this is not intended as a forum for medical advice, only discussion.
to vasectomy for birth control
I really enjoyed my
conversation with you by phone yesterday. I am truly sorry that you have
been 'part of the experiment,' but am very thankful for the good that is
coming of it due to your research efforts and willingness to speak out. I
don't know if you are familiar with Natural Family Planning (NFP). It is a
form of birth regulation that is scientific, inexpensive, can be used at
the 99% level of effectiveness to postpone or achieve pregnancy and there
are NO harmful side effects. Plus, it is completely reversible at any
time. When recommending birth regulations on your website, you may want to
include this one, as there are no harmful side effects.
I have read scientific
articles stating that the condom (which seems like a harmless little
device!) can cause early miscarriage due to the fact that the woman's body
does not recognize the sperm initially and attacks the newly conceived
baby. But, with repeated exposure to the sperm (which you won't get with a
condom) her body learns to recognize the sperm as a 'friendly.' So, any
form of unnatural birth regulation device is going to have some kind of
The Couple to Couple
League has a lot of really good information on all forms of birth
regulation and is in the forefront in the Natural Family Planning
movement. Their website is: www.ccli.org
Good luck, God Bless and
keep up the good work.
you for your feedback and the information. I hadn’t heard or read any
information about negative side effects of condoms, other than failure, of
course, but that is interesting information. I actually included a
reference to the Couple to Couple League web site in my book, and discuss
natural family planning as an alternative. It has been my experience both
personally and in reading the research on the subject of birth control
that surgical sterilization for either men or women causes the most
significant long-term reactions in the body, followed by any chemical
(hormonal) form, and finally that the use of barriers leads to the least
reactions. This makes me wonder if the type of reaction you speak of
would be less prevalent with a diaphragm. Any input or other references
on the subject would be useful since most of the people accessing this
site are concerned with contraception to some extent. My take: Natural
Family Planning is a great idea if you let your head do the thinking for
you consistently, and not just your desires.
Subject: What Happens
To a Man After a Vasectomy
I would like a copy of
your article "What happens to a man…." My husband had a vasectomy 2 years
ago after deciding 9 children were enough. A lot of the side effects you
have described he has had. Thanks
Response: You can get a download
of this document at
http://dontfixit.org/files/What_Happens_to_a_Man.pdf, or through the
homepage itself. By the way, if you would like direct responses to your
emails instead of waiting for the messages to be posted, please give your
email address when you post your question or comment.
Subject: How to get
If It Works, Don’t Fix It book
How can I get a copy
of your book?
Thanks for asking. Did you ever start off with an idea and then find that
some of you basic presumptions were backwards. I have. I started this
web site assuming that it would be an adjunct to the book. What I have
found is that the web site is getting 3-400 visits per day and the volume
of work for the web site has slowed the progress of publishing the book.
I have sent the If It Works Don’t Fix It: What Every Man Should Know
Before Having A Vasectomy manuscript to a few editors, most of whom
think the market is too small. I find this hard to believe when this can
be an issue for up to half of the population given the equipment
discussed, and the other half of the population who is in relationship
with us, but everyone is entitled to their opinion. I have turned my
focus now to completing some updates and revisions to the book, and plan
to send it to more publishers in the near future. If that doesn’t work in
a reasonable timeframe, I’ll self-publish over the Internet to get it out
and available. In the meantime, if a manuscript copy would be of benefit
to anyone needing the information, I’ll be glad to send one, just ask, and
make sure I know how to get it to you.
I am a 26-year-old male
who had a vasectomy on April 13, 2001. After the procedure my penis
swelled up to the size of a coke can and was black from the base to the
head. My nut sack hung to my inner thighs, and my butt cheeks were
bruised. My wife called the doctor the next day and told him what I
looked like it told me that was normal and that I needed to go back to
work on Monday. I did what the doctor told me and my work sent me home
because I could not stand and I was in so much pain. I called the doctor
again and he said that it was normal. After a few weeks I went and seen a
urologist against the wishes of the doctor (my Primary Care Physician who
performed the vasectomy) and the urologist did exploratory surgery on me.
