Message fo Fletcher
john
earlier.
Your situation apears very similar to mine about 18 months ago.
Ignore the people who say it's all in your head, unless they have
experienced it themselves, they cannot know how devistating it feels.
I think it pays to be rational about it and consider the following;
1/ The loss of intensity on ejaculation is probably caused by
permanant or temporary damage to nerves and disruption of peristulsis
type contractions.
2/ Any kind of surgery is quite crude and unlikely to restore such
damage.
3/ The build up of sperm pressure in the upper reaches of the vas
makes things more easily exited. Sperm are pushed up during arousal,
therefore the more times arousal happens without ejaculation, the
stronger the effect(when wanted and sometimes when not!). Vasectomy
cancells this effect, but not the rest of what would be called sex
drive this early on.
4/ I believe that part of the ejaculation pleasure is relief of the
pressure in the system lower down.
After about 3 months I started having some problems with
backpressure pain as well, so I had more things to consider as well,
and ended up paying for an open-ended conversion.
My arguement against reversal, in my case, was as follows.
After a reversal, there could be scar tissue still blocking the
vas, or the contractions might not be able to jump the join, either
way the vas would still be effectively blocked. There are therefore 4
possible outcomes from a reversal;
a/ Both L + R still blocked
b/ L blocked, R free
c/ L free, R blocked
d/ Both free
Outcomes b,c or d would be considered a successful reversal on
fertility grounds, if the chances of this are around 70%, then the
chances of d on its own could be only 25%. In which case an open ended
conversion is a safer bet for the cure of backpressure.
It is now about 12 months since my conversion and still no
significant pain or discomfort has returned. The feeling of relief on
ejaculation was restored immediately. Pleasure on ejaculation varies
around 40-70% of what it was pre-vasectomy, compared with 0-40% when
it was close-ended.
The loss of pleasure is quite rare, but I have found a few people
affected similarily, One I spoke to had his vasectomy about 20 years
ago , and the feelings never really returned. Another had a reversal
(for fertility reasons) but strength/depth of ejaculation still wasn't
restored 100%.
To sum up, if you not happy with things the way they are, then go
for a reversal or conversion as soon as possible, but don't expect a
miracle cure, What cannot be changed is not worth getting depressed
about, but with the right building blocks in place, time is a great
healer.
John
David
> After a reversal, there could be scar tissue still blocking the
> vas, or the contractions might not be able to jump the join, either
> way the vas would still be effectively blocked. There are therefore 4
> possible outcomes from a reversal;
> a/ Both L + R still blocked
> b/ L blocked, R free
> c/ L free, R blocked
> d/ Both free
>
> Outcomes b,c or d would be considered a successful reversal on
> fertility grounds, if the chances of this are around 70%, then the
> chances of d on its own could be only 25%. In which case an open ended
> conversion is a safer bet for the cure of backpressure.
I sort of follow your logic here in that if restoration of fertility only
has to be one tube sucessfully re-attached, therefore if fertility is
restored in 70% of cases (for the sake of argument) you put the chances of
both tubes being re-attached at rather less. The 25% figure is your guess.
However, the good news is that the chances of vasectomy reversal relieving
PVP are as good as (or better) than the chances of restoring fertility. For
example
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11061886&dopt=Abstract
puts it at 69% becoming completely pain free, and
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8996346&dopt=Abstract
comes up with 27 out of 32 cases (84%) having relief of pain.
> It is now about 12 months since my conversion and still no
> significant pain or discomfort has returned. The feeling of relief on
> ejaculation was restored immediately. Pleasure on ejaculation varies
> around 40-70% of what it was pre-vasectomy, compared with 0-40% when
> it was close-ended.
I'm glad you had success from the conversion, and I'm sure your experience
here would be of use to others. I haven't seen any figures as to how
sucessful O/E conversion is at resolving PVP. I did have a brief look for
some statistics just now, but can't (unfortunately) find any.
David
www.vasectomy-information.com
trifold
Hello John,
I'm glad conversion to open ended worked to eliminate your pvp. As
for what you say about a mechanism that could result in vasectomy
reducing ejaculation pleasure, I don't follow you entirely:
<41c6a9f0.03092...@posting.google.com>...
