A Vasectomy Experience
tcwalk...@gmail.com
person I have been able to fully talk about it with has been my wife
and, to a more limited extent, my other family members.
I was a perfectly happy and healthy 29 year old last December (12/04).
My wife and I were through having children and I felt like I was taking
the responsible approach by doing my part for birth control. All of
the available literature states that the vasectomy procedure is the
most effective and safe form of pregnancy available. I researched
extensively, so I thought, to learn about the risks and potential long
term effects. I saw men who feared that it could affect testosterone
levels but I discounted that based on the research I found. I saw the
same indications for potential problems with prostate cancer; the
research didn't seem to support it. I saw what I thought were actually
very few real potential complications. What I wish I had paid more
attention to was the sentence or two that now pops out when I look back
at that literature that went something like this, "Some men report
ongoing pain which is usually brief and remedied with conservative
measures." That must not have been too alarming because evidently I
didn't dwell on that too long. Some literature (websites and
brochures) I look back on now don't even mention it as a potential
complication. What I never really saw was a statement to the effect of
"Some men develop a long term pain syndrome for which there is little
treatment available and the patient may have to live with this pain for
the rest of their life." Would that have stopped me? I don't know, it
seems like when you hear about a drug or procedure that has a 3% to 6%
complication rate you tend to instantly think "Oh, so that means it
won't happen to me, though." I may have still gone through with the
procedure, I may not have. I will never know. I would like to have
known what an "epididymal blowout" was. If you haven't had your
vasectomy yet, make sure you have your doctor explain this term to you.
I had my first consultation with the Urologist who eventually did the
procedure in November 2004. He asked if I had any questions and I
asked the ones I could think of. I didn't really know at the time to
ask about the post-vasectomy pain syndrome. He talked about how it was
a very straight-forward procedure and very simple. He was mostly
concerned with how young I was and how many children I had and what sex
they were (I guess men who only had daughters might later regret a
vasectomy and want to try for a son?). During the examination he even
said I was the ideal subject for a vasectomy because I was fit and thin
and it was easy to get at my vas.
I had the procedure done in November. It went very smoothly. It was
quick, seemed like 20 minutes or so and he seemed very experienced. I
went home and took the pain meds and spent the rest of the week on the
couch. I do remember being told that some men will try to get up and
around after the second day and get back to work too soon and not to
try it. I didn't have to worry about that because just the mere act of
undoing my pants for urination caused me too much pain down there. I
was told by my primary care physician--when I went for my
referral--that she knew a Urologist who was working on his roof the
weekend after his vasectomy. I was in no such condition. I didn't
feel myself for about two weeks.
The rest of December and January went pretty well. My wife and I
resumed our normal healthy sexual relationship and all seemed well. I
did have a kind of nagging ache that acted up at times during the day
but I figured my body was still healing. I never really hit above 2 on
the 1 to 10 pain scale. It wasn't even as bad as a headache.
Around February I began to feel that ache more and more and it would
begin to turn into a burn occasionally. Again, I figured I had surgery
so my body still needed to heal.
Around early to mid-March is when the real nightmare began. It was
about the time my first sample was due. I started to worry that
something was wrong because it had been months since the surgery. I
had begun to tell my wife that something didn't feel right.
She told me to call the doctor. I did so and what I got was an
"on-call" nurse. The urology practice I used has many doctors and
sites so this is how they handle medical/post-op questions. The nurse
acted like I should be fine by now. "No", she said, "this doesn't
really ever happen." She added, "But then again, I've never had a
vasectomy." Cute. Even though it hardly ever happens, she did know
what they usually do when it does happen. She said they bring you in
and give you antibiotics and NSAIDS and then,
"Most men feel better." I eventually made an appointment. The soonest
she could get me in was 6 weeks from then. That shows you how serious
it was.
My wife had a fit because the pain hit my like a hammer that night and
I knew something was not good down there. She called the next day
herself and got me an appointment that day with a "first available"
urologist. I went in and was seen almost right away.