He laid my sack wide open he removed a water sack and a bunch of other
stuff. He treated me for about 3 months giving me every thing from
Loretabs, to Perkiset. He then told me it was time for me to go back to
work, and that the moving around would get rid of the pain so I did what
he said and I was in so much pain that my work sent me home again. Both
of the doctors I had seen up until this point were affiliated with the
Baptist Health. My wife told me she wanted me to go see a doctor that was
not affiliated with the Baptist Health System, and my made me an
appointment with a different urologist when I went to this doctor he told
me immediately that I had permanent nerve damage. He knew this from the
ultrasound that the last urologist took just the week before. The first
urologist had told me that nothing was wrong, and the second urologist
came up with the conclusion that I had permanent nerve damage, and said
there was nothing that he could do and sent me to a pain management
doctor. The pain magnet doctor has given me 3 spinal injections and a
trial spinal cord stimulator put in me. Next, week a neurosurgeon will be
putting a permanent spinal cord stimulator in my back from the #10 to the
#2 lumbar. I will have to carry a little pager like thing that will give
me electric shocks. If I don't do this then they will burn the nerve out
and I will loose all control of being able to use the bathroom, and have
sex. I am currently taking Neurontin, and Oxycontin (this drug is all
over the news because of how highly addictive it is also it is used for
terminal ill cancer patients) and these drugs have helped to make me be
able to walk, not upright, but walk. I have a 7-month-old son that lives
with me, and a 4-year-old stepson with whom I am not able to play. My
wife and I got married in July and I was sick. Do you have any idea what
I am going through? I feel like I am the only person in this whole world
who feels like this. I would love to be able to talk with someone else
who has some idea of the pain that I feel both physically and mentally.
There is much more to this story but I was just trying to give you the
small version of it.
off, you are definitely not alone, as the testimonies of so many men
writing to this forum will demonstrate. The kind of pain, procedures,
drugs, and frustration you have described are far too common. My message
to you is this. Keep working on finding the best way to cure the cause of
the nerve pain you are experiencing, not just to cover it up. Painkillers
and spinal cord stimulators are OK if you can be functional with them, but
they don’t deal with the cause of the pain, they just mask the symptoms in
various ways. I’m well acquainted with this dilemma since I deal with it
daily. The two doctors that I know of who offer the most promise in this
regard are Dr. Connie Haber in Pittsburgh (412/372-7900) who specializes
in “photon therapy” that has been shown to be quite effective in helping
to heal damaged nerves in a non-invasive manner. Also consider talking to
Dr. Lawrence Levine in Chicago (312/563-5000) who has written the most
comprehensive information I have found on this type of nerve damage and
the surgical treatment for it, that is if you are willing to consider more
Subject: Pain and
depression for four years after vasectomy
Dear Kevin, firstly,
thank you for providing such a site for us men out there with problems
that seemingly no modern doctor can fix. It is comforting to know that
unfortunately I am not alone in the development of adverse symptoms after
having a vasectomy. Can you please consider the following information?
Vasectomy 4 years ago and subsequent reversal 1 year later due to the
Pain in left testicle and pelvic region
Reduced ejaculate and shooting power (this is the biggest problem!!)
Recently white blood cells found in prostatic fluid (DIFFICULT IN GETTING
Recently, frequent urination but no blood or pain
I have seen numerous
doctors and natural healers, over the past 4 years and none can identify
my symptoms- it is in your head?? Well, I was fine before the vasectomy
operation so what has happened?? I seem to have...? Symptoms of an
infection of some type. Can an operation cause an infection of the
prostate or vas deferens for that matter and can an infection last for 4
years? Can this infection reduce the volume and shooting power of
ejaculate? Are there others out there with similar problems? Can you shed
some light on this matter for me and suggest possible treatments?
Thank you for listening.
Maybe others have found some cure.
Dr. Lou Zaninovich)
Jeff: Yes, you are more likely to get an infection after vasectomy, more
so than after other types of operations. I would have thought, though, it
would have been evident even before the reversal.
Your present symptoms of
frequency + white cells in the prostatic fluid does suggest infection.
Depends on how many white cells. Was the fluid cultured for bacteria?
