What to tell the family When you have PVPS
Luan
form a 5 month absense:
I have much work to do when I arrive home and I really did not get a
vacation here in Thailand as I was working full time. The rest of my time
was spent trying to find a cure to PVPS. I have become a sort of expert on
the dark side of vasectomy. If I had known even 1% of what I know now this
never would have happened. If men would talk a little more, or not lie
about the problems they have this would not have happened. I never would
have considered vasectomy had I known anything about the complications and
problems about 30% of men have. I asked a few close male friends but they
said nothing... until I reported back with my problems - then they say YES
they had some problems. I wonder how many people could have told me what I
needed to know? I used to read Dr. Tanaka's medical books in the 1980s
looking for any mention of complications from vasectomy but to the best of
my ability to understand medical terms I never found any mention of short
term or long term problems that would cause me to be concerned. My common
sense told me this business of tying off the vas tubes might cause
problems but I actually never heard of any problems and when I asked many
questions I was told this is not a problem. WELL, this is a PROBLEM about
30% of the time and this problem is a long term ailment 6% of the time -
and I am among that 6% and I surely wish some nice person would have
talked about this casually to me before last September. Why is this not
common knowledge? Why after 50 years of doing this to men are men still
stupid? Now I see medical people are beginning to print some true
information but it is too late for me. I wrote to Mayo Clinic and scolded
them for leaving out the truth about vasectomy complications and the next
month they changed their information on the site to read a more true
picture. I guess American medical people are getting ready for the law
suits that are surely coming.
There are very few doctors that treat this problem. It is called PVPS but
not well accepted as a medical condition as I think most doctors try to
deny it. One doctor who does treat this condition is in Atlanta - his name
is Witt I believe. I do not know who I will seek out for treatment but He
might be the one. If I can find someone closer to home that is best but I
am not too sure there are any. Maybe you know all about this and can help
me. What I believe I need is reversal surgery to give me the best chance
of recovery but I already had a reversal attempted here in Bangkok and it
failed. There are no doctors in Thailand treating this problem. And they
WILL NOT TREAT this problem. I was naive to imagine I could walk into a
private hospital and more or less demand vasectomy reversal. This is not
the case. I went to Mechai Viravaidya and he met with me personally and
his staff arranged for me to see another doctor (number 12) who they said
was very good. I allowed him to try reversal but he was not equipped well
enough or maybe he did not even have the needed skill to reverse me. (look
up Mechai Viravaidya on google) It is 8 months now and damage is being done
as time passes so I will not want to waste any time.
Basically if you are unaware... Vasectomy (closed ended type -
traditional) begins a time bomb ticking in the mans body. This is about a
30 to 40 year event. The man and doctor hope: 1) that the destruction that
is happening causes no pain 2) that the man will die of some unrelated
cause before this bomb explodes (before his testicles shut down
completely). The medical profession and business hopes: 3) Men will keep
their mouths shut if they are suffering so this business can go on as
usual. There is one variation to vasectomy that is an improvement and that
is the open ended vasectomy but it is uncommon so far. From what I have
learned my chances of a good recovery decline as time passes. Good results
come within the first year. I have no time to waste in this matter. Men who
wait too long often get temporary relief but later find they have damaged
the Epididymis too much and it will need removal which is a much more
serious operation than reversal.
I will not be talking of too much else until I find treatment for this
problem. It is because people don't talk that I got caught in this mess.
Just one casual mention of these problems would have saved me all this
misery. This is serious business and it will cost me over 10,000 dollars
that is in itself a huge waste not to mention the fact that my chance for
full recovery is not more than 80% and maybe as low as 40%. This little
"snip" as some call it, could easily shorten my life by many years. ( My
blood pressure remains 20 points higher than before vasectomy)
I will attach a medical study/review to help you understand what I am
talking about in case you really don't know any facts on this subject. Of
the 500,000 men each year in usa that have vasectomy 15 to 20,000 have
outcome like me. Why is this not known as common knowledge? All I want
is a pain free day… and painless orgasms at night. I will be happy to
began to rebuild my ruined “sensation abilities” the destruction of which
happened immediately after the vas was cut – and it is said “nothing
changes”. This business is a pack of total lies, promoted mostly by the
men who are the potential victims. So now you say this is
unbelievable…and it is. How can I explain it? Easy, men are all
different and they make love totally differently too. Some just have sex.