The doctor asked me to describe the problem, which I did, and he felt
around my testicles. He snapped off his latex gloves and just said,
"Well, this sometimes happens." He said some men get this blue balls
feeling that just doesn't go away. I hadn't really thought about blue
balls since I was a teenager but that struck me because that was
exactly it, but ten times worse. I told him what the pain was doing to
me and how I heard you could live with the pain for years. His
demeanor changed markedly. He would no longer look me in the eyes and
really quit listening to me very well. He whipped out his prescription
pad and set me up with some antibiotics and told me to take 9 advil a
day (spaced out during the day) for 3 weeks. He said they needed to
"break the cycle of inflammation and infection". I asked him if there
was any hope and he said that some men get to a point where it comes
and goes and they just come in for help as needed. He told me I should
probably see my main urologist from now on because he "gets in trouble
for taking over other people's patients."
About two weeks into this course the pain lit up to where I was
frequently reaching 6 to 8 on the pain scale. One day on the way to
work I thought I might need to pull over the car and I questioned
whether I would be able to go into the office when I got there. I
decided to get back in to see a urologist asap. I was able to get in
again that day after describing the pain. I saw a different urologist
this time. He was much more compassionate. He felt my testicles and
said my epididymis felt enlarged. He was the first to present my pain
of probably being related to a back pressure phenomenon. I asked about
reversal and, to my surprise, he seemed willing to try. He told me I
would probably have to pay but honestly I would have signed my 401(k)
over if I could have known it would remedy the pain. My only concern
was that he had only done 20 reversals in his entire career and he
wasn't quite sure whether he would use loupes or a microscope.
Fortunately I learned a day or two later that a doctor who specialized
in reversals and who had done thousands of them practiced at a local
university. Plus through the university they were fairly affordable.
I went to see this doctor and was a bit afraid at first that he
wouldn't do the reversal for pain. I considered just going in and
saying that I wanted to have more kids if that was what it took. This
doctor told me that in his observation PVPS happens in 10 to 15% of all
cases. That kind of shocked me because I had heard 3% to 6%. He told
me that it was up to me but that it may work, it may not work, or it
may make the pain worse. I was willing to try. He was the first
urologist to tell me that he had had a vasectomy himself. He said,
"Mine even hurts from time to time." I told him, "Well this pain is
ruining my life." He kind of
flippantly told me, "Yep, I've had patients say that before."
I had the reversal two weeks ago today and I'm trying to keep my
spirits up. I still feel the PVP. I am hoping that it goes away. It
doesn't seem to be as bad but the reversal recovery itself was pretty
painful and I'm not sure how much of that I'm still feeling.
I never truly understood what chronic pain meant before. Pain makes
you feel lonely. It takes up mental capacity that used to be used for
other thoughts. It sands the beautiful details off of life and makes
the most routine tasks difficult. What's worse, this type of pain is
hard to talk about with co-workers. How do you tell a co-worker you
have PVPS. I sometimes lie and say I have back pain and had surgery
for that just so I can characterize it for them without telling them.
My family can see it in my eyes. I'm not at all what I used to be.
It's hard for me to look at a picture of myself from last year because
the thought that immediately jumps into my mind is that was "before it
happened." That was when I was happy.
Now I just try to keep my life simple and hope that the reversal worked
and one day I regain what I had.
I think the vasectomy procedure is an excellent option on paper. It
does appear to be safe and for at least 85% of men they will think it
is the best option and they will be very appreciative. For at least 3%
to 6% of men, we will be reminded that mother nature isn't always so
easily manipulated.
trif...@netscape.net
reversal solves the problem for you. I do have a couple of questions.
Did you have the open ended procedure or the traditional close ended
one? If the closed ended, than did they talk to you about reopening
the vas to prevent the back pressure problem they seem to think was the
cause of your pain? Getting a reversal so soon after vasectomy seems
unusual. It is often tried later after more conservative--and less
costly and dangerous--methods have been tried.
trifold
www,vasectomy-information.com
www.vasectomy-faq.org
tcwalk...@gmail.com
I didn't know much about the open ended vs. closed ended procedure
until I began experiencing pain. I actually asked the first urologist
I went to for pain whether their practice did the open ended or closed
ended procedure. He said that they had only done one open ended
procedure to his knowledge and that was a special request from a
patient. He then added that the open ended procedure would produce
granulomas and those cause pain in and of themselves. I've since read
that, despite this fact, there seems to be less pain with the open
ended procedure.
None of the urologists I saw suggested converting to an open ended.