Cultures should be done aerobically and anaerobically (anaerobic bugs are
bugs that only grow where there is no oxygen so you may not pick them up
on normal cultures).
Usually infection in the
prostate causes pain at the tip of the penis and when it is examined with
a finger it is quite tender. Infection of course could be higher up in
the seminal vesicles or in the epididymis: are you tender on top of the
Yes, infection could
affect your ejaculation mechanisms. Yes, prostate infections are
notorious for being chronic and can persist often intermittently for
years. Yes, other guys do have problems; Kevin can vouch for that.
The depression could also
be related. One of the common symptoms of low testosterone levels is
depression. There have been cases where the damaged testicle, post
vasectomy has been found to produce less testosterone. Have you had your
total testosterone and free androgen index tested? Even if these are
normal unless they are high normal it is worth a trial of Testosterone
Therapy in case it is causing the depression.
Depression of course can
also be due to other causes. If there is a family history of depression
then better treatment would be anti depressants such as Prozac (SSRI type
Please note I am only
thinking aloud and you can only accept medical advice by a Doctor who has
obtained a full medical history, full examination and blood tests but it
is something to go on.
Let me know how you go.
Subject: Still in Pain
I've posted here before. I am 45, had a vasectomy just over
4 years ago by a general doctor. After a year of pain, I followed my
urologist's advice and had an epididymectomy. The pain after that was
worse than before. Sometimes there is no pain, more often there is mild to
strong there pain, and sometimes the pain is strong enough that it
severely impacts me and I take Vicodine. Depending on the month, I take
anywhere from 6 to 20 Vicodine. I start with one, but it usually takes two
to kill the pain now. Recently I went to a pain specialist. First he tried
me on Clonidine, a high blood pressure medicine. It did nothing for the
pain and I could not sleep while taking it. I averaged 3 hours per night
waking every 20 to 40 minutes. Next he tried Zonegran, a medication for
epilepsy. I had slurred speech, and it did nothing for the pain. Next was
a nerve block using Femoral. The two days after, I had no pain most of the
day, but when I did have pain, it was very intense, more than usual. The
following week I had more pain than usual. He now wants to try Phenol 6%
solution. This strips the outer layers of the nerve, supposedly stopping
the pain sensation going to the brain. He said it may take 1 to 3 times to
work but I'm a good candidate for this. Obviously, I don't want to do this
because I haven't had good luck in the past. I'm trying Quercetin 500mg
twice a day. Once in the morning and one at night. Doesn't seem to be
helping. How much did you take when you used it? After the Quercetin is
gone, I'm going to try the Wobenzym. It says to take 3 pills twice a day.
Did that amount seem to work for you or did you take a different dose? If
that does not seem to help, the next step is to see another doctor down
or up to S.F. Who would you recommend seeing first?
In regards to your
questions, since your pain comes and goes, I would normally investigate a
reversal first, since most of the guys who I've talked to that have had
success with reversal had that type of cyclical pain. The epididymectomy
you had makes this impossible though, which is why I cringe every time I
hear of a guy going down this type of path of no return. You cant put
parts back in once they’re out, and many surgeons don’t consider this.
Treating what must be
injured nerves is a likely path to pursue. I can make several
recommendations in this regard: Dr. Steve Mangar (831/751-3334) is a pain
specialist now in
who has been quite helpful to me. Dr. Robert Kessler at Stanford Urology
(650/725-5546) was quite helpful to me in confirming the neuropathy
diagnosis. I will be seeing Dr. Lawrence Levine in
Chicago (312/563-5000) soon to discuss the possibility of eventual
nerve stripping of my spermatic cords, since he is arguably the most
expert doctor on the subject. Prior to pursuing any further surgery,
however, I will be seeing a Dr. Connie Haber in
for a course of “Photon Therapy” which is reputed to be a very effective
treatment for chronic nerve pain.
If it were me though,
before contemplating any surgery I would try six months or so of hormone
therapy first if your system can tolerate it to see if lowering your sperm
production helps to mitigate the symptoms, before cutting you open in any
way and potentially starting another inflamed episode of autoimmune
response. Take my word, that kind of reaction is not fun and can
immobilize you for months. I know, I've lived it, and I’m sure you can
relate. Dr Werthman (310/277-2873) has been very helpful with me in
regards to the hormone therapy, and has a good handle on the combinations
of initial anti-androgen, plus Androgel or other testosterone therapy to
follow on a regular basis. Philip Werthman is also the best man I know to
see about a reversal, even though that is not applicable in your case.
