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

From: RS
Date: 7/31/01
Subject: Electric shock sensations in the testicles

I am 39 years old and had a vasectomy 2 years ago. I have had pain ever since. The urologist did one midline incision and used metal clips to clamp off the vas. I have pain on the underside of the base of my penis (close to the incision), pain on the top of my right testicle and a shock like feeling during arousal and sex in my left scrotal area. Has anyone else had these shock-like feelings, kinda like an electrical impulse? Back in March 2001, I had a conversion to an open ended vasectomy on recommendation of many sources. The pain is still there. I hear having a reversal has a 50% chance of relieving the pain. Is it worth doing that?

Response: I think you and I have had similar experiences, so I can relate to much of what you have said. My original vasectomy was in August of 1999, and I too have experienced pain in varying amounts since the moment the surgery started. When time and medications didn't solve the problem, my urologist tried an open-ended vasectomy in January of 2000, but evidently the damage had already been done because the congestion and more severe pain came back within a few days. Even a subsequent vasovasostomy reversal has not resolved the pain issue for me.

I can also relate to the cattle prod in the testicle like sensations you describe, especially during sex. This has made me really gun shy about intercourse, which I'm sure you can understand. The best information I have found indicates that this pain is due to nerves that were cut and traumatized during the vasectomy and possibly additionally to nerve entrapments in scar tissue that formed following the surgery. Also, in my case traumatic neuromas formed at the vasectomy site in both sides and were removed during the reversal/reconstruction.

Urologists are often quick to recommend more surgery such as reversal or nerve stripping to fix what a prior surgery botched up, but the longer I go the more this approach becomes questionable in my mind. Bodies don't like to be re-traumatized in areas where they have already had significant trauma, and according to several pain experts I've seen, the chances of ending up with continued or worsened pain are significant.

Reversal seems to work when the source of the pain is truly congestion and ruptures, but you will have to go a long way to find a urologist who is competent enough to diagnose this before cutting you open. I can't quote percentages for you, but there are numerous men I have corresponded with who have had relief of pain after their reversals, and numerous others who are still in substantial discomfort, including myself. Ironically, you can go from being fertile and without pain, to sterile and in pain, to fertile again and still in pain. Not the best of progressions, is it?

Interestingly, I have had several men tell me that on of the sources of their pain was the metal clips used during the vasectomy procedure.
From: T
Date: 7/31/01
Subject: Pain finally resolved, but testicle shrinking

I had a reversal in March 2001, 21 years after my vasectomy. PVP was caused by a distended right convoluted vas, just like the fire hose in the cartoon. The surgery has healed now and I am sure I chose the right course of action.

My sperm count is still zero, but that is the least of my concerns. A few sperm would have confirmed at least one of the vasa remained open to prevent a recurrence of the congestion. Sensitivity to any caffeine remains quite high, which is frustrating. As I don't smoke or drink I deserve at least that pleasure although, strangely, prior to the 17th century caffeine was virtually unknown in the West.

I have been taking some homeopathic remedies and undergoing acupuncture. Hard to assess but I feel they help somewhat. My main regret is the bilateral loss of around one-third of my testicular mass during the last 7 years of PVP. Although my antisperm antibody count was only background (v.low) I suspect the atrophy is largely due to exposure of necrotic sperm to the immune system, which goes on to zap the semeniferous tubules also.

Response: This speaks well to issues like testicular atrophy and autoimmune orchitis as results of vasectomy and subsequent procedures. I try to explain to men that pain can occur at any time following the procedure, and this is a perfect example.
From: TB
Date: 7/31/01
Subject: Erectile dysfunction and pain and inflammation after vasectomy

My husband had a vasectomy about 70 days ago. We were not told of any possible side effects other than maybe swelling or redness on the outer side of the testicle. We waited approx. 10 days before having intercourse. I immediately noticed my husbands penis was not as firm or erect as it used to be. We thought wed give it more time. Then my husband experienced some short stabbing pains
underneath his appendix area. We went to the emergency room. The Dr. there contacted the physician that performed the vasectomy. They concluded
that my husband may have had a reaction to the surgery causing inflammation and possible infection.

