A Personal Choice With Dr. Monteith Where Permanent

THE MAGAZINE Is Not Forever FOR HEALTHCARE PROFESSIONALS A Personal Choice with Dr. Monteith Specializing in Male and Female Reversal and No-Needle No-Scalpel Vasectomy

Women and men travel across the United Many within the medical community re- The new practice name is a reflection of States and around the world to A Personal call the practice when it was Chapel Hill the broader vision, says Dr. Monteith. “Our Choice of Raleigh, a unique practice dedi- Tubal Reversal Center, founded by Gary S. new name may not be understandable to cated to outpatient, minimally invasive Berger, M.D. Dr. Monteith joined Dr. Berger the general public but for those who seek sterilization and sterilization reversal ser- there in 2008, and together they provided our services the immense meaning of our vices in a state-of-the-art facility. a unique form of reversal name is readily apparent,” he says. that allows faster patient recovery, avoids The surgical specialty practice exclusively prolonged hospitalization and decreases A Personal Choice is conveniently located offers tubal ligation reversal, and vasec- patient recovery time. near North Hills Mall and Midtown Raleigh, tomy and vasectomy reversal. Tubal rever- so patients can stay in one of the nearby sal and vasectomy reversal have proven to After Dr. Berger retired in 2013, Dr. Monte- luxury hotels and walk to many restaurants be more effective and are more affordable ith expanded on his health care vision by and entertainment venues. The area also than alternative treatments, and vasectomy giving male patients greater reproductive provides closer access to Raleigh Durham is safer than tubal ligation. choice. In late 2013, he relocated the prac- Airport. tice to Raleigh, which includes a state-of- “I provide male and female patients un- the-art, in-office operating room equipped Experienced, Effective, biased care after they have made very with laminar airflow HVAC, central vacu- Affordable Surgical Services personal choices about how best to con- um and oxygen, modern anesthesia and The cornerstone of Dr. Monteith’s prac- trol their ,” says Charles W. Monte- patient-monitoring equipment. He also tice is offering female patients who desire ith, M.D., medical director of A Personal incorporated single-incision vasectomy re- more children after tubal sterilization an Choice. versal and vasectomy. affordable treatment alternative to in-vitro fertilization.

“Most of our patients have divorced, remar- ried and would like to have a child with their new partner. Unfortunately some have lost children to tragic events, while others simply have had a change of heart and want to reverse a decision they have grown to regret, because none of us can predict the future,” he says.

Since inception of Chapel Hill Tubal Re- versal Center, more than 12,000 correc- tive tubal surgeries have been performed. Since his first such procedure, Dr. Monte- ith has done 2,000 outpatient female ster- ilization reversal surgeries. His experience is critically important to those seeking a re- This in-office operating room is where sterilization reversal surgeries are performed. versal surgeon. It explains why more than

Reprinted from the November 2014 issue of The Triangle Physician Since 2008, Dr. Monteith, along with Dr. Berger, has performed more than 160 pro- cedures to remove these devices. In com- parison, “Most gynecologists have never removed one of these newer sterilization devices,” he says.

Dr. Monteith recently had a paper accepted for publication in Obstetrics and Gynecol- ogy, in which he describes the rates within a larger cohort of his patients who have undergone reversal. He expects the results of his research to be- come available before the end of 2014.

Patients also seek Dr. Monteith’s experi- Dr. Monteith (second from left) and his medical team perform a sterilization reversal. ence in removing Essure coil devices, after experiencing adverse symptoms. “In initial 95 percent of patients have traveled great tion of the has historically studies submitted to the FDA, less than 3 distances to the practice. been the most difficult tubal blockage to percent of women experienced pain of surgically correct. Pregnancy rates after varying degrees after Essure sterilization… Additionally, the outpatient tubal ligation Essure sterilization are age dependent but . With more women undergoing the proce- reversal services at A Personal Choice are are approximately 35-40 percent. dure, we are now seeing more Essure-relat- approximately half the cost and twice as ed complications and those seeking expe- successful as a single in vitro fertilization “I have been particularly proud of our rienced surgical removal for treatment of (IVF) treatment. Despite support for tubal efforts in reversing this newer form of fe- these complications,” he says. reversal by leading infertility professional male sterilization, because it provides our organizations, in vitro fertilization is widely patients with an alternative to IVF and Dr. Monteith removes Essure devices dur- viewed by many medical professionals as because most of the medical community ing an hour-long outpatient surgery with the only option for women with a tubal li- believes these newer procedures cannot minimal risk to the patient, including low gation. This misconception exists, because be reversed. We simply used an older, his- risk of device fracture, and without the hospital-based female sterilization reversal torical surgical procedure to correct the need for a . is unaffordable to most patients and, as a newest form of female sterilization,” Dr. result, younger doctors have not been ex- Monteith says. posed to female sterilization reversal, ac- cording to Dr. Monteith.