My experience with
the nerve blocks is that they may have good diagnostic value, but have had
no lasting effect beyond several hours and, in fact, tend to aggravate the
already traumatized nerves for at least several days afterwards. Pain
medications may make life more bearable, but they only cover symptoms and
don't promote healing. You have to consider the dependency and addictive
properties of whatever you are taking, too. In the words of my dentist
when I told him about what medications I had to take regularly, "They're
all selective poisons," which is why you can't eat them like food.
Quercetin has had good results in treating prostatitis in the studies I
have read, but as for post-vasectomy pain syndrome, neither the literature
nor my personal experience has given any indication of long-term benefit.
However, as an anti-inflammatory, Quercetin and Wobenzym are as good as
you can get for natural substances that can be easier on your system than
Subject: Considering a vasectomy
have read several months' worth of posts and have searched the Web fairly
extensively, so I have a firm grasp on the issues: if I have a vasectomy,
open-ended or otherwise, there is a high likelihood that I will develop an
autoimmune response as the sperm enter my bloodstream. Various side
effects can occur as a result of the antibodies my immune system throws at
these perceived "invaders", right?
As I consider my upcoming appointment for my vasectomy, what I really want
to know is - what are the numbers? In what percent of patients do problems
develop, how many years in the future, etc.? Without these data, stories
like yours and the others on this site, while certainly regrettable,
really are merely anecdotal, in that they cannot be compared to the
"larger picture" of the whole set of patients undergoing this operation.
It's like the warnings on medications - some percent of women taking birth
control pills experience major side effects...but most take them with
little or no problems arising. So rather than considering only the
real-but-minimally-likely risks, I believe a fully informed consumer must
also consider the probability of harmful side effects.
I agree with you that the medical industry tends to minimize the harmful
potentials of most (if not all) of the procedures and drugs they sell to
the public, and then they tend to deny culpability when their
almost-mystical beliefs in the dogma to which they blindly adhere prove to
be erroneous. I trust doctors about as much as I do politicians. What I
do put my trust in is the methodology doctors claim to follow – science.
Maybe vasectomies cause severe problems often enough that they should be
discontinued completely, as with so many procedures lauded by doctors
throughout recent history as “scientifically proven”, like circumcision,
lobotomy, or the gender-reassignments at Johns-Hopkins. And certainly I
agree that a procedure should be proven to be safe before it is allowed to
be performed indiscriminately, and yet the opposite often occurs.
However, since vasectomy is obviously performed on a vast scale, surely
somewhere numbers of reported complications have been assembled?
I don’t want to appear dismissive of your plight, or of the difficulties
many others have experienced; I just want to know my own odds of
experiencing those same risks as I consider undergoing this procedure.
Thanks for caring enough to have provided a thought-provoking and
Response: I appreciate your well thought out questions and the
concerns you have about what is "real" in this situation. It has taken
two years of research for me to determine how a man in perfect health,
such as myself and many of the others who have written to this web
site, could go in for a "simple" vasectomy and end up as a chronic pain
patient. Rather than telling stories, though, let me quote the figures
from the medical research on the subject. If you would like assistance in
obtaining any of these journal articles for your further reference, just
let me know:
Urologists know that
pain is men’s top concern in considering a vasectomy (ABC News, 2001),
yet men have consistently “experienced more pain and discomfort during
and after the procedure than they had been led to expect by the
operating surgeon” (Campbell’s Urology- 6th edition; also Li et al,
1991). This was certainly the case in my procedure(s).