This closed ended vasectomy – one size fits all – is going to bring
outcomes that are all over the place. Men need to be evaluated and
screened before any surgery takes place. There is no system to do this as
it might suggest there are problems sometimes. Easier to just ignore the
problems and label those who complain as mentally unable to accept the
choice they made. After all we just complain about Pain – something hard
to prove. And we complain about our sex life – something that is a joke
to most of those who are not affected.
David
>I sent this letter to my 4 sisters one week before I plan to arrive home
> form a 5 month absense:
They are your flesh and blood - you could try talking to them. To be honest,
it does not sound like a family letter. It sounds rather more like a
newgroup post.
>
> If men would talk a little more, or not lie about the problems they have
> this would not have happened.
I find this offensive. One of your repeated, regular themes is to blame
other men for your current situation, claiming they lied to you, don't speak
up and so on. I most certainly would not lie to my fellow man, and nor would
others on this board. I'm sure we would all have the decency to honestly
answer any questions asked.
In a post on 8 april 05, "Update Re: How long should you wait to have a
reversal for pvp" you made the point that you have been having painful
ejaculations for 20+ years. I have asked you the question of if you told the
doctor beforehand of this condition, or if you have tried to get treatment
for it. You did not answer, so I'm assuming that you didn't tell the doctor
this whilst discussing vasectomy, and you therefore didn't discuss if the
vasectomy would make things worse or not.
You don't strike me as someone that has problems with using the internet. It
also strikes me that as well as visiting a couple of doctors pages on the
web, you could have found this, or one of the other forums that discuss
vasectomy for some independant views before you had the vasectomy. In
addition, there isn't a shortage of websites that offer independant
viewpoints on vasectomy. It's true that there may be a lot of rhetoric that
isn't possible to substantiate out there, but at the same time, by doing a
very simple search you do find enough information to firmly get the message
that a small percentage of men have problems.
> Why after 50 years of doing this to men are men still
> stupid? Now I see medical people are beginning to print some true
> information but it is too late for me.
Well, without any difficulty whatsoever I can point you to medical studies
into treatment methods for PVP that were published 20 years ago. It's not
true to say that people are "beginning" to publish information on pvp - it's
an ongoing process. It is true that the internet makes it rather more
accessible.
> I wrote to Mayo Clinic and scolded
> them for leaving out the truth about vasectomy complications and the next
> month they changed their information on the site to read a more true
> picture. I guess American medical people are getting ready for the law
> suits that are surely coming.
Maybe you can explain why vasectomy has so far uniquely been immune from
mass litigation, unlike other conditions?
> There are very few doctors that treat this problem. It is called PVPS but
> not well accepted as a medical condition as I think most doctors try to
> deny it.
The reason that there are so few doctors treating it is most likely due to
the rarity of the condition, as opposed to anything else. The condition *is*
accepted, but the deffinition is rather nebulous. Many men feel that the
discomfort they feel in the first few days is pvp. This is down to the
expectation they get from some doctors websites that it's totally painless,
and like dentistry you can go back to normal activities as soon as the
anesthetic wears off.
> Basically if you are unaware... Vasectomy (closed ended type -
> traditional) begins a time bomb ticking in the mans body. This is about a
> 30 to 40 year event. The man and doctor hope: 1) that the destruction that
> is happening causes no pain.
What "Destruction"?
> 2) that the man will die of some unrelated
> cause before this bomb explodes (before his testicles shut down
> completely).
What shuts down???
> The medical profession and business hopes: 3) Men will keep
> their mouths shut if they are suffering so this business can go on as
> usual.
If you seriously think that you can make a worldwide business that is
seriously flawed, and relies on all of the customers in every country not
complaining to continue then that is a barmy argument - sorry.