The Dr. put him on an antibiotic and ibuprofen. This seemed to take care of the sharp stabbing pains but did not cure his erection. He still complains of some
tenderness and some sharp pains that go up near his stomach although they seem to pop in and out real fast. We have been back to his physician that performed the surgery several times now with the same complaints. The Dr. refuses to acknowledge that the vasectomy has anything to do with his erection.

He seems to be blaming it on my husbands age (46). However, there was nothing wrong with his erection prior to surgery and ever since the surgery it is definitely NOT the same. The Dr. is sending my husband to see a urologist for this problem. But he can't get in for two weeks. In the meantime the both of us remain very frustrated with the situation. After reading all the horror stories about men and their vasectomy complications I am so afraid for what my husband may have to go through I am sick to my stomach and barely keeping my sanity. Can anyone out there give us advice or suggestions on what may be wrong or help on how to go about fixing this?

Response: Testosterone levels and production are affected by vasectomy as demonstrated in numerous studies on the issue. A good book to get on the subject is Maximizing Manhood: How to Beat the Male Menopause by Dr. Malcolm Carruthers. It would also be a good idea to get a testosterone level blood test to see if hormone therapy might be warranted.

It has been my experience that pain in the abdomen and genital areas can have a significant deflating effect on erections. This may also be related to what your husband is experiencing. It may be worthwhile also to have a sperm antibody blood test to see if any of the inflammatory reactions might be due to antibody action, which is also common.
From: BG
Date: 7/22/01
Subject: Ejaculatory problems, pain and swelling after vasectomy.

My husband had his vasectomy done over a year ago. He had suffered for a while with pain and swelling. Sometimes it was quite severe. The biggest problem is that he says the ejaculation/release is not as intense as it used to be prior to the vasectomy. This of course is stressing. Has anyone else heard of this or have any information.

Response: In answer to your question, many doctors will tell your husband to get a psychological evaluation since they don't know of any connection between they injury caused by vasectomy and ejaculatory or other problems. The fact of the matter is that we all know that our bodies are one big, complex system, and to say that you can disrupt one part without any effect on the rest of the system flies in the face of common sense.

I was recently reading an article from a medical journal by Dias (1983) wherein 200 vasectomy patients were studied and surveyed about changes in their sexual behavior following their vasectomy procedures. Thirty-three percent of the men experienced changes including (in descending order) poor erections, less intense sensations, more intense sensations, early ejaculation, taking a long time to climax, orgasms with no feeling, and poor lubrication. So, if anyone tells you that this sort of thing just doesn't happen, let me know and I'll send you a copy of the article.

The hard part is what to do about the problem. Some men have told me that they treated themselves for prostate inflammation and this helped with some of the ejaculatory symptoms. Prostatitis is quite common after vasectomy in both infectious and non-infectious forms according to www.prostate.org (look on the vasectomy page). There are other treatments options also if your husband has recurrent pain symptoms as you described. I'm attaching the latest version of the treatment therapies for your reference.
From: JN
Date: 7/21/01
Subject: Pain management suggestions for persistent post-vasectomy pain even after epididymectomy.

Three years ago I started with a vasectomy and ended up in pain. I tried a reversal to cure the pain, and then tried having my epididymides removed over a year ago. I had a nerve block done in my lower back six months ago. It reduced the pain to a level I could come to terms with, but has now worn off. Have used all of the following drugs: Celebrex, Neurontin, and now Clonidine 0.1 mg at night. It seems to help a bit. Im desperate for some new methods to reduce the pain. Thanks.

Response: I am quite familiar with the situation you are describing, having sought a reversal myself and having tried many of the medications you mentioned to resolve the post-vasectomy pain I have experienced. My experience of this has been that no medication fully takes the pain away but may only take the edge off. Then you have to consider the side effects and possible addictive and/or dependency producing properties of the medication in light of your overall health. I have actually found practices like meditation, yoga, and swimming as a form of exercise to be far better than any drug I have taken in creating a sense of well being even though I am still in pain. The University of Massachusetts has a model stress and pain management program that was founded by Dr. Jon Kabat-Zinn. This process is taught in many locations around the country.