Despite evidence to the contrary, it still seems to be something
urologists shy away from. At least that's they way the four I saw
felt.
One thing I would love to hear some opinions one is this. The
urologist who did the reversal actually told me that he generally
doesn't like to do a reversal for pain after one year. He said that
after a year the nerve pathways for pain have generally been
established and there is less chance of alleviation of pain. I looked
up this effect to see if it was true and I did see some discussion of
nerves and pain being like a dirt road. After a while a path gets worn
in the road and ultimately the pain can still be felt even when the
cause is gone. This, I read, is why sometimes people who get shingles
will experience pain years later. Maybe this is why neurontin is tried
for PVPS sometimes?
So, given that I was at the six month mark or so I figured I should go
ahead and do something if there was a risk of permanent nerve pain.
Maybe this was ill-advised but I was willing to spend the money for the
reversal for a chance at recovery.
Thanks again for the reply.
Tom
David
> I didn't know much about the open ended vs. closed ended procedure
> until I began experiencing pain. I actually asked the first urologist
> I went to for pain whether their practice did the open ended or closed
> ended procedure. He said that they had only done one open ended
> procedure to his knowledge and that was a special request from a
> patient. He then added that the open ended procedure would produce
> granulomas and those cause pain in and of themselves. I've since read
> that, despite this fact, there seems to be less pain with the open
> ended procedure.
Certainly the medical research tends towards this, but medical opinon and
practices seems to be slow to change. Open ended has been around for some
years now, and it isn't as popular as it should be.
>
> None of the urologists I saw suggested converting to an open ended.
> Despite evidence to the contrary, it still seems to be something
> urologists shy away from. At least that's they way the four I saw
> felt.
Reading posts here and elsewhere, I get this impression too. I do wonder if
the litigation culture has a hand in this. I haven't seen any studies that
look at open ending a closed ended vasectomy for treatment of CTP (where
pressure from vasectomy is the suspected cause). It may be that doctors are
afraid to offer treatments unless there is a fair bit of published research
behind it just in case we sue them. However, we do know that it is
practiced, and at least one regular member of this forum has had it done.
>
> One thing I would love to hear some opinions one is this. The
> urologist who did the reversal actually told me that he generally
> doesn't like to do a reversal for pain after one year. He said that
> after a year the nerve pathways for pain have generally been
> established and there is less chance of alleviation of pain. I looked
> up this effect to see if it was true and I did see some discussion of
> nerves and pain being like a dirt road. After a while a path gets worn
> in the road and ultimately the pain can still be felt even when the
> cause is gone. This, I read, is why sometimes people who get shingles
> will experience pain years later. Maybe this is why neurontin is tried
> for PVPS sometimes?
I haven't heard this one. Usually, doctors are unwilling to do a reversal
before a year or so has passed, as very often the condition settles down
without the need for surgery.
>
> So, given that I was at the six month mark or so I figured I should go
> ahead and do something if there was a risk of permanent nerve pain.
> Maybe this was ill-advised but I was willing to spend the money for the
> reversal for a chance at recovery.
Hopefully it will work for you. Please let us know how things progress.
--
David
www.vasectomy-information.com
www.vasectomy-faq.org
yabig23
I went through something similar last year and can relate completely to
the way you feel about the rest of life taking a back seat. There seems
to be a certain threshold for pain that once you go above nothing else
really matters and you just live day by day.
In my case the pain was caused by trauma during the vasectomy itself
that twisted and trapped the nerves, rather than through backpressure
as it sounds like in your case. The procedure itself (as I found out
much later) was open-ended which while usually the way to go just added
to the problems at the vas site since any swelling (like a granuloma)
increased pressure on the already aggravated nerve endings.
Nothing offered relief except for testosterone therapy which can only
be used short term, so I had a reversal at 9 months which turned into a
reconstruction of the spermatic cord once the doc saw what had happened
to it. After a few weeks I started to get relief and am now
consistently 90-95% better than before the reversal last November, so
give yourself some time as your body adjusts to the reconfiguration. If
you are still in pain at 6 months post reversal I would suggest trying
testosterone for a few months to make sure the pain is still sperm
pressure or leakage-related.