Urologists know that
pressure build up and congestion in the epididymis following a vasectomy
will almost certainly lead to “blowouts” in the epididymis and or vas
(Campbell’s Urology- 6th edition; also Shapiro et al, 1979). Knowing
this alone would have been enough to cause me to reconsider the
Urologists know that
75% or more of men will develop autoimmunity to their own retained sperm
cells following vasectomy (Campbell’s Urology, 6th edition; numerous
other articles quote autoimmune reactions occurring in as high as 84% of
vasectomy patients). Doctors will often dismiss this as no big deal
saying that this reaction is "harmless," but then again it's our bodies
the reaction is happening in, not the doctor's, isn't it? This
autoimmune reaction can be life-long, and there is no proven way to stop
it, short of removal of the testicles, which may be offered to you
repeatedly if you start having problems.
Research has shown
that the likelihood of developing an autoimmune reaction can be
predicted by a pre-vasectomy sperm count test (Linnet et al, 1977). So,
the more fertile you are, the more likely you are to have a reaction.
What can't be predicted though is exactly how you body will respond. A
good deal of research has been done by Dr Kenneth Tung and others
regarding vasectomy creating a condition known as autoimmune orchitis,
which is a degenerative disease of the testicles.
It is commonly
quoted in the medical literature that up to 1/3 of men have experienced
some degree of chronic testicular discomfort following their vasectomy (Choe
et al, 1996; also McMahon et al, 1992), some estimates go as high as 70%
(Levine et al, 2001). Choe et al, 1996 also found chronic testicular
pain to be the “most common post-vasectomy complication that may
adversely affect quality of life in men undergoing vasectomy,” and “the
high litigation potential of this procedure warrants thorough counseling
of factors that may affect quality of life.” Similar warnings are found
repeatedly elsewhere in the literature. No such discussion ever took
place in my case, despite the fact that “Pain syndromes, in general,
frustrate all physicians” (my original urologist, New Times, 2/8/01),
not to mention the frustration the pain causes the patients. Chronic
testicular pain following vasectomy can start days, months, or even many
years after the procedure.
protocols exist for either the treatment or diagnosis of post-vasectomy
pain syndrome, and physician knowledge of this condition, even among
urologists, is surely lacking in many cases. Beyond this, it is not a
subject that urologists like to discuss openly, often due to the
responses are to be expected following vasectomy. Sperm granuloma form
in up to 97% of vasectomy patients (Shapiro et al 1979). Vasitis nodosa
has been found in 66% or more of vasectomy patients (Taxy et al, 1981)
and has been shown to contain various qualities of benign tumors.
Painful traumatic neuromas have also been found in cases where vasitis
nodosa was present following vasectomy.
Hormone and sperm
production are affected by vasectomy (Carruthers, 1996), despite the
numerous claims you will hear to the contrary.
Nerves are commonly
cut during vasectomy (Pabst et al, 1979), and there can be damage to
blood and lymph vessels (Carruthers, 1996). The facts and ramifications
of this were surely not made clear to me, and this has been the major
source of neuropathic pain I have experienced.
commonly led to behavioral and psychological changes in 1/3 or more
of men undergoing the procedure (Vaughn, 1979).
Vasectomy has been
repeatedly linked to increased incidences of numerous serious diseases,
including prostate cancer. The controversy surrounding the prostate
cancer issue continues, but when Bernal-Delgado et al (1996) reviewed 14
studies on the link between vasectomy and prostate cancer, 11 of those
studies found a link to increased incidence due to the procedure.
Despite this, you will find numerous protestations within the urology
industry that there are no proven links. You'll have to look at the
evidence for yourself on this one and make up your mind.
Failure to disclose
these and other facts regarding vasectomy, both verbally and in writing,
is a common source of litigation following the procedure when
complications set in (Preston, 2000).
Does that give you
enough to go on? There is a lot more, and if you would like a copy of my
book, If It Works, Don't Fix It: What Every Man Should Know Before
Having A Vasectomy, I'd be glad to offer you a copy if you want to
delve deeper. I hope this information helps you in your decision
process. If you do decide to go ahead, let me know what the results are.
Subject: Treatment options
have looked over your web site with great interest. I wish I had known
this information 10 years ago before I got my vasectomy. I saw a couple of
mentions to a form of self-testicular massage to alleviate pain, but I
didn't find a description of it. Could you point me to a description?
Also, could you point me to more information about the "testosterone
treatment" that is mentioned a few times.
