slight pain after 16 weeks
mojo risen
it, especially after my volume of ejaculate has seemed to return to
normal. For the first 3 months, it seemed to be reduced by 25-35%.
That started playing games with my head but all seems normal in that
area.
I am still having a bit of trouble on the right side with a slight
amount of dull, aching pain (discomfort). The Urlogists had a bit of
trouble with this side during the procedure. I have asked
him,twice,about this pain. He said that 2% of all patients experice
pain that is perpetual. He also said that he is not alarmed, at this
point, because it is still a relatively short time after the surgery.
He expects this discomfort to eventually go away.
Anyone out there with similar experience?
Paul E Garcia
My (second) Uro has advised that a successful Vasectomy outcome depends on the
testes slowing/stopping sperm production in response to the tubes being sealed.
If not, then problems.
My uro also advises that these things take time to clear up, and additional
surgery (like reversal) is reserved for the most severe cases of PVP (but are
unfortunately required sometimes). I figure I'll take over a year's total time
to heal completely.
recentlyfixed
I also continue to have a variety of nagging aches and pains six
months after my vasectomy. I've been reading these threads, and
occasionally posting, for about five months. I'm still amazed by the
numerous remarks about ongoing pain and aches posted in many of the
threads, and responses reportedly from the poster's doctor/urologist.
Many of these are even from regular posters who appear to be quite
happy with their vasectomy experience.
Recent posts include mojo risen and Paul Garcia (above in this
thread), miguel B (mild achey feeling before and during orgasm),
rbungay (pain returned 5 weeks after his NSV due to playing 2 games of
hockey), Trifold (occasional "sex hangover" during 1st year after
vas), Greenfeather (exercise makes sore 9 months post vas), Mike C
(abdominal pain after exercise), my case (swelling after running), and
others I've not mentioned. And yes, I also know that people with good
outcomes generally don't return here and comment on their experience.
These all deal with issues past the first week or two post-vas, which
is what most of us are told will be the recovery period. It seems
that only when problems arise we start hearing doctor/urologist
comments like "2% of all patients experience pain that is perpetual",
"he expects this discomfort to eventually go away", "these things take
time to clear up", "additional surgery (like reversal) is reserved for
the most severe cases of PVP (but are unfortunately required
sometimes", and the proverbial "it's all in your head".
Why aren't the doctor's disclosing a little more of this information
upfront? Why doesn't someone, or some group, do some current research
on vasectomies, pvp and pvp treatment, pre-vas disclosure, post-vas
recovery (short and long term), etc. It's apparent from a lot of
posts that doctors should at least be informing everyone of the pvp
possibility, potential exercise related problems, ways to follow up,
etc.
David
> I also continue to have a variety of nagging aches and pains six
> months after my vasectomy. I've been reading these threads, and
> occasionally posting, for about five months. I'm still amazed by the
> numerous remarks about ongoing pain and aches posted in many of the
> threads, and responses reportedly from the poster's doctor/urologist.
> Many of these are even from regular posters who appear to be quite
> happy with their vasectomy experience.
> Recent posts include mojo risen and Paul Garcia (above in this
> thread), miguel B (mild achey feeling before and during orgasm),
> rbungay (pain returned 5 weeks after his NSV due to playing 2 games of
> hockey), Trifold (occasional "sex hangover" during 1st year after
> vas), Greenfeather (exercise makes sore 9 months post vas), Mike C
> (abdominal pain after exercise), my case (swelling after running), and
> others I've not mentioned. And yes, I also know that people with good
> outcomes generally don't return here and comment on their experience.
You are to be congratulated on your well researched posting! Regarding the
"symptoms" mentioned, I would question if the posters concerned all actually
state, or believe the vasectomy to be the cause of the symptoms. I'd also
question if the posts in this forum are in any way representative of the
majority of men's experience - something you yourself touch on above.
>
> Why aren't the doctor's disclosing a little more of this information
> upfront?