In your case having a reversal at only 6 months post vas seems very
agressive, but then again I know what it's like to have to wait while
not getting better and if that was ultimately what needed to be done
then you may possibly have prevented more damage such as blowouts, etc.
Assuming there was no trauma during the original op I agree with the
others that looking into an open ended conversion to relieve the
pressure may have been a good route to go. Since the vas itself had
gone smoothly I doubt you have nerve damage, unless it was somehow
caused by epididymal rupturing?
As far as knowing the risks up front, I think the fine print on the
release we sign should say "in an extremely small number of cases some
men's lives will be drastically affected by post-vasectomy pain that is
difficult to diagnose and may or may not be treatable. Odds are you'll
be fine and loving the freedom vasectomy brings, but then again you may
be among the unlucky few so do your research."
Keep us updated as things progress.
pvpas...@aol.com
You are to be commended for coming forward with your pvp story. Through
my work with the Canadian PVP Association I am aware that most men with
pvp do not go public with their condition. Most do not use the
anonymity of internet sites such as this one to discuss their pvp.
You story is well written in that it conveys to the uninitiated what it
is like to have pvp and to deal with pvp. Neither is easy. Most men,
given the choice, would not want to experience the pain for even a
limited period of time. You convey well how pvp takes over your life,
and how it prevents closure after vasectomy.
Are you aware that there is at least one support organization for those
with pvp? It is the Canadian PVP Association. We can be contacted at
pvpas...@aol.com, should you choose.
Greg
trif...@netscape.net
> Thanks for the reply.
>
> I didn't know much about the open ended vs. closed ended procedure
> until I began experiencing pain. I actually asked the first urologist
> I went to for pain whether their practice did the open ended or closed
> ended procedure. He said that they had only done one open ended
> procedure to his knowledge and that was a special request from a
> patient. He then added that the open ended procedure would produce
> granulomas and those cause pain in and of themselves. I've since read
> that, despite this fact, there seems to be less pain with the open
> ended procedure.
I wonder what he thinks now about the open ended procedure?
> One thing I would love to hear some opinions one is this. The
> urologist who did the reversal actually told me that he generally
> doesn't like to do a reversal for pain after one year. He said that
> after a year the nerve pathways for pain have generally been
> established and there is less chance of alleviation of pain. I looked
> up this effect to see if it was true and I did see some discussion of
> nerves and pain being like a dirt road. After a while a path gets worn
> in the road and ultimately the pain can still be felt even when the
> cause is gone. This, I read, is why sometimes people who get shingles
> will experience pain years later. Maybe this is why neurontin is tried
> for PVPS sometimes?
I don't know. But I have read that one standard treatment for pvp is
"spermatic cord denervation." Perhaps this is a treatment that would
deal with the complication he is describing. Again, this is a
treatment I understand is often tried instead of reversal. BTW, does
the doctor expect sperm will return to your ejaculate after this
reversal?
>
> So, given that I was at the six month mark or so I figured I should go
> ahead and do something if there was a risk of permanent nerve pain.
> Maybe this was ill-advised but I was willing to spend the money for the
> reversal for a chance at recovery.
Again, I hope it works for you.
Steve
trif...@netscape.net wrote:
snip
>
>But I have read that one standard treatment for pvp is
> "spermatic cord denervation." Perhaps this is a treatment that would
> deal with the complication he is describing. Again, this is a
> treatment I understand is often tried instead of reversal. BTW, does
> the doctor expect sperm will return to your ejaculate after this
> reversal?
I considered spermatic cord denervation - very briefly - as I evaluated
the options I faced in my PVP experience. Once I understand the
implications of the surgery - definitely NOT a 100% success rate, with
very limited study....
http://www.asra.com/Abstracts/Archives/Fall_2002/2002F_A25.pdf
and - if you aren't cured, your options become more limited after the
surgery - for ex., if my memory serves me correctly, you are no longer
a candidate for a reversal after spermatic cord denervation.
My urologist did not even suggest it as a possible course of treatment
for me because of these reasons....
Steve
trif...@netscape.net
>
> I considered spermatic cord denervation - very briefly - as I evaluated
> the options I faced in my PVP experience. Once I understand the
> implications of the surgery - definitely NOT a 100% success rate, with
> very limited study....