In terms of what medications to use, I really couldn't say, except to find a good pain management doctor (I had good luck at Stanford Univ. Pain Management Clinic) and see if the doctor can help coach you through. As you know, this is the pain you can't hide from, regardless of how much medication you have in you.

I've also heard good things about a urologist in Texas named Larry Lipschultz who has worked with several post-vasectomy pain patients. You may want to get a hold of him.
From: MH
Date: 7/21/01
Subject: Legal action

My frustration in dealing with the pro-vasectomy crowd has kept me out of circulation, until now. Congratulations on a great site. I would like to field the idea of formulating a class-action group (legal action). I would like to see accountability for damage due to misinformation.

Response: It is unfortunate, but at present one of the only good ways to get the attention of an industry that is causing a problem but making a profit at it is though significant legal action. I have found this to be the case in my situation and that of many others.

The problem in these cases however, is that the medical community essentially supports this lack of disclosure, as incredulous as that may sound. Community standards in medical practice will often prevail over what makes good sense. If the truth were really known, no one would have the procedure done, and all the surgeons would have to sharpen their knives on other body parts, or just spend more time at the golf course.
From: KW
Date: 7/19/01
Subject: Osteoporosis and low testosterone following vasectomy.

I have been reading the information on your website with great interest. I was initially searching for information on the failure rate of vasectomies, because now, 9 years after my husband's vasectomy, I may be pregnant.

My husband also has osteoporosis. The facts about the development of antibodies and the auto-immune response to them has me wondering if his vasectomy could be responsible for his development of this devastating disease at his young age of 35 years old?

I have contacted many doctors (both urologists and endocrinologists) that insist that his vasectomy has nothing to do with it, but it has everything to do with him having a mild testosterone deficiency.

I am tired of us being lied to. I pray daily for some upfront answers to this puzzling situation. I pray that I am not pregnant with a child we cannot raise. I pray for my husband to once again to have strong bones.

I suppose he was blessed with a pain free recovery. He thank god has had none of the PVP problems, or cysts... etc. But how in god's name could his surgeon have neglected to tell us of the possibility of the long-term consequences? It is criminal.

Thank you for getting the facts out there. I wish there were those as brave as you before we made the mistake.

Response: Thanks for you questions and comments. In the medical journal articles I have read, vasectomy failure rates are quoted anywhere from zero for the very cocky doctors (sorry about the pun) to up to six percent. That's a pretty wide range, and makes you wonder where the truth is. I know of at least four men who are acquaintance of mine in my local area who have experienced vasectomy failures with pregnancies resulting.

Also, vasectomy is known to produce antibody responses that attack sperm and testosterone producing cells in the testis, a condition known as autoimmune orchitis. Check out any of the references on the site by Kenneth Tung on the subject or search the Internet on the term autoimmune orchitis and you will see what I mean. Lowered testosterone levels have been know to lead to osteoporosis, as has long-term use of corticosteroids, like Prednisone. Ironically, Prednisone often gets prescribed for the kinds of inflammation that occur in post-vasectomy pain syndrome. Low testosterone is also sited often as a cause of erectile dysfunction.

The best way to test for sperm antibodies is with an immunobead assay blood test. This may be a good start in convincing doctors that you aren't making all this up. But then again, what do we know? It's only our own bodies that we are talking about.
From: SR
Date: 7/15/01
Subject: No problems three weeks after vasectomy

I just had my vasectomy 3 weeks ago. I was doing some surfing on the net and I ran across this site. I am pain free as of now. Because my wife is no longer able to take the pill I decided to go ahead and get the procedure done after our family physician recommended this urologist to us as he had the procedure. I hope that I won't experience any of the problems you've had. My wife and I are in our early forties. If I'd had any idea what the pill did to a woman's sex drive I'd have done this ten years ago. As of right now our sex life is as good as it was when we were newlyweds. The way you talked about the hormone imbalance I can only assume that would be affecting me now, it isn't. I'm glad I did this.

Response: I can certainly understand your motivation for having pursued a vasectomy in light of the health risks for your wife with continued use of the pill. This is actually what caused me to seek out vasectomy initially myself.

