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Remember, this is not intended as a forum for medical advice, only discussion.

From: T
Date: 5/1/01
Subject: Relief after 21 years

Great collection of data thar' boy. Best TRUE LIFE vasectomy site on the web.

I just had a reversal - 21 years on - for pain relief. The smoking gun was a congested and distended right convoluted vas. Still some discomfort, and sensitivity to caffeine, but largely relieved by the op.

The odds of getting pain or complications from the unkindest cut are just too high. ALL YOU GUYS: JUST SAY NO!

Response: In subsequent correspondence with "T", he revealed that his pain began 15 years after his vasectomy. He spent much of the last 6.5 years finding a doctor who understood post-vasectomy pain syndrome enough to assess how to treat it properly, in this case with vasectomy reversal. "T" says his pain is still present but decreased, he's off medication, and has experienced some testicular atrophy, which, unfortunately, is not uncommon following vasectomy. Several others have mentioned this sensitivity to caffeine also. See below.

From: MR
Date: 4/30/01
Subject: Caffeine increases pain

I was wondering if others might have made the following observation. I began to have testicular pain 3-4 years ago. Over the past few months I have discovered that a major factor in my testicular pain has been caffeine. If I drink no coffee, no tea, and avoid caffeinated drinks, my problem is minimal. But even half a cup of coffee brings on discomfort, and if I drink caffeine beverages regularly I become almost incapacitated with pain.

Response: If laying off of the caffeinated drinks reduces pain, this seems like a small price to pay. I don't have any idea what the relationship might be with this kind of body chemistry response, but after several years of chronic post-vasectomy pain myself, nothing really surprises me any more.

From: AH
Date: 4/27/01
Subject: Spouse's reaction to vasectomy

I am a female spouse seeking any help I can find. To make a very long story short, my spouse had his vasectomy 200% AGAINST my beliefs and convictions. I tried telling him all the items you are bringing to the public (thank you, thank you, thank you) and by God the urologist told him to my face that I was nuts, that NOBODY really had any complications and I was just basically to be ignored and it was his RIGHT to do this without my consent right now after meeting with him for less than 6 minutes tops. Come to the next room and let's get started and send her to the waiting room to wait!

…No body talks about spouses who DO NOT want sterilization in the marriage and we are run over like trains by the same "professionals" who only want to make money on the procedure or counseling afterwards to "help you see how ridiculous" feeling anything other than rapturous joy and the complete picture…. They only have a vested interest to do sterilization as often as possible on anyone over 18 and… they live with none of the very real physical, financial, and emotional consequences and just surgically mutilate the next person for the next guaranteed income source…. How many of the ones all messed up keep going back to the same doctor who messed them up in the first place?

…Good luck on your work! I will submit it for shelving at my local library. Trust me, the public libraries will stock these items when requested and this could expand your needed exposure of this medical standard of lies, untruths, misleading questions and dismissals based on opinions, not facts, by providers and open up the liability for health altering procedures that are not having the "informed consent" in ANY time they are being performed on otherwise healthy adults.

Response: Several things about this situation amaze me. The fact that the urologist denied anyone having complications flies in the face of so much evidence that there seems to be a huge liability here. Speaking of liability, literature from within the urology industry repeatedly recommends that a couple be in complete agreement about sterilization in any form before the procedure is done. That is, after informed consent is obtained. The next puzzling issue is why the urologist did the procedure immediately. Many states have required waiting periods after the initial consultation. If you would like any of the information about these legally oriented items, please let me know.

From: DL
Date: 4/25/01
Subject: Post-vasectomy pain therapies

I had a vasectomy in October of 1998, and have groin pain in my left testicle since. Although the pain is not near as severe or frequent now, when the pain comes back, I contemplate having some sort of reversal. The pain seems to come back if I lift something heavy, or squat down in a incorrect way. I have been a very active person, but since the operation my life has changed. You mentioned swimming as a pain relief, could you explain more on that? Also, what do you think about reversal, and do you know of any specialist? I am so glad to talk to someone who has the same problem, but it sounds like you have had a much more severe problem.

Response: Our "problem" motivates us into unusual discussions and to consider unusual options, doesn't it? The question of whether a reversal will work or nor seems to be dependent on several factors. If congestion and ruptures in the epididymis wit the associated autoimmune response is the only culprit, then a reversal can help. Some men recommend vasoepididymostomy to bypass the injured area as much as possible. Some recommend vasovasostomy to reestablish the most natural flow. It is hard to say who is right. I had a vasovasostomy performed in April of 2000, and still have consistent pain.