> 1/ The loss of intensity on ejaculation is probably caused by
> permanant or temporary damage to nerves and disruption of peristulsis
> type contractions.
Nerve damage I could see as having this effect, although I think the
nerves involved in orgasm are not located in the scrotum. In any case
I'm not sure how a reduction in peristalsis, which occurs
continuously rather than during ejaculation, could result in reduced
pleasure at ejaculation. (And I'm not sure peristalisis declines
after vasectomy anyway.)
> 3/ The build up of sperm pressure in the upper reaches of the vas
> makes things more easily exited. Sperm are pushed up during arousal,
> therefore the more times arousal happens without ejaculation, the
> stronger the effect(when wanted and sometimes when not!). Vasectomy
> cancells this effect, but not the rest of what would be called sex
> drive this early on.
I cannot see how build up in the upper reaches of the vas deferentia
(known as the ampullae) could be importantly affected by vasectomy
because the ampullae fill with other fluids during excitation in
addition to sperm, and these other fluids are much greater in volume
than the sperm that gathers there. So any feeling of "fullness" due
to pressure in the ampullae would continue even after vasectomy.
Giraud
> I cannot see how build up in the upper reaches of the vas deferentia
> (known as the ampullae) could be importantly affected by vasectomy
> because the ampullae fill with other fluids during excitation in
> addition to sperm, and these other fluids are much greater in volume
> than the sperm that gathers there. So any feeling of "fullness" due
> to pressure in the ampullae would continue even after vasectomy.
Really? I did not know that the ampullae could "back fill," although
it sounds possible. I thought this might be in the department of the
"not well known" (i.e. this and the peristalsis and whether it occurs more
or less continuously or more during arousal and/or ejaculation)? I still
would like to know more details about all of this, if they are even known.
I can believe that there are no good studies of this. It might be hard
to measure things medically that happen at ejaculation (I picture a guy
connected to a machine and forcing arousal and climax...!).
Giraud
trifold
>
> Really? I did not know that the ampullae could "back fill," although
> it sounds possible. I thought this might be in the department of the
> "not well known" (i.e. this and the peristalsis and whether it occurs more
> or less continuously or more during arousal and/or ejaculation)? I still
> would like to know more details about all of this, if they are even known.
> I can believe that there are no good studies of this. It might be hard
> to measure things medically that happen at ejaculation (I picture a guy
> connected to a machine and forcing arousal and climax...!).
It would be an odd way to spend the afternoon, for sure (but not that
bad either, even if they didn't pay me)!
I agree the information available on exactly what happens during
arousal and ejaculation is a little unclear--even contradictory. But
what I've seen makes it hard for me to go along with what I think is
John's suggestions: 1) horniness in men is caused in part by an
accumulation of sperm in the ampullae (two bulges at the nether ends
of the vas tubes); 2) an important part of the pleaure of ejaculation
derives from emptying theses bulges; 3) vasectomy, which interrupts
the movement of sperm along the vas tubes and into the ampullae,
therefore reduces the feeling of horniness and the sensation of
ejaculation.
My problem with John's conslusions is that, as I understand the
mechanics (and "machinery") of excitation and ejaculation, the
ampullae (where sperm gather in a non vasecomtized man) are closely
connected to the seminal vesicles, and these, together with the
prostate, produce much more of what what non-vasecomised men ejaculate
than sperm (see the extract from a medical journal below). In the
milliseconeds before ejaculation, the seminal vesicles secrete various
juices that mix with sperm from the ampullae, and that are then moved
into a bulb close to the urethra. Then prostatic contractions push
prostatic fluids into the same bulb. Then the bulb contracts--and the
usual mess results (together with major muscle spasms throughout the
body). (I rely for most of this description of what happens right
before and during ejac. on a website I just located:
http://www.sex-project.com/manphase.shtml)
I conclude from this that if the feeling of horniness derives from any
"backup" of fluids at all, it derives from the back up of juices from
the seminal vesicles and prostate, not from the backup of sperm in the
ampullae. And I conlude as well, that pleasure at ejaculation, to the
extent it derives from the release of this backup (rather than muscles
spasms etc), derives from the movement of these fluids (from prostate
and seminal vesicles), not from the movment of sperm.