>
> http://www.asra.com/Abstracts/Archives/Fall_2002/2002F_A25.pdf
>
> and - if you aren't cured, your options become more limited after the
> surgery - for ex., if my memory serves me correctly, you are no longer
> a candidate for a reversal after spermatic cord denervation.
>
> My urologist did not even suggest it as a possible course of treatment
> for me because of these reasons....
Well, maybe it is something he would consider if reversal does not do
the trick. It occurs to me that if nerve damage is the cause of the
pvp, not sperm backpressure, than reversal may not be the answer.
trifold
www.vasectomy-information.com
www.vasectomy-faq.org
>
> Steve
Luan
painfull months I read many stories of disaster resulting from Vasectomy.
After about 6 months I re-read some of the same stories and they were
different then. At about 6 months I could fully understand. I think
anyone without the actual experience of PVPS cannot really appreciate your
writing or anyones account of their suffering. I have a doctor friend -
Fred - retired for 5 years. I began to e-mail him with some questions
and descriptions of my symptoms. He told me to take the "horror stories"
I might find on the internet with a BIG GRAIN of salt. After a few months
I realize my vasectomy is a horror story too. I began to tell him the
truth of what it is like to have PVPS. He quit answering my e-mails. I
know it is impossible to understand what PVPS does to the life of the
victim - unless you have PVPS or maybe if you are a doctor who treats it.
The rest of people take that big grain of salt and think we are crazy.
PVPS does make a man feel lonely. I saw Fred at a concert on May 12 but
we did not speak. Our friendship of over 20 years is changed, at least
until this misery of PVPS is past. The man I asked - Dave - before I
decided on vasectomy for all the details of his vasectomy is another close
friend (Dr of Phycology) and now because he did not tell me the complete
truth that friendship is pretty well destroyed. Dave wants me to build a
road on some lakeshore property he has near me. He knows I can build the
road as he wants it done because I did this for him before. I tell Dave I
have only one objective in my life now - to recover from PVPS and I will
not promise anything to anyone until this is a reality. Maybe Dave
doesn't know that his omittion to telling me of his vasectomy
complications is at the center of of my feelings of betrayal. The man who
rents my farm - Steve - told me of his vasectomy a few years ago. (Steve
had a vasectomy 11 years ago) Now I talked to him more about my
experience. On our third conversation, 2 days ago, he finally reveals
that he had severe pain at times for over 2 months. He asked me to stop
talking about it as the memory of it was bringing back too much discomfort
and he said he was beginning to fear a return of his bad experience (he was
joking more or less but clearly he had some bad days) First: people who
have no experience of PVPS cannot understand well what PVPS is or what it
does to the man. Second: they cannot believe that it occures in 3% to 9%
of the men who undergo vasectomy. Both of these facts I agree, are
completely unbelievable - not logical - and terrible! I did not know
beforehand even what PVPS was, I never heard of it! After having PVPS
for 7 months I believe it!!! To satisfy my curosity about the percentage
I began to do my own personal survey of friends and neighbors. I have
talked to about 30 men of the 45 I have on my list. I find 2 who have bad
outcome, one was done 11 years ago and the other 30 years ago. The older
man lost his testicles, the 11 year man lost his ability to have
erections. (his wife told me he can have a weak erection with 2 viagra
but that medication gives him a huge headache for over 12 hours) I know
both of these men well for 7 years +. The 11 year man has told no person
of his problem - NOBODY! I now know that of the 30 men I have talked to
there may well be some who did not tell me all the story. I usually ask
my questions in public places after someone askes me how I am or how I am
doing. They are not expecting I will really tell them of something
personal like my PVPS. I just want the truth! Can anyone tell me what
is wrong with the truth?? After being gone for 6 months I called my
neighbor - Neil - and asked him some simple question and then asked how he
was doing. I did not know of a heart attack he had when I was in Bangkok.
He told me he was waiting for a heart transplant and living with a machine
to help his damaged heart. I was shocked and did not know exactly what to
say as he was healthy when I departed last November. I shared my problem
with PVPS and joked that if my Nuts do not recover I may have a heart he
can use. How strange that we can talk about a heart with no problem but
we cannot talk about our testicles. The only way men will ever get some
decent birth control is if they TALK ABOUT IT! The barbaric way
vasectomy is practiced is due to the refusal of men to share information
openly. Vasectomy is a lot like DATE RAPE. We go into it expecting to be
treated fairly and ethically and professionally. 5 to 10 % come out RAPED
and then treated like the rape victims - blamed for the bad outcome we get.