To be fair, some doctors do inform you that there is the risk of PVP without
prompting. Also, from the threads here most doctors (when asked) will
discuss the issue in consultation. However, it is clear that counselling is
inconsistent, the pvp issue isn't universally discussed and the guidelines
doctors operate under don't (currently) seem to be standardised.
> Why doesn't someone, or some group, do some current research
> on vasectomies, pvp and pvp treatment, pre-vas disclosure, post-vas
> recovery (short and long term), etc. It's apparent from a lot of
> posts that doctors should at least be informing everyone of the pvp
> possibility, potential exercise related problems, ways to follow up,
> etc.
The concensus of opinions in previous threads over the years here is in
agreement on this issue - probably the *only* thing the diverse factions
ever could agree on! Many of the medical studies make the point that
counselling is "variable" to say the least, and better pre-vas counselling
leads to better informed, and happier patients.
What we all eventually agreed on was that doctors should be given guidelines
to follow for counselling. The doctor should hand out written information
that discusses known risks (including pvp), and the booklet should include
the evidence upon which claims are made. We also managed to agree that it
should also discuss associations that had been investigated where no causal
link had been found,
again with the evidence to back any statements.
So, is this actually happening anywhere on the planet? Yes. In the UK to
start with. The following is from the current discussion guidelines due for
implementation shortly. The full document can be read at
www.vasectomy-information.com/pages/rcogdraft.pdf It's a 1.5Mb download.
One point often made by the men who have a negative exerience of vasectomy
is they feel that the only thing that would make more information and better
discussion forthcoming is legal action. In the above document para 3 of the
introduction says:-
"Sterilisation procedures, both male and female, are a frequent subject of
litigation. (4-6) The Family Planning Association (FPA) contraceptive
education helpline receives many calls suggesting that practice surrounding
sterilisation provision is less than perfect. It is partly for these reasons
that a national guideline was thought necessary."
This is far from the commonly held viewpoint in this forum that litigation
*needs* to happen - clearly it already has (or at least the fear of it).
Bearing in mind that the UK is not a highly litiginous society the above is
pretty strong stuff.
The document makes clear that to avoid potential litigation, doctors need to
follow the guidelines. The guidelines include giving the patient written
information during the consultation on the procedure, the risks and the
evidence behind statements. It has to be made available in the patients
primary language, and Braille and audio formats. I put my oar in during the
consultation phase to point out that the patient should be given the
vasectomy section of the document in it's entirety - not just a potted
version.
What does it say regarding pain specifically?
"7.9.6 Chronic Pain
7.9.6.1 Recommendation
Men should be informed about the possibility of chronic testicular pain
after vasectomy. (11)
Chronic pain, which can be described as testicular or scrotal and may
develop months or years after the vasectomy, is an important complication of
a procedure which is done for essentially social rather than medical
reasons. The incidence of chronic postvasectomy pain ranges from 12 percent
to 52 percent, depending on the study population. This is likely to
represent an overestimate, as most of the studies involved questionnaire
surveys and men with complications may be more likely to respond. The
proportion of men who sought help or whose quality of life was adversely
affected was between 0.9 and 5.2 percent. (98-101,103, Morris 2002)
The only study that tried to assess testicular pain in a control group of
men without vasectomy found a prevalence of pain of any type to be present
in 26 percent. However, vasectomy was associated with a doubling of the rate
of occasional testicular pain (47 percent vs 23 percent 95 percent CI for a
difference 10 percent-35 percent). Severe testicular pain was only reported
in 6 percent of cases and 2 percent of controls. None of the vasectomised
men expressed regret. (Morris 2002)
Epididymectomy, vasovasostomy and denervation of the spermatic cord have
been described in case series as effective treatments for this condition
(103-105, West 2000, Nangia 2000) but no RCTs were found. Two RCTs have
shown that the injection of a local anaesthetic into the vas at the time of
vasectomy may prevent chronic pain; further studies with longer follow up
are warranted. (106, McConaghy1998)".
In the tables at the bottom, they summarise key methodology and findings
points, along with an "Evidence level" grading.