As for the peristalis that in a non-vasectomised guy moves sperm up
the tubes into the ampullae, what I have read is contradictory re:
whether it happens all the time or just during excitation; nor where
it happens (that is, all along the vas tubes, or primarily further up
the line, that is the other end of the vas seals); nor that it stops
altogether after vasectomy.
I do know that I did not experience any decline in pleasure after my
vasectomy--and that other men I know say the same thing. Taken all
this together, I have to conclude that the post-vasectomy decline in
pleasure John reports is not a normal consequence of vasectomy, but
either a consequence of something peculiar to his vasectomy (perhaps
the same thing that resulted in his pvp); or that it is not related to
his vasectomy at all.
My hope is that he will regain full pleasure after some passage of
time. Perhaps what he feels now (or isn't feeling) is just a
consequence of recovery from the conversion to open ended.
trifold
http://www.vasectomy-information.com
****
Walsh: Campbell's Urology, 7th ed., Copyright © 1998 W. B. Saunders
Company
Physical Characteristics
Freshly ejaculated semen is a coagulum that liquefies over a 5- to
25-minute period. The
seminal vesicles secrete the substance responsible for coagulation.
Patients with congenital
bilateral absence of the vas usually have absent or hypoplastic
seminal
vesicles. Semen in
these patients does not coagulate and has a low volume. Secretions
from
the testis,
epididymis, bulbourethral glans (Cowper's glands), glands of Littre
(periurethral glans),
prostate, and seminal vesicles compose the normal seminal fluid. The
fluid is released from the
glands in a specific sequence during ejaculation. Prior to the
ejaculation of the major portion of
the ejaculate, a small amount of fluid from the glands of Littre and
the
bulbourethral glands is
secreted. This is followed by a low-viscosity opalescent fluid from
the
prostate containing a
few sperm. The principal portion of the ejaculate contains the highest
concentration of sperm,
along with secretions from the testis, epididymis, and vas deferens,
as
well as some prostatic
and seminal vesicle fluids. The last fraction of the ejaculate
consists
of seminal vesicle
secretions. The secretions from Cowper's glands account for 0.1 to 0.2
ml, prostatic
secretions account for 0.5 ml, and the secretions from the seminal
vesicles account for 1.5
to 2.0 ml. The majority of ejaculated sperm come from the distal
epididymis, with a small
contribution from the ampulla of the vas. The unobstructed seminal
vesicle is not a
reservoir for sperm.
john
> > >
>> I agree the information available on exactly what happens during
> arousal and ejaculation is a little unclear--even contradictory. But
> what I've seen makes it hard for me to go along with what I think is
> John's suggestions: 1) horniness in men is caused in part by an
> accumulation of sperm in the ampullae (two bulges at the nether ends
> of the vas tubes); 2) an important part of the pleaure of ejaculation
> derives from emptying theses bulges; 3) vasectomy, which interrupts
> the movement of sperm along the vas tubes and into the ampullae,
> therefore reduces the feeling of horniness and the sensation of
> ejaculation.
>
sperm up
> the tubes into the ampullae, what I have read is contradictory re:
> whether it happens all the time or just during excitation; nor where
> it happens (that is, all along the vas tubes, or primarily further up
> the line, that is the other end of the vas seals); nor that it stops
> altogether after vasectomy.
>
on the rest. I'm not suggesting this at all, what I'm suggesting is
that on ejaculation the release of pressure at the ampullae
hydraulically relieves the pressure lower down. This relief of
pressure, in my opinion contributes to the feeling of
satisfaction/relief after ejaculation which, in my, case was certainly
missing until my conversion. As for specific pleasure at ejaculation I
believe that most of the problems I and others have experienced are
related to unintentional 'third party' damage to nerves during the op.
The effect on myself immediately followed the op., at which time there
would still have been plenty of fluid in the vas to fill the ampullae.