Experienced Essure Removal Specialists Dr. Monteith is the first surgeon in the world to report within peer-reviewed medical literature successful pregnancy and birth after reversal of two of the newest forms of female sterilization, Essure and Adiana.

Essure and Adiana sterilization were both approved by the United States Food and Drug Administration in 2001.These newer forms of female sterilization cause block- age of the fallopian tubes in the narrowest portion of the tube. Blockage in this por- Dr. Monteith (first row, center) is on a vasectomy mission in Kisumu, Kenya at Marie Stopes Health Clinic.

Reprinted from the November 2014 issue of The Triangle Physician from my female patients to provide vasec- tomy reversal. During a vasectomy surgi- cal mission, we discussed the concept of how the possibility of vasectomy reversal makes vasectomy more acceptable for some men. Soon after my return from this mission trip, one of my own vasectomy pa- tients inquired about having his vasectomy reversed. It was then that I decided in or- der to be a complete physician that I need to learn and offer vasectomy reversal.”

Above: Dr. Monteith (center, on floor) is with a vasectomy mission team in Cebu, Philippines. Right: Dr. Monteith comforts child while father has vasectomy.

Gentle Touch Vasectomy: Gentle Touch Vasec- The Science of No Scalpel, the Art of tomy, an open-ended Minimally Invasive Vasectomy vasectomy procedure Although Dr. Monteith is board certified in requiring neither a obstetrics and gynecology, he also offers needle for anesthesia male patients Gentle Touch Vasectomy, nor a scalpel to com- widely known as the most minimally inva- plete the procedure. sive form of vasectomy that requires nei- He is the only vasec- ther a needle for anesthesia nor a scalpel tomy provider offering men the choice of Today, after receiving one-on-one training for a skin opening. He has performed more having a single-visit vasectomy procedure with vasectomy-reversal colleagues, Dr. than 500 of these procedures in the U.S. and, if patients live long distances away, Monteith reverses vasectomies as an outpa- and internationally. the option of returning semen samples by tient procedure in his office operating suite, mail for after-vasectomy testing. while the patient is under general anesthe- “My background in women’s health is what sia, He keeps the procedure affordable, motivated me to provide vasectomy. It was An active supporter of No Scalpel Vasecto- which gives his female patients another suc- my personal experience that my female my International, Dr. Monteith has partici- cessful alternative to in vitro fertilization. patients were exposed to all of the risks of pated in vasectomy mission trips to Kenya pregnancy and most of the burden of hav- and the Philippines and is an active par- Learning More About This ing sterilization. Women often get tubal li- ticipant in online discussions with vasect- Unique Practice gations because of convenience of proxim- omists world-wide regarding all aspects of Dr. Monteith’s specialty practice is locat- ity to childbirth and barriers faced by men vasectomy. He also joins other vasectomy ed at 3613 Haworth Drive, Raleigh North who are not as integrated into the health providers every November on World Va- Carolina near North Hills Mall Midtown care system,” he says. sectomy Day to increase vasectomy aware- Raleigh just inside the I-440 beltline. For ness by offering free vasectomies to those those who would like more information “My goal in learning vasectomy was to who do not have adequate health care cov- about the services he provides, Dr. Mon- provide the best vasectomy procedure erage for the procedure. teith maintains two active websites with and experience possible while at the same extensive information for both patients time decreasing barriers most men are ex- Mini-incision Vasectomy Reversal and health care providers. Information posed to when considering vasectomy. Va- Dr. Monteith performed vasectomy for about A Personal Choice and its tubal liga- sectomy is a safer and better for men and years before he began offering microsurgi- tion and vasectomy reversal procedures is women.” cal skills to male patients seeking reversal online at www.tubal-reversal.net. Infor- of vasectomy. mation about A Personal Choice and Dr. Monteith is now one of the few pro- minimally invasive vasectomy is online at viders in the Carolinas offering affordable “Over the years, I heard constant requests www.bestvasectomy.com.

Reprinted from the November 2014 issue of The Triangle Physician