Response: The information on testicular massage is available in the
article on post-vasectomy treatment options. You'll find the link near
the bottom of the
www.dontfixit.org home page. The descriptions are accompanied by
diagrams that are sure to make you wince if you are in pain, but the idea
of this still beats surgery.
treatment I pursued has been the use of 7.5gm of Androgel daily to get my
sperm count down to zero and ease the aggravation that sperm production
causes on the immune system and the tissues that get attacked
subsequently. This has actually been quite successful so far, and I would
be happy to discuss the idea further. You'll probably want to consult an
endocrinologist about this in conjunction with whatever urologist you can
talk into the idea if you want to pursue it. I can give you several names
if you need.
Subject: Two years of pain after vasectomy
After much cajoling, my husband had this procedure 2 years ago. He used
to say, "My soul shrinks at the thought of a vasectomy." I wish I had
listened. He has been in constant pain for 2 years, although, sometimes
much more severe than others. This pain has caused him to feel
"emasculated." It has ruined a great sex life, and has ruined our 17-year
marriage. No one we've spoken to (urologists) have patients that have
successfully been treated. We have no idea how to proceed and find
someone who can help us. We live in Atlanta and are desperate for some
help. My husband seems to think reversal is the answer, but the urologist
says no; he doesn't think that is going to make any difference. Any
advice would be very appreciated.
Response: You will get mixed opinions about surgery to mitigate
post-vasectomy pain syndrome. Many pain specialists I have consulted with
say that more surgery to correct the damage that was caused by a prior
surgery is a highly questionable course of action, and that it is just as
easy to end up in more pain as to relieve it. Their premise is that once
a body is traumatized in a particular area, re-traumatizing the same area
is not good. My experience with the reversal I had done would back this
up since I became fertile again, but in enough pain to where it really
didn't matter, if you understand my meaning.
Many urologists will propose various surgical solutions, since that is
what they are trained to do, some better than others. Of the men that I
have had contact with, those with delayed onset of pain, weeks, months or
years after their vasectomy, seemed to respond best to reversal of their
vasectomy to relieve the pressure build up and ruptures that resulted.
Many have had to have the more involved version of a reversal, called a
vasoepididymostomy, because the rupturing was extensive enough to need to
be bypassed in reattaching of the vas.
The other popular surgical solution proposed by many urologists is
surgical denervation (nerve-stripping) of the spermatic cords. Be
forewarned though, more than just the nerves are removed, including the
vas, lymph vessels, cremaster muscle, veins, and any other connective
tissues. This has a claimed high success rate for men with nerve damage
pain from their vasectomies that started immediately after the procedure,
such as I have experienced, but it is a path of no return, since once the
parts are gone, they're gone whether it fixes the problem or not.
In regards to who to
contact for more information, Dr. Mike Witt in Atlanta has been
recommended by one of the men contacting me. Dr. Philip Werthman in Los
Angeles (310/277-2873) would be a good contact about the prospect of a
reversal. Dr. Laurence Levine in Chicago would be a good contact about the
prospect of surgical denervation. Dr. Levine has also authored several
medical journal articles on the subject, which I would be glad to share
with you in addition to articles on the subject of reversals for relief of
Subject: Running out of options to cure pain.
I had a vasectomy in the
Nov 1999, and have had chronic pain in my right testicle ever since. I was
not told about the possible pain side effects of this operation. I was
told that there was no link between a vasectomy and prostate cancer.
Within days suffered from an infection, then later had a granuloma
removed. One year later I had my epididymis removed and have recently had
a nerve block. None of these procedures have relieved the pain.
I have positively refused any more surgery. It was suggested I have the
testicle removed! My research on the net and my pain specialist have
changed my mind.
I am now following alternative paths. Can anyone make any suggestions? I
read somewhere reflexology or acupuncture may benefit?
If I can be of any help to anyone, please pass on my e-mail address.
Response: The article on post-vasectomy treatment options is available on
the home page of the web site for your reference. You have already been
through many of the surgical options that are listed, and I don't blame
you for not wanting to undergo any more procedures.
In the article on post-vasectomy treatment options, you will find a list
of several alternative therapies including yoga, massage, and an
acupuncture protocol that may be beneficial. Here's wishing you the best
of luck in treating your condition.