Of the incidence studies (98-101, 103, Morris) we are looking at:-
98 - sample size 42 men
99 - sample size 253, reponse rate 68%
100 - sample size 6,428 but no reporting of pain other than spermatic
granuloma
101 - sample size 470, response rate 42.3%
103 - sample size 56, response rate 70% mean time since vas 19 months
Morris - sample size 198, 102 controls.
Sadly, these documents represent the majority of recent research into the
incidence of PVP, and as seen not all the documents actually look at pvp.
The guidelines text does point out that in these questionairre based
studies, men with problems are more likely to respond causing a level of
innacuracy.
IMHO, what *would* help is a standardised auditing procedure as under
discussion by the BAN-SV group in the UK. Where doctors publish their
practice complication rates, the statistics are considerably lower than the
possibly misleading figures from the questionairre based studies listed
above.
Is the same setup likely to happen in the US? Hopefully. There is a recent
document on Medline (no abstract) that appears to be produced by the US
equivalent of the RCOG who produced the UK guidelines.
Change doesn't happen overnight, but it does seem to be moving in the right
direction. What we can do, is continue with the high level of quality
discussion we have here currently.
David
www.vasectomy-information.com
Steve Law
I have posted here in the past on Vasectomy problems that the medical
establishment does not tell men. The 2% figure is just that a figure.
There are no real studies that shown that it is that low.
The earlier comment about a urologists saying it takes the stopping of
sperm production to reduce the pain makes sense. The continual back
pressure and leaking of the sperm into the scrotum are a source of
pain. Bad news, the feedback method to stop the production of sperm is
the lowering of Testosterone.
My reversal cleared up the PVP and increased my testosterone levels.
Vasectomy is not an option for the un-informed, which currently is
everybody due to the lack of informed consent on PVP, Testosterone
loss, and increased rate of prostate cancer.
Go back using Google Groups and read the point - counter-point
discussions involving Steve L.
Steve L
HankC
<david.b...@ntlworld.com> wrote:
>>
>> Why aren't the doctor's disclosing a little more of this information
>> upfront?
>
>To be fair, some doctors do inform you that there is the risk of PVP without
>prompting. Also, from the threads here most doctors (when asked) will
>discuss the issue in consultation. However, it is clear that counselling is
>inconsistent, the pvp issue isn't universally discussed and the guidelines
>doctors operate under don't (currently) seem to be standardised.
>
My doc mentioned PVP and even told me as a matter of fact that I could
expect some minor (occasional) aches for ever. I'm happy to report,
though, that at 3 months post even the occasional aches seem to have
disappeared (including the 'sex hangover' thing that I also
experienced up to a couple of weeks ago). My 9 month old even kicked
me in the nuts today and I didn't experience anything out of the
ordinary for such a blow.
IMO, I'd rather have self-informed patients candidly interviewing
their doctors than having doctors read some canned statement about
procedure risks. V-I.com provided me with with a lot of knowledge and
allowed me to 'grill' my doc at the interview. I was satisfied with
his answers and elected to have him do the procedure.
I think taking responsibilty from patients (or consumers, parents, or
whatever for that matter) just lulls everyone into a false sense of
security and causes problems. The internet makes it damn easy to
become informed nowadays. If you're going to let someone cut your
balls, you're going to buy home networking gear, or you're going to
let your state force compulsory pre-school on your kids you damn well
should do your homework before the event.
David
> expect some minor (occasional) aches for ever. I'm happy to report,
> though, that at 3 months post even the occasional aches seem to have
> disappeared (including the 'sex hangover' thing that I also
> experienced up to a couple of weeks ago). My 9 month old even kicked
> me in the nuts today and I didn't experience anything out of the
> ordinary for such a blow.
That's good to hear.
>
> IMO, I'd rather have self-informed patients candidly interviewing
> their doctors than having doctors read some canned statement about
> procedure risks. V-I.com provided me with with a lot of knowledge and
> allowed me to 'grill' my doc at the interview. I was satisfied with
> his answers and elected to have him do the procedure.