> There is one variation to vasectomy that is an improvement and that
> is the open ended vasectomy but it is uncommon so far.
Many people feel that it is overall an advantage, but the downside is that
sperm granuloma's occur much more often. I would agree that it should be
more widely available than it is - especially as it's statistically as
reliable as conventional vasectomy.
> From what I have
> learned my chances of a good recovery decline as time passes. Good results
> come within the first year. I have no time to waste in this matter. Men
> who
> wait too long often get temporary relief but later find they have damaged
> the Epididymis too much and it will need removal which is a much more
> serious operation than reversal.
If you have evidence to back up these statements, then I would be interested
in adding it to the website. Rushing into surgery prematurely is in general
a bad idea - especially as problems often resolve themselves given time. You
had your vasectomy last September if I recall correctly.
> This little
> "snip" as some call it, could easily shorten my life by many years. ( My
> blood pressure remains 20 points higher than before vasectomy)
I seriously doubt if the rise in blood pressure is due to anything other
than stress - you do sound to be understandably under stress at the moment.
> I will attach a medical study/review to help you understand what I am
> talking about in case you really don't know any facts on this subject.
Why would you attach medical studies to a letter to your sister?????
> Of
> the 500,000 men each year in usa that have vasectomy 15 to 20,000 have
> outcome like me.
Where do you get this statistic from?
The 500,000 is a guestimate done some years ago. The US has no mechanism to
collect sterilisation statistics. My personal opinion is that it's probably
an underestimate by some way. In other countries with similar lifestyles,
where there *is* a mechanism for colleting such statistics, the percentage
is 18% to 20+% of men having a vasectomy. The 500,000 figure represents a
much lower percentage. I am unaware of any statistics that claims 15,000 to
20,000 men in the US having problems - it sounds like guesswork to me. In
any case, if there were this number having problems, how/why are they all so
very, very eerily silent about it? It's true that there are a lot of men
that wouldn't come forward, but it's equally true that there are a lot that
would be very,very vocal on the issue.
> Why is this not known as common knowledge?
Why is *what* not common knowledge?
> This business is a pack of total lies, promoted mostly by the
> men who are the potential victims.
Again, the whole idea that men universally lie to their fellow man is
offensive and quite frankly preposterous.
> Men need to be evaluated and
> screened before any surgery takes place. There is no system to do this as
> it might suggest there are problems sometimes.
Well, that is partially down to us. We have a responsibility to mention
problems to doctors, as they aren't mind readers. I suspect that you didn't
inform him of your 20+ year history of painful ejaculations as you wanted a
vasectomy for whatever your reasons and motivations were at that time. Had
this point been mentioned, and the doctor said he couldn't guarantee it
wouldn't make things worse, would you have gone ahead anyway?
> Easier to just ignore the
> problems and label those who complain as mentally unable to accept the
> choice they made. After all we just complain about Pain – something hard
> to prove. And we complain about our sex life – something that is a joke
> to most of those who are not affected.
There *is* a phsycological aspect to vasectomy - take a look at some of the
older studies, and you will see that a link between sexual dysfunction and
non-acceptance of vasectomy was established many years back.
Luan, I'm sorry if this reply comes over as un-sympathetic. It isn't meant
to. I do understand that it's an immensley stressful time for you, and I do
understand your frustration with the lack of movement on the issue you are
having. I hope you are able to get a resolution to the pain soon.
--
David
www.vasectomy-information.com
www.vasectomy-faq.org
Giraud
> What I believe I need is reversal surgery to give me the best chance
> of recovery but I already had a reversal attempted here in Bangkok and it
> failed.
When did you have this reversal - a week or two ago? How can you
conclude that it failed at this early time, and what criteria are you
using to determine success or failure (i.e. sperm present or pain
relief)? I understand that a reversal is fairly invasive, and just the
recovery may take at least this long. Did the doctor explain the
reversal, what to expect, and how long recovery would take? Please
explain, as this doesn't quite make sense.