On the issue of when peristalsis occurs, I am in no doubt. The
pain that I had during sex was caused by pressure on the nerve tissue
caught up in the tied ends on the testicular side. Pain only started
after a period of arrousal and increased until ejaculation. It then
took a few minutes to die away again. Also, following my conversion, I
could feel the warm fluid release on ejaculation for the first couple
of times, before the granulomas had establised themselves.
Sometimes experience beats vague references.
John.
trifold
> on the rest. I'm not suggesting this at all, what I'm suggesting is
> that on ejaculation the release of pressure at the ampullae
> hydraulically relieves the pressure lower down. This relief of
> pressure, in my opinion contributes to the feeling of
> satisfaction/relief after ejaculation which, in my, case was certainly
> missing until my conversion.
I still wonder how much pressure builds up due to sperm accumulation
in non-vasecotmised guys relative to the pressure that builds up from
the other goop we ejaculate (the stuff that comes from the prostate
and the seminal vesicles). Since much more of what gets ejaculated
come these other two sources, and these surces are not interrupted by
vasectomy, it seems to me the pressure build up would be experienced
for non vasectomised and vasectomised guys in very similar ways; as
would the experience of release at ejaculation. This makes sense
based on my own experience pre and post vasectomy, as well that of
other men I know.
>As for specific pleasure at ejaculation I
> believe that most of the problems I and others have experienced are
> related to unintentional 'third party' damage to nerves during the op.
> The effect on myself immediately followed the op., at which time there
> would still have been plenty of fluid in the vas to fill the ampullae.
Yes, I agree with you here. Also with what you said in another post.
You speculated there that you experienced pain after the vas. during
excitation and at ejaculation, and that you suspected this was due to
pressure being brought to bear during that time on nerves caught up in
the vasectomy seal. This makes a lot of sense to me. The pre-ejac
pain might be due to your balls pulling up during arousal. Then there
are are contractions at ejac. that might also cause the pain. What I'm
not sure about is whether peristalsis isn't going on other times as
well. I do know that sperm doesn't go from testicles or epidydims all
the way to semen in a few seconds. It takes weeks, as I understand
it. (That's why guys have to wait several weeks to clear out after
vas.)
>Also, following my conversion, I
> could feel the warm fluid release on ejaculation for the first couple
> of times, before the granulomas had establised themselves.
This really is amazing. I have never felt anything like this, which
doesn't mean it doesn't happen. I do believe when I ejac. some sperm
makes its way through my vas seals, because if I go without ejac. for
a day or so, I feel pressure in my epi, and this pressure subsides
after ejac.
> Sometimes experience beats vague references.
I don't doubt experience is useful. But I'm not sure experience
always explains causality.
john
> not sure about is whether peristalsis isn't going on other times as
> well. I do know that sperm doesn't go from testicles or epidydims all
> the way to semen in a few seconds. It takes weeks, as I understand
> it. (That's why guys have to wait several weeks to clear out after
> vas.)
>
mechanics. The system is full of fluid already, so the moment the
'pumping' starts, fluid emerges at the other end. The 'pump' effect
along the vas is triggered by arousal in order to 'load' the ampullae
in preparation for 'firing'. When you start your car in the morning,
fuel is available at the engine immediately but that portion of fuel
has been sat in the fuel lines overnight, not in the fuel tank.
(Just as an aside, IF the ENTIRE system was only activated by
arousal, then a priest who had no 'impure' thoughts would be able to
stay celebate without any physical effects. Interesting thought ?)
John
David
> mechanics. The system is full of fluid already, so the moment the
> 'pumping' starts, fluid emerges at the other end. The 'pump' effect
> along the vas is triggered by arousal in order to 'load' the ampullae
> in preparation for 'firing'. When you start your car in the morning,
> fuel is available at the engine immediately but that portion of fuel
> has been sat in the fuel lines overnight, not in the fuel tank.
> (Just as an aside, IF the ENTIRE system was only activated by
> arousal, then a priest who had no 'impure' thoughts would be able to
> stay celebate without any physical effects. Interesting thought ?)
