the way I would like to be treated. In these tough economic times, its definitely a challenge !! Please let me know if there is anything you think we can do better.

To answer one of the questions above, the optional bio-wrap is a scaffold material derived from human amniotic membrane tissue that helps with tissue healing and might reduce scarring and disorganized nerve regrowth.

We have done a bunch of cases so far, and its been going really well so far. Unfortunately, I did miscalculate some of our disposable costs and anesthesia costs and have had to increase our pricing for our procedures a bit. I am trying to make sure that we keep our margins as minimal as possible to relay all the cost savings of doing these procedures in an office setting w/ IV sedation to the patient.

Below is a listing of our revised self pay pricing at Avant:
a) Vasectomy Reversal - total out of pocket charge is $4500 - includes surgery, IV sedation (we also offer nitrous sedation now for patients who do not want IV anesthesia) & first post-op phone f/u,
b) Targeted blocks & cord blocks - usually covered by insurance, but if pt desires self pay pricing - $800 total out of pocket charge (includes IV sedation), if pt desires nitrous (total charge is $600),
c) Targeted peri-cord or nerve cryoablation - usually covered by insurance, but if pt desires self pay pricing - $4000 total out of pocket charge (includes IV sedation), there is an additional $500 charge for the optional allogen injection
d) Targeted microsurgical denervation of the spermatic cord - usually covered by insurance, but if pt desires self pay pricing - $4500 total out of pocket charge (includes IV sedation & first post-op phone f/u), there is an additional $1000 charge for the optional cord bio-wrap
Thank you for letting us take care of you

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I have had to rewrite this several times because I get so angry. I came to you in 2018 for a blood clot in my left testicle and you performed over a dozen surgeries and procedures within a 5 month window and you said you didn’t find a blood clot. I last saw you to remove over 30 titanium sutures that were in my groin after I got gangrene after you put a wound vac on my my groin that didn’t last a week before it broke and the ER here rushed me over to your hospital for emergency surgery which you wasn’t going to perform at first but said you would for my peace of mind. It’s a good thing you did because I’d have probably lost more than one testicle and upper groin if you hadn’t. But after that last procedure you sent me home with those sutures in for almost 3 months and they were tearing from my penis so you removed them early during a checkup and you never contacted me since. Over 2 years after you caused irreparable damage, and telling me the whole time you were going to be there for me for life, you haven’t called once.
I currently have a pain pump implant and it’s just enough so I can walk and go to dr appointments and do quick errands. But I can’t sit up for more than an hour before the spasms and cramps start and the pain puts me back in bed. I was approved for one final procedure for another implant to target medicine to my Dorsal Root called Preailt, which is a snail venom that targets that specific nerve and blocks the pain. I got the approval and the virus hit and it was postponed. I then lost my insurance due to Medicaid and after the stay at home was lifted and they were ready to do this surgery, I no longer was able to because Medicaid won’t approve it.
I have no clue how I got caught up in having so many surgeries back to back to back with you and each time they were abscesses and infections. And then gangrene?!
I can’t find any drs who feel comfortable in seeing me. There’s only one pain management dr in my region within 100 miles who takes my Medicaid and he wouldn’t see me. I have to drive 1.5hrs to Cocoa and pay out of pocket which I really can’t afford. But he’s actually helping me as best as he can but I have to find a way to pay for this last procedure because I can’t live in this type of pain much longer. I gave myself until I turn 40. If I have to live 90% of my life lying in bed with pain in my groin and shooting down my whole leg, there’s no sense thinking I can just deal with it for 10, 20, 30 some years. Two has been too long and I will try one more.
But my live was destroyed once I got cut open back in Feb 2018.
I am still in unbearable pain and have been fighting to try and get help. Once I lost my insurance and put on Medicaid, they don’t pay for much.

Dear Mr. Russell_B,
Due to HIPAA restrictions, I cannot discuss your medical care in this forum. I will always be glad take care of you and try to help you. I take care of many difficult cases. Please call our new office at 407-547-1654 and I would be glad to do a no charge phone f/u with you. Since I have moved from the PUR clinic, I do not have access to any of our previous records, but we simply have to get your permission and then we can get all the records transferred over to us. Please call our office and we will do our best to help you. The reason I work with such difficult cases is that I really have only have one interest here, and that is your well-being. If there is anything I can do to help you, I will try my best. Chronic pain in this area is difficult to treat and we do not have all the answers. We are doing a lot of research in this area and are trying to develop better treatments all the time. If you are interested, please call our office and I would be glad to do a no charge phone f/u with you today evening to try to help you any way I can.

Sijo J. Parekattil, M.D.
Medical Director, Avant Concierge Urology
15548 W. Colonial Drive, Winter Garden, FL 34787
407-547-1654 I 407.650.2724 fax I sijo@avantconciergeurol.com

What’s cost for botox

Please call us at our office for pricing: (407) 547-1654
Thank you