Giraud
Luan
honest,
it does not sound like a family letter. It sounds rather more like a
newgroup post.
thought came to me to post it here I was not thinking at all of this site
while I was writing
I find this offensive. One of your repeated, regular themes is to blame
other men for your current situation, claiming they lied to you,
experience and he did not mention the complications he had. I was looking
for a reason to dig deeper but he did not tell me. Then after the fact one
cousin revealed to me his problems post vas and I did not know he ever had
a vasectomy. I work with him many weeks every year and he never said a
word. that is why I am telling men to be open and honest or risk causing
problems like this.
As to my 20+ year history of Pain with ejaculation...that never occured to
me as I knew how to manage it and more or less forgot it. I did not put
together the connection with PVPS for months and until someone here
mentioned it. This is a common condition and any doctor doing vasectomy
NEEDS TO ASK ME!! It is not my business to study this operation and try
to educate the doctors. And any reason to suspect even the tinest risk
would have made me abort this decision.
Why would you attach medical studies to a letter to your sister?????
Because my sister is a nurse...another one is the wife of a doctor and
another one worked in hospitals all her life. The 4 th one is the
secretary to the district attourney for 30 years
What "Destruction"?
well we all know to have reversal for fertility it is best to do it sooner
than later. In the Journal of Andrology you can read some good description
of how the Epdidymis protects the testicle and sacrifices itself to the end
in this effort. That is the destruction I refer to.
Many people feel that it is overall an advantage, but the downside is
that
sperm granuloma's occur much more often.
I much prefer to have the problem of sperm granuloma rather than the
destruction of my epididymis. The problem of granuloma can be fixed and
the vas reconnected leaving a functional system later rather than a
destroyed or partially destroyed epididymis that may fail later and need
removal.
If you seriously think that you can make a worldwide business that is
seriously flawed, and relies on all of the customers in every country not
complaining to continue then that is a barmy argument - sorry.
The gambling/gaming industry does this with great success. Vasectomy is a
gamble isn't it?
Let me say, I am sure there many men who have pain like me and never say a
word. What is rare about PVPS is the man who speaks up concerning it.
There was a period of many weeks when I thought I would not talk about it
either. Then I decided THAT was the problem. You don't know how many men
are in the closet and neither do I. In Thailand there are NO PVPS
cases...Imagine that! I was the first and only one in a country of
millions. I visited 12 doctors and they never heard of PVPS. Can you
explain that????? They say there is nothing wrong with me. To any Thai
man PVPS is a JOKE unless he has it. If he has it he will NEVER admit
it!! NEVER!! NEVER! I know this.
Luan
at Rama 9 hospital. he has done 500 reversals according to his word and
7000 vasectomies. I arrived at 9 am. We talked for half an hour. I
changed into a hospital robe and they made the OR ready for me. At 10:30
the cutting began...he had 2 assistants. At 11:30 he was finished but he
said he did not find any opening on the testicular side. He showed me the
old vas ligation and what he cut out as damaged tissue. He said he
connected the vas to healthy tissue, but no fluid was present and he did
not find the lumen. So it is obvious that my blockage is at the opening
of the epididymis and he may as well have connected the vas to my
earlobe!! I was a little upset but he said he thought he might have cured
the problem if it was nerve pinching in the lower ligation. He was trying
to make me feel good enough to pay my bill. I was back in my office at 2
pm working as normal - very little pain, no medication. Next day still
very little discomfort. I woke up with erection as usual these days.
Next night - 39 hours after he began cutting I tried it out and gently
coaxed an ejaculation and it was the same as before. Since then I have
had 5 more all the same but more pain if the second one is close to the
previous one. I will go in to have stitches removed in 11 hours from now
and discuss the surgery with him in more detail and try to get my money
back. I am nearly back to normal now. He probably is a clever surgeon
as I would have more pain if he was a butcher! He didn't have tools
(operating Microscope) to connect vas to epididymis and I had asked for
that to be present in case it was necessary. He showed me how he does
normal reversals - he has his own method and it looked pretty clever, and
I have talked to other doctors who have different ways too not needing
microscope. Reversals start at 350 dollars here in Thailand. However,
they will NOT do reversal for pain problems, I had to get Mechai
Viravaidya to order this operation.