>
> John
My understanding of the system is that what happens is the sperm are
moved
from the seminiferous tubules within the testicular structure to the
epididymus for maturing and storing. They stay in the epididymus for
about a
month, and at the end of this time are either degenerated and
absorbed, or
are expelled to begin the journey up the vas deferens to the ampulla
for
storage prior to ejaculation. The epididymis is an extensively coiled
tubular organ attached to the posterior surface of the testis. If you
uncoiled it, you would end up with one tube about 5-6 m (about 17 ft)
long!
The peristalsis is required because the vas deferens is about 30cm
long, and
very narrow bore tubing - it's 'aint that 15mm copper stuff we use for
household plumbing. Without some method of transportation the sperm
would
simply stay sat sitting in the epididymus. Peristalsis and
spermatogenis are
going on all the time 24/7. As the vas deferens are only microns
internal
diameter, how likely is it that starting a pump when arousal starts
would be
able to physically move a lot of sperm up a 30cm pipe only microns in
diameter to the ampulae in such a short space of time? Hence 24/7
peristalsis movement of sperm into the storage tank at the top.
The system is indeed full of fluid at all times, but the peristalsis
isn't
started by arousal - it's working all the time. The ampulla is a
storage
vessel with the ability to expand/contract to a certain extent (like a
gasometer storage tank) depending on how full it is. Once full and
with no
more expansion capability, the constant refilling will cause sperm to
dribble out the top.
During ejaculation, the contents of the ampullae are "flushed"
alongside the rest of the goop as previously described by Trifold.
Not too sure there *is* such a thing as a totally celibate priest. An
Irish
freind of mine who was obviously exposed to a lot of religion during
his
upbringing had a few tales to tell!
john
As the vas deferens are only microns
> internal
> diameter, how likely is it that starting a pump when arousal starts
> would be
> able to physically move a lot of sperm up a 30cm pipe only microns in
> diameter to the ampulae in such a short space of time? Hence 24/7
> peristalsis movement of sperm into the storage tank at the top.
>
Well, er , ..... um. I'm obviously wrong then. I can only conclude,
from my experiences, that the rate and pressure are merely stepped up
considerably during arousal.
I'm surprised at your comment about celebate priests, as I have
always assumed then to be as common as perpetual motion and cold
fusion.
John.
David
> I'm surprised at your comment about celebate priests, as I have
> always assumed then to be as common as perpetual motion and cold
Ignore me - I've got sick kids at home to look after and am bitter and
twisted today!!
David
www.vasectomy-information.com
phlox
when you turn on the tap to run a bath. the water you get is in the local
tank.
Sure there are compensating flows from the water cachement area to ... and
then to... and so on
but the immediate flow is from the tank which is the 20 - 30 vm of the
vas deferens with the addition of the seminal fluid from the prostate. and
the vas is nowhere near emptied at an ejaculation.
It seems to be a pretty well established fact that it might take 20 / 30
ejacs. to empty just that part of the system.
Phlox
Fletcher
I had given up on this forum as far as getting any help on my problem.
I am printing this string out to show my Dr. before I have my reveral done.
Fletcher
phlox <ph...@phlox.freeserve.co.uk> wrote in message news:<3F7605AF...@phlox.freeserve.co.uk>...
Fletcher
agree most people here have not had this experience we speak of.
Trifold for one told me not to bother with a reversal due to expense
and no guarantee of results.
He seems to have the least constuctive advise of anyone here.
I think he just likes stiring the pot.
Fletcher
DROVE...@SUPANET.COM (john) wrote in message news:<41c6a9f0.03092...@posting.google.com>...
trifold
> This is the first advise I have received that has been helpful and I
> agree most people here have not had this experience we speak of.
> Trifold for one told me not to bother with a reversal due to expense
> and no guarantee of results.
> He seems to have the least constuctive advise of anyone here.
> I think he just likes stiring the pot.