>
> I think taking responsibilty from patients (or consumers, parents, or
> whatever for that matter) just lulls everyone into a false sense of
> security and causes problems. The internet makes it damn easy to
> become informed nowadays. If you're going to let someone cut your
> balls, you're going to buy home networking gear, or you're going to
> let your state force compulsory pre-school on your kids you damn well
> should do your homework before the event.
I couldn't agree with you more. I strongly believe that men considering
should be doing their own research and as you say "Interviewing" their
doctor. In fact, there are a couple of doctors sites that say this is the
approach you should take.
The UK guidelines I strongly support because I don't think that the patient
who has done their own research is the norm. Yes it *is* easy to do - I
agree. I believe that the majority of men make decisions primarily based
upon the information given to them by doctors and how their friends/family
fared with having it done. Therefore a lot of the information that is
available from this group and other internet sources isn't seen.
I don't think the effect of the guidelines will be to take responsibility
away from those who do their own research. This will always continue, and I
personally believe will grow. In fact, given the written information from
the doctor that would be the starting point of additional research for me. I
view the guidelines as a positive step to ensure those who don't do their
own research for one reason or other are better informed that they currently
are.
Asking your doctor how many he does per month, how long he's been doing them
and what is personal complication rate is are perfectly legitimate questions
to ask him, and ones he should be prepared to answer. Also, asking how he
would treat complications (should they arise) is equally legitimate.
David
www.vasectomy-information.com
Paul E Garcia
>sperm production to reduce the pain makes sense. The continual back
>pressure and leaking of the sperm into the scrotum are a source of
>pain. Bad news, the feedback method to stop the production of sperm is
>the lowering of Testosterone.
I had posted information regarding vasectomy and sperm production noted above,
although I don't know if its my posting that Steve L is specifically referring
to.
My Uro did indicate that the point of a Vasectomy is to slow/stop sperm
production. But, if we take Steve L's comment above (suggesting a normal
physiological process rather than personal experience) at face value, it would
indicate that all men with a conventional V are destined to suffer from low
Testosterone levels and the attendent physical symptoms. If this is the case,
we would have heard about it somewhere. However, most materials state that
this doesn't happen. My pain is just about gone (implying that the slowdown
has happened) but I feel as good and energetic physically as ever (and that's
with the strain of a second child to care for as well as relationship issues).
I'm going to have my HMO reissue the second opinion referral I requested
earlier, since I still have the lump and want to have it evaluated (given my
family's history of cancer). Maybe I'll bring this up and confuse the
situation even more :-).
ROB
My pain is minimal at best and doesn't cause any undo concern on my
part. You have to realise that I've fallen 100 feet from a helicopter,
made 75 combat jumps, been shot 3 times and had 7 knee surgerys. To
say that occasional aches and pains are a part of my life would be an
understatement.
My wifes health comes first and foremost in my life. If I have to
deal with an occasional ache then so be it. 1 year ago this month she
was a mess from hormonal birth control, now she's back to the woman I
met some 20 years ago and I wouldn't go back for all the tea in China.
A surgery carries with it the possibility of aches for the rest of
your life. I researched it and knew that going in. Steve's posts made
me research and ask questions. This is the information age and if you
don't do your homework you have no one to blame but yourself for not
making an informed decision.
It took me about 6 months to arrive at my decision to get a
vasectomy. In 3 weekends I read about 80% of the posts on this news
group.I had seen about 100 different sites about vasectomy and most
say there is that risk. I also looked at sites involved with tubal
ligation and decided that wasn't an option for my wife and it was my
turn to step up and take care of the birth control.
All good medicine,
GREENFEATHER
ryeish
wrote:
>paule...@cs.com (Paul E Garcia) wrote in message news:<20040102063430...@mb-m15.news.cs.com>...
>> Me too.
>>
>> My (second) Uro has advised that a successful Vasectomy outcome depends on the
>> testes slowing/stopping sperm production in response to the tubes being sealed.
>> If not, then problems.
>>
>> My uro also advises that these things take time to clear up, and additional
>> surgery (like reversal) is reserved for the most severe cases of PVP (but are
>> unfortunately required sometimes). I figure I'll take over a year's total time
>> to heal completely.