Giraud
is very cheap for a reversal (1/2 what my vasectomy cost). And I find
it hard to believe that non-microscopic techniques have much chance at
success. There are some very good diagrams on the Web that show why
microscopic methods are better (at least it looks convincing). As for
showing you "damaged" tissue, did you have cautery when you had your
vas? Does the burned end count as "damage?" Also, it took him only an
hour? I hope, for your sake, that this guy is not a con artist.
-Giraud
Giraud
non-microscopic techniques are not uncommon, even today. They take less
time and cost less, and they do have decent success rates (over 50%
pregnancy rate, as stated by one web site I saw).
David
> As to my 20+ year history of Pain with ejaculation...that never occured to
> me as I knew how to manage it and more or less forgot it. I did not put
> together the connection with PVPS for months and until someone here
> mentioned it. This is a common condition and any doctor doing vasectomy
> NEEDS TO ASK ME!! It is not my business to study this operation and try
> to educate the doctors. And any reason to suspect even the tinest risk
> would have made me abort this decision.
It's an elective procedure, so as well as the doctor having a responsibility
to discuss risks, it's also the patients responsibility to offer up
information from his medical history that may be relevant. The guy doing the
vas may not have your medical records, and certainly isn't a mind reader.
I know that counselling isn't good all the time - that is an acknowledged
problem, and down to the medical profession to resolve. The solution in the
UK I believe is pretty good. The new guidelines require that the patient is
given written information on the procedure, including risks. The information
comes in three varieties - leaflet, full text without the references, and
full tect with evidence tables and gradings. Either way, the patient will
have some written information to mull over.
> If you seriously think that you can make a worldwide business that is
> seriously flawed, and relies on all of the customers in every country not
> complaining to continue then that is a barmy argument - sorry.
> The gambling/gaming industry does this with great success. Vasectomy is a
> gamble isn't it?
There are risks attached, and these are statistically low. I don't know if
this is the same as gambling. I'd like to think people read all the info,
and did a risk assessment.
> Let me say, I am sure there many men who have pain like me and never say a
> word. What is rare about PVPS is the man who speaks up concerning it.
> There was a period of many weeks when I thought I would not talk about it
> either. Then I decided THAT was the problem. You don't know how many men
> are in the closet and neither do I.
We don't disagree that some men would never discuss problems. That is also
the same for many other diseases and conditions. However, assuming pvp is as
common as you think it is, I fail to see why there aren't significant
numbers of men that are being noisy about it - especially in a litigation
crazy place such as the US.
> In Thailand there are NO PVPS
> cases...Imagine that! I was the first and only one in a country of
> millions.
This point got me thinking, so I've done some research this afternoon. I
wondered what contribution Thailand had made to the stack of published
vasectomy studies. Actually, there are more Thai studies than you'd think
there were.
Many of the earlier studies really refer to how many vasectomies had been
done. Clearly the Thai government wanted large numbers of men sterilised
because of the population explosion, and Thailand adopted the procedure
earlier than many countries.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12265371
gives a bit of background history.
It was published in 1979, and correctly identifies that the detectable
levels of sperm antibodies is elevated in vasectomised men, so despite
vasectomy being government driven, scientists weren't afraid of publishing
studies that were true to science rather than government dogma.
It's interesting that the main target group seems to have been the rural
population. It's pretty horrifying that they seem to have let anybody have a
go at doing vasectomy!!! The following study says that "Of the 340
vasectomized men, 34% were operated on by MDs, while the rest were operated
on by Army Medics (37%), Village healers (18%), Nurses (4%), and Junior
Sanitarians (2%). " I'm suprised that the reported complication rate was
ONLY 15%!
Luan
non-microscopic techniques are not uncommon, even today. They take less
time and cost less, and they do have decent success rates (over 50%
pregnancy rate, as stated by one web site I saw).