The reversal did not take away the autoimmune response, and I have pursued testosterone therapy since with reasonable success in this regard. The best specialist I know of is in Los Angeles: Dr. Philip Werthman, at 310/277-2873. He has been guiding me through the process and has been great to work with. The issue remaining in my case, and evidently that of many others, is nerve damage from the original vasectomy that exacerbates the pain response. This is very hard to resolve, as injured nerves don't tend to get better with more surgeries. Neurectomy has been suggested, but the pain specialist I have been working with at Stanford recommends against it.

Non-invasive therapies seem to do the most good. Swimming takes the load off in my experience and at least allows me to work out my upper body. A gentle yoga practice also seems to alleviate the spread of pain. Myofascial release therapy for the abdomen, lower back, and pelvic floor muscles has also been helpful. There are forms of testicular massage you can do for yourself that are intended to alleviate congestion and stimulate blood flow. Let me know if you want a copy of any of this information. As you know, one of the key issues is to be able to alleviate the spread of pain enough to have a life while you search for a cure. Taking charge of your own healing and finding out what works well for your body is key in this process.

From: GB
Date: 4/7/01
Subject: Open-Ended Vasectomy

I am interested in having a vasectomy and have read some of the problems associated with it. Does open-ended vasectomy overcome any of these possible problems?

Response: Some research has shown open-ended vasectomy to reduce the incidence of chronic testicular pain following vasectomy by a factor of three. This research also shows that open-ended vasectomy virtually guarantees that granulomas will form at the testicular end of the vas. A key point to remember is that both open-ended vasectomy and closed-ended vasectomy have a high likelihood (70% or better) of resulting in a life-long autoimmune reaction due to sperm cells being retained in the body and rupturing into the bloodstream. See the reference section of the website for a list of articles detailing this response. Many doctors claim that all these responses are harmless. My experience and the experience of many others who have posted messages to this site is that the effects can be devastating and painful. You have to decide if you want to take the risk as opposed to other forms of birth control. Learn these risks before having the procedure, because once you do, it is often very difficult to turn back.

From: MO
Date: 3/1/01
Subject: Appropriate medical procedures and inappropriate erections

I had a spermatic cord nerve block done on Monday on the advice of my doctor, and since then I have turned black and blue on my right side of my scrotum and even on the right side of my penis in addition to a great deal more pain than usual since my vasectomy. I called my urologist today to express my concern about the discoloration and increased pain that the Vicodin was not touching. I had to see another urologist since my doctor was in surgery (here we go again, explaining the story to another doctor). Well, he said that I had a good size hematoma and that it should go away in about a week. He then asked if I had even had anyone milk my prostate to check for infection. I had never had this done before. He thought it would be best since I had two signs of prostatitis: painful testicles and pain following ejaculation. It turns out that I had a great deal of white blood cells in the secreted fluids that indicate an infection. I don't anticipate that this is the only reason I'm having pain, but it may contribute. The doctor prescribed a round of the antibiotic Levoquin to treat the prostatitis and an antidepressant called Trazodone. I looked up the Trazodone on the Internet and found that the side effects can include prolonged, painful, or inappropriate erections. I got a kick out of the "inappropriate" part. I'll admit, with all this pain, I could use some 'inappropriate' erections to give me more confidence. I'll let you know how things go.

Response: After everything you've been through, you should have license to have an erection anywhere and any time you want. Here's hoping it just doesn't hurt to use it too much. Prostatitis is seen commonly after vasectomy, both in the infectious and noninfectious variety, according to the Prostatitis Web Site, Vasectomy Page at www.prostate.org. Urologists at UCLA have been doing studies on this subject and trying various bioflavenoids, such as Quercetin as methods of treatment. For myself, I've decided that any direct assault on the nerves in my groin causes way too much additional pain for any "diagnostic" benefit that might result, and any blocks that I will allow to be done need to approach the subject from the back, as in the Superior Hypogastric Nerve Block that I've had done at Stanford Pain Clinic.

From: KP
Date: 3/2/01
Subject: Man-o-pause

Can you guys believe this? I have been getting very hot and not knowing why. I called my internist and he said this what I am getting is like female menopause because my hormones are so out of balance after my vasectomy. He said to take vitamin E. This is the only somewhat funny thing that has happened yet. I had better not have grown ovaries too! Any suggestions?

Response: Dr Malcolm Carruthers discusses how vasectomy can affect testosterone and other hormone levels in his book MAXIMISING MANHOOD: BEATING THE MALE MENOPAUSE. This is evidently quite common as an undisclosed side effect of the procedure, and many men have experienced impotence and other symptoms as a result. Hormone replacement therapy can help this condition in many cases according to Dr. Carruthers.


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