>
>I also continue to have a variety of nagging aches and pains six
>months after my vasectomy. I've been reading these threads, and
>occasionally posting, for about five months. I'm still amazed by the
>numerous remarks about ongoing pain and aches posted in many of the
>threads, and responses reportedly from the poster's doctor/urologist.
>Many of these are even from regular posters who appear to be quite
>happy with their vasectomy experience.
Given the limited pool of people here to poll from the % who do have
no pain could be right. 4 of the guys why wife works with had no pain
at all from it and were mended a couple of days post vas.
I feel a little something now and then, usually after an orgasm. It's
a dull ache that I don't notice it unless I focus...it's there,
nothing that I can't live without though. Yesterday I was outside all
day and never felt any soreness despite being active all day.
My urologist said that some folks had post surgery issues - soreness,
etc that sometimes was changed if the vas was undone. He said he'd
undone a few over the years. He said he had his done in house and that
once in a while his testacles were a tad sore after orgasm...more of a
dull ache like being a little hungry than actual pain - and something
an advil or something would take away.
After seeing my wife in the hospital with pre eclampsia, her blood
pressure really high and her so loaded up on meds she had no clue
where she was at getting the vas made sense. Even with the occaisonal
ache.
I do wonder if that ache isn't mentally triggered...your boys are
saying "hey, don't need us anymore?"
trifold
> The earlier comment about a urologists saying it takes the stopping of
> sperm production to reduce the pain makes sense.
First, there does not seem to be consensus among urologists that
vasectomy reduces sperm production. I have read many medical accounts
that state sperm production is not reduced.
>The continual back
> pressure and leaking of the sperm into the scrotum are a source of
> pain.
Only if sperm is not broken down and absorbed at a rate that prevents
backpressure pain. The rate required to prevent pain would depend on
many factors, including how far from the testicles the vas ends were
sealed. If the vas tube is sealed too close to the testicle, then
backpressure is more likely.
>Bad news, the feedback method to stop the production of sperm is
> the lowering of Testosterone.
Evidence? Fact is, testosterone is sometimes administered to REDUCE
sperm production in men who experience backpressure problems.
>
> My reversal cleared up the PVP and increased my testosterone levels.
You don't know that.
>
> Vasectomy is not an option for the un-informed, which currently is
> everybody due to the lack of informed consent on PVP, Testosterone
> loss, and increased rate of prostate cancer.
Despite research, there is no evidence vasectomy causes reductions in
testosterone. Research has also clearly shown vasectomy does not
cause prostate cancer.
On the other hand, in my opinion, the incidence of chronic scrotal
pain after vasectomy does need to be researched more fully to
determine which procedures are more likely to produce it and what
mechanisms are involved (as well as how best to treat it). Any such
research, of course, would have to begin by defining "chronic" and
"pain," distinguishing between men who experience mild soreness for a
few months (like I had) and those who face the kind of pain they feel
they need help with.
trifold
Thanks for this report. The issue of sperm production after vasectomy
is interesting. I have read some acconts that sperm production
naturally decreases after vasectomy, others that insist there is no
change. Did your urologist explain the mechanism that causes the
reduced sperm production he describes?
trifold
http://www.vasectomy-information.com
paule...@cs.com (Paul E Garcia) wrote in message news:<20040102063430...@mb-m15.news.cs.com>...
David
> After seeing my wife in the hospital with pre eclampsia, her blood
> pressure really high and her so loaded up on meds she had no clue
> where she was at getting the vas made sense. Even with the occaisonal
> ache.
Same experience here. My wife had pre-eclampsia and was hospitalised a
couple of weeks before the birth of our first, and ended with a 2 months
premature baby. The second pregnancy didn't go exactly according to plan
either. I know this sounds selfish, but *I* didn't want to go through that
again - hence my wanting to have a vasectomy after child #2 was born.
>
> I do wonder if that ache isn't mentally triggered...your boys are
> saying "hey, don't need us anymore?"
I don't think you are the only one to have this thought, and many would
agree that there is something in this.
David
www.vasectomy-information.com