>
> Fletcher
Actually, I never said this. I understand reversal can help pvp. I
often advise men look into conversion to open ended first, as it is
much cheaper, much less prone to complications, and like to solve pvp
related to sperm backpressure. I am skeptical about reversal as a
cure for other things, such as loss of ejaculatory pleasure, because I
see no reason to believe vasectomy affects ejaculation.
trifold
http://www.vasectomy-information.com
Fletcher
Thanks,Fletcher
DROVE...@SUPANET.COM (john) wrote in message news:<41c6a9f0.03092...@posting.google.com>...
Fletcher
Explain this away then.
Fletcher
From: trifold (trif...@netscape.net)
Subject: Re: ejaculation after vasectomy
View this article only
Newsgroups: alt.support.vasectomy
Date: 2003-06-24 06:48:30 PST
fletche...@yahoo.com (Fletcher) wrote in message news:<9b6cb964.03062...@posting.google.com>...
> I sure would like some answers on this issue.
> I have done tons of searches on the net.
> I found one site that said groin trauma can cause ejaculation dysfunction.
> At 6 weeks post-vas my condition is the same.
> My oragsms have lost sensation and my sex drive is low.
> I will go 6 months tops and if nothing changes I will have it reversed.
>
> Fletcher
Have you seen a doctor about the loss of sex drive and lost sensation
you are experiencing? He could measure your T levels (which have
bearing on sex drive) and also look into why you seem to be feeling
less at ejac. Without knowing the source of these problems, going for
a reversal is just a shot in the dark. Not only a shot in the dark,
but a shot in the dark that is expensive and risky. Keep in mind,
reversing a vasectomy also constitutes "groin trauma"--arguably more
"trauma" than the original vasectomy. I wouldn't do it unless someone
told me it was a likely cure. Other things might be at work here, and
you should explore them first.
trifold
http://www.vasectomy-information.com
fletche...@yahoo.com (Fletcher) wrote in message news:<9b6cb964.03100...@posting.google.com>...
David
a variety of opinions that you can use/ignore as you like. Earlier in the
thread you responded to a post of mine saying it was the only sensible
advice in the thread. What you responded to was my comment to another poster
to ignore an off-topic comment as I said it when I was in a grouchy
mood! You also said that you were going to print the thread to show your
doctor! Quite a difference between opinions of the thread.
OK, you said that at six weeks post vasectomy you were experiencing
problems, and if things hadn't resolved you'd go for reversal at six months.
The advice to consider ALL options and not have a fixed goal of one option
ONLY was good advice.
Reversal can help in several ways, but it is NOT foolproof. Like all
procedures including the original vasectomy it carries it's own risks. In
some cases reversal does not alleviate symptoms and further surgery is
necessary - Greg #2 being a case in point. His reversal didn't help and he
had an epididymectomy some time later. Isn't that a bit of a double whammy
of groin trauma??
Your idea to wait for six months before embarking on further surgery is
good, as often the healing process gets you to the point where the existing
problem is tolerable/manageable without surgical intervention. If at that
point there is no or little improvement then it may well be advisable to opt
for a carefully considered surgical option. The advice to consider
(alongside specialists) what the best option may be in your individual case
is not in my view "Stirring the pot", but good advice. Having your mind
fixed on ONE option (which may not be the best option in your case) at a
specific point in time is not a good idea - I'd advise keeping an open
mind - which is all Trifold actually did. All we have to go on is the
information you provide. If we offer opinions based on that information that
you don't like then that's fine - ignore the advice.
How are things at the moment? How far post-vasectomy are you, and is it
improving/getting worse?
David
www.vasectomy-information.com
trifold
> Explain this away then.
>
> Fletcher
Ooops. I guess I can't. I *did* say it would be foolish to jump into
reversal without examining things that could cause the symptoms you
complain of. If you consider this bad advice, then jump away. I'm
glad I gave it though. It's the right advice, and I'm sorry you don't
find it helpful. (I do want to repeat, I have never argued against
reversal as a possible treatment for chronic scrotal pain, which is a
documented complication of vasectomy--unlike loss of sensation at
ejaculation.)
trifold
http:www.vasectomy-information.com
Fletcher
It has not gotten worse or better.
Currently scheduling a date for my reveral.
Will update post-op.
Thanks,Fletcher
david...@tesco.net (David) wrote in message news:<ca30e9b9.03100...@posting.google.com>...
john
> I would like to ask if you had an increase in sex drive after the reversal?