I'm glad to hear that you have not had any overt symptoms of problems from your vasectomy as yet. But be aware that most often the more painful symptoms of congestion and rupturing of the epididymis, followed by autoimmune responses, take some time to develop. Six months to a year is average, but I have heard of it taking as long as 15 years to develop. You need to remember that you have blocked one of the most prolific cell producing mechanisms in your body, and it will react in some way. Hopefully though, not in any way that causes you discomfort.

In regards to the hormonal changes that follow vasectomy, I'll quote from Mo et al, 1995 in the Journal of Urology: "We believe that vasectomy may influence serum androgen levels by reducing the conversion from testosterone to dihydrotestosterone in the long term. The influence on this conversion would be different in the early and late long term (many years later) after vasectomy. If increased testosterone levels in men who underwent vasectomy 20 or more years previously is confirmed, it could indirectly support the hypothesis that the elevated risk of prostate cancer after vasectomy was notable among men who underwent vasectomy 20 or more years ago."

So, you see, it's a bit of a time bomb, and you have joined the experiment, probably without being informed of such. I don't mean to be the prophet of doom, but this does give cause to take precautions to guard your health. Check out the post-vasectomy treatment options portion of the website, and some of the ideas there may appeal to you. Id be glad to add you to the mailing list to keep you informed of the progress of vasectomy related health issues.
From: No Name Given
Date: 7/14/01
Subject: Herbal treatment for Post-Vasectomy pain and swelling.

I've had complications from my vasectomy...dull to sharp pain and a swelling of the tube. I looked up the word for this. I looked up that word in my wife's herbology book...which led me to YARROW TEA. GET IT AT A HEALTH FOOD STORE. REMARKABLE RESULTS. PAIN GONE IN A DAY!!!! I DIDN'T BELIEVE IT WOULD WORK LIKE THAT............DRINK A COUPLE CUPS OF YARROW TEA AND SEE IF IT'S NOT SO. I've had three flair ups since my vasectomy two years ago... and yarrow tea has been a blessing. Tastes OK too.

Response: Are you sure you dont own stock in a yarrow tea company? Actually, my experience is that just about anything beats surgery and heavy medications to treat post-vasectomy pain and swelling, and if yarrow tea can help in some instances, bring it on. Id check to see if yarrow tea has any other effects on the body too. Thanks for the input, and let me know if youd like to be on the confidential mailing list.
From: E
Date: 6/4/01
Subject: Family member experiencing PVPS.

Thank You!
My brother-in-law had a vasectomy 25 yrs ago. Two years later my sister became pregnant and tests proved the vasectomy failed and was fixed again.
Today he is suffering from epididymitis and the doctor is heading towards a testicle removal.
I've been searching the net to find out more on the problem, my own little logical mind was saying...it's a result of that vasectomy. I thought nobody would agree with me!
I realize this is a long "time" result. But, he has suffered from kidney stones, urinary infections, lower back pains: for many years, and now a year's battle with infections and severe pain.
They asked him to submit to a pain center for various experimental treatments before the amputation is decided.
I'm greatly distressed over the cover-ups for medical mistakes and neglect.
What can one really do? Where is accountability and justice?

Response: This is important information to share. Many men experience the kind of long-term complications that you have described and doctors discount the connection with vasectomy. Here is one thing I have learned: doing more surgery to try to cure the pain that a surgery has induced often does not work. Those are not my words, but are the words of the pain specialist I have worked with at Stanford named Dr. Steve Mangar. Many of my other doctors have expressed agreement with this.

Many of the symptoms you mentioned, i.e. kidney stones, infections, and epididymitis have all been mentioned repeatedly in the medical literature as occurring more frequently after vasectomy.

Most of the journal articles that I have read say that castration to resolve pain will only work about half of the time. That's not a very good shot at relief when you will be missing body parts that have a significant affect on your health, hormone balance, and sexual self-image. I've had numerous doctors offer to remove my testicles to try to resolve the pain I've experienced. When I ask if they'd like to join me in the experiment to see if that helps my pain, the conversation usually concludes abruptly.

As far as what to do, keep telling the truth of what you have learned. Let's create a chorus about this so loud that even the American Urological Association will be able to hear.

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