I have been told here that it is partly my fault for not telling the
doctor enough. I have been blamed for letting my "passion" rule my
decision and thinking with my "loins" and not my brain. It is true that
Passion did motivate me to decide on this but passon is not LUST and
Passion is part of LOVE. I did notice the words used and I do remember
and I did not appreciate the attitude of those who posted this! Yes,
PVPS makes a man lonely partly because he gets treated badly by the
ignorant "lucky" men who are so proud of their "good" result and want him
to go away and not mess with "their" obvious wonderful practice of
vasectomy. I have been blamed here for having a strong opinion concerning
vasectomy and my facts of 3 to 9% PVPS are doubted. For anyone interested
please call Dr. Michael Witt of Atlanta, Georgia and talk to him about
this. I got my information from the "Repair Man" not the sales man. Dr.
Witt I am sure will be happy to make an appointment with anyone interested
in PVPS or vasectomy in general and have a phone conversation or personal
conference. He will answer all questions and give you good information so
make a list and give him a call. As victims of vasectomy we know that if
the truth could be told not many men would risk the operation as it is
presently practiced. We are in the minority but not nearly so small a
minority as is commonly thought. Thanks again for your carefully thought
out and tastefully written account.
Luan
PS I am presently on Testosterone Therapy and finally able to work a
decent day and sleep well for the first time in 9 months.
tcwalk...@gmail.com
before and I have to say this is the most mature and supportive group
of people I have ever seen. A lot of times in a newsgroup there is a
"Pro" contingent and a "Against" contingent and posts simply involve
flames back and forth between the two sides. I was very careful in my
original approach not to say "Don't go get a vasectomy because of what
happened to me." I simply wanted to share my experience and I
appreciate that people from both camps (good experience and bad)
responded in a mature and helpful manner.
Tomorrow will be four weeks since my reversal. I have to say, I think
I am a lot better at the moment. I have good days/nights and bad
days/nights. Some nights I wake up and the pain is there and I can't
get back to sleep and some days the pain is with me but I think I am
much better.
The pain used to cycle a lot. I've heard others say this as well. For
me it used to cycle from an ache gradually to a burn. I used to know
that if I had the ache in the morning I was going to have the burn in
the afternoon. Sometimes mixed in there I would get the little
spark-like pain that was kind of like lightning strikes as a visual
representation. I imagine this was nerve pain but I don't know.
Post-reversal the only pain I have felt is the burning. I have no more
of the ache and very little of the spark/lightning. I am truly hoping
that the burn, which is centered in the epididymis, is still related to
the back pressure and distension and that this is occuring becuase it
needs to heal even thought the pressure may now be released. Ibuprofen
or Naproxen (NSAIDs) and Ice seem to help a lot.
Many days I will be sitting at work and realize, "Hey, I feel no pain
right this second." I still feel the pain when I feel around my
epididymis area but I have to actually touch it to feel the pain. It
doesn't provide the pain unless bothered. I can't express how much of
a relief this is in words.
The depression of the ordeal is the hard part now. Some days I will
begin to feel the pain withouth doing anything and then I start to
worry and feel depressed that it is coming back. I kind of tell myself
that I won't feel cured until I am out of pain for as long as I was in
pain (6 months or so). I told my wife last night that I keep thinking
that I will wake up and it was a nightmare. What a cliche, but how
true.
I asked the urologist who did my reversal what the data was on
reversals closing up over time becuase of scar tissue or other reasons,
whatever they may be. He said that the best studies he was aware of
stated that about 20% of reversals are closed back up after 5 years.
I'm sorry I don't have an actual study to quote and I know this is
worthless info without a true academic study to quote but I do worry
about the reversal site closing back up and PVPS coming back. I guess
in life such worries are pointless and I will just hope for the best.
My true test will be when I go back to exercise. I'm hoping to not get
a bout of epididymitis from running and working out. I will be sure to
wear a good jock strap for many months if not forever.
Thanks again for the replies and support.
TC