>
> Thanks,Fletcher
>
>
for a reversal in the end, I went for an open ended conversion
instead, because of the backpressure problems. But, for what it's
worth, no the 'horniness' was not returned after the conversion. I
would not have expected it to either, because the flow up to the
ampullae was not restored. I think a reversal would have restored it,
but it was a question of priorities for me, and being more sure of
removing the 'ball ache' etc long term was more important.
John
Fletcher
Thanks for the info and could you please explain the difference
between open-ended conversion and a regular reversal.
Thanks,Fletcher
DROVE...@SUPANET.COM (john) wrote in message news:<41c6a9f0.03100...@posting.google.com>...
David
"Fletcher" <fletche...@yahoo.com> wrote in message
news:9b6cb964.03100...@posting.google.com...
> John,
> Thanks for the info and could you please explain the difference
> between open-ended conversion and a regular reversal.
Both procedures would be done with the intention of relieving back pressure.
If back pressure is NOT the source of pain, then it may be that neither
procedure is the answer in your case. However, the good news here is that
the doctor should be able to ascertain easily if back pressure is an issue,
by feeling the epididymus and maybe following up with an ultrasound
examination. The other good news (in a way) is that back pressure is
probably the problem in a big majority of cases - hence the statistics of
70%-80% effectiveness of reversal. Open ended there are rather fewer
statistics available on unfortunately.
I'm assuming that resolving the pain is the issue, and restoration of
fertility is neither here nor there.
As I'm sure you are aware, back pressure results from the sperm that is
still being produced after the vasectomy has nowhere to go. Sperm
re-absopbtion is normal in vasectomised and non-vasectomised men, and this
occurs in the epididymus. If this doesn't happen fast enough, or the vas was
cut too close to the epididymus back pressure may occur and cause pain.
One way that this is relieved naturally is by sperm granulomas. Basically,
weak points in the vas remnant or epididymus will "balloon up", and can be
painful. Granulomas do occur in the majority of vasectomies, but are in the
main asymptomatic (there, but not painful) and usually dissapear after six
months or so. The can be spotted on ultrasound examination.
A reversal will re-join the vas deferens with the intention of having the
sperm flow naturally through the system and out the usual exit. Open ended
conversion is where the testicle end is turned into an open end that will
allow sperm to leak into the scrotum, hence relieve the back pressure. Open
ended is a good idea to try if you are sure you want to remain sterile.
eversal may involve more scrotal trauma than conversion due to how the
procedure is carried out.
One thing to be aware of re the open ended technique/conversion - granulomas
tend to occur more often. The ends of the vas do not remain open, but will
have scar tissue form round the cut end. Granuloma's will still occur as
there will be some pressure due to scar tissue. There is a paper on the
website that gives more info on the open ended technique. Therefore, if any
pains you have are due to granuloma as opposed to back pressure, open ending
the vasectomy may well not help. This is why I have said all along that
diagnosing what is the cause of the pain is essential in choosing what
procedure is best to relieve it. Both granuloma and back pressure are easy
enough to check for, and before making a decision I'd certainly have the
necessary tests.
David
www.vasectomy-information.com
john
> John,
> Thanks for the info and could you please explain the difference
> between open-ended conversion and a regular reversal.
>
> Thanks,Fletcher
>
>
The conversion is simply changing the 'standard' vasectomy (all 4 vas
loose ends tied up) into an open ended vasectomy (the upper ends tied
up, but the lower ends left open). There is information about this
variation on the vasectomy-information website. The main advantage is
that it prevents excessive backpressure from building up in the
testicle area. This is a fairly crude explaination but should give you
the gist of it.
A reversal is reversing the original vasectomy by rejoining the vas
and hopefully restoring flow along both 'pipes'. The normal purpose is
obviously to restore fertility, but it would probably help your
situation as well by putting things back to as near where they where
as possible. You should be aware though, that the set up will never be
exactly as it was and that the surgery carries its own risk of furthur
damage to surrounding tissue/nerves etc.
I hope this is of help, John