I too was a litle surprised and actually didn't believe the $350 cost of
reversal here. I got this information from a nurse who works in the OR
and assists in doing these. Her husband is an ENT doctor and they have
helped me to see GOOD uroloigists here. Mechai Viravaidya told me the
absolute max my reversal would cost was $760 in the Rama 9 Hospital and
that was supposed to be with the use of a microscope. The Dr. I had told
me NO NEED to use a microscope for usual reversals and he can do it in 50
to 90 minutes with a local. I had him explain this to me in detail. I
will be seeing him in 2 hours for the follow up and I have many questions
about the outcome for me. I will try to get some of my money back due to
the failure. You might like to know, things are a lot better here in the
dental health care field as they do recognize TOOTH ACHE as opposed to
PVPS. You can get a root canal repaired for 60 to 90 dollars and that
means you can fly here from anywhere in the USA Get one tooth fixed and be
home with money left over ( you also do not need an appointment as it
usually is set up for the next day and they work on saturday and sunday
too). The quality of the dental work is excellent. And if I was without
complications and wanted a vasectomy reversed for fertility reasons there
is no doubt I would come here for that and save a bundle. Remember, a
fast proceedure means a faster recovery. Anytime you lay on the table
with a General for 3 or 4 hours you will need more recovery time. They
have some clever ways of reconnecting and it works. IF for fertility
usually the long term is not necessary so if their methods are not good
for many years maybe that is not an issue, I don't know the long term life
of these methods but what counts is to get a baby or 2 asap probably.
Baby can have a good start for college education with the money saved.
Luan
> showing you "damaged" tissue, did you have cautery when you had your
> vas? Does the burned end count as "damage?" Also, it took him only an
> hour? I hope, for your sake, that this guy is not a con artist.
As I said you can type in the name Mechai Viravaidya into google and read
a little on this man. He is the person who, with 3 other doctors in a
private personal meeting on 25 april, 2005 suggested I see Doctor Panit
Jivanantapravat for treatment. Unforutnately no doctors in Thailand have
experience treating PVPS as they have orders not to. My vas was tied off
with silk not burned... and this ligation is in my poesession. However,
the vas from the ligation to my epididymis was dead and outpouched and
destroyed by the pressure resulting from he closed ended proceedure. That
portion was shown to me and then sent to a lab for study. I have the
report on what they found under the microscope as well as a photo. Please
read some of the information on Mechai Viravaidya and report back to me as
to whether you think he is a CON ARTIST. I had to trust his suggestion to
see Dr. Panit but I believe he did not send me to someone who was a CON
ARTIST. My left side broke open before any damage/blockage to the
Epididymis occcured (64 days post vas) The right side did not break in
time as the epididymis is blocked now so nothing is coming out. Doctor
Panit attempted to connect the vas to the epididymis but this is hard to
do without the operating microscope I believe. We are now giving it a
chance to reconnect if that is possible by having me take testosterone and
prednisolone to relieve the pressure and swelling/inflamation for a while (
a decision we worked out together). I have little faith of things coming
around without more surgery so I will try to get an appointment with some
experienced doctors at the Mayo Clinic asap. So far the testosterone
therapy has not had time to give me relief.
My daughter worked at Mayo on Prostate cancer research. She tells me Men
are generally terrible about talking of problems they have with sexual
related organs. They often wait too long to get help to even save their
lives. She says this "unreported vasectomy nightmare" is believable from
her experience. I worked for a dear man in the 1960s from Milwaukee, WI
He got prostate cancer but until he could not Pee he did not seek any
medical help or talk of it. Four years after he finally gave in and saw a
doctor he died of bone cancer. It is easy to ignore the suffering men have
concerning vasectomy as very few will complain unless this is actually
TERRIBLE and it usualy isn't unbearable. Vasectomy complications seldom
or never get reported as the cause of death. I am sure many men suffering
as much or more than me have not complained or if they have gave up doing
so. I like sex. I like sex every day. I suffer most when I have
ejaculations and I suffer from the loss of my most effective form of
stress relief. Vasectomy complications of this type are unacceptable to
me.