this is not intended as a forum for medical advice, only discussion.
Vasectomy Forum Through 12-31-01
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Subject: Lots of symptoms.
About 3 months ago I had a rather painful
vasectomy (close-ended). Since then, I've had slight pain in urination,
lower abdominal pain, and occasional pain in my right testis. The various
pain seems random, but almost always constant. Urination strength is
halved, as is ejaculation strength. No blood in the urine has been found.
Doctors seem clueless, and suggest painkillers, which rarely help except
in insane doses (i.e. 800mg Neproxin) and only temporarily.
I figure I have one of 4 things:
epididymitis, one of 2 STDs (gonorrhea or chlemydia), prostatitis, or vas
deferens rupture. Seems most fixes are antibiotics, which the docs are
loathe to try (military docs). Any ideas?
Response: (from Dr. Lou Zaninovich) I would
say infection is definitely high on list of possibilities. Yes, it could
well be prostatitis, but not necessarily confined only to this area. I
would get a Micro, Culture and Sensitivity (MC&S) lab test of seminal
fluid on a couple of occasions. Also MC&S of urine: Mid-stream as well as
the first 5 mls. Probably does have some epididymitis. No doubt does have
rupture and leakage of sperm with sperm antibodies. Epididymitis could be
inflammatory [non-bacterial] or infective. I would NOT be loathe to try
antibiotics first. At least it’s a good way of confirming the diagnosis.
If he has high dose for few days, should note an improvement within 2-3
days. If that is so, I wouldn't hesitate to keep him on antibiotics long
term. These are just my thoughts of course and he MUST see a Doctor who is
willing to keep following him up until a solution is found. I would love
to know if he was the type of man who got pain/discomfort in the testicles
if he went for long time without ejaculating and how long was "LONG."
Would also like his full story for my records
Subject: New to the PVP experience.
I commend you for your website, it's shared
experiences, and information links. I am in my late 30's and did some
light research to see which would surgical procedure would be the better
alternative to conventional birth control - also weighing the pros/cons of
their potential after-effects.
The vasectomy was the obvious choice, at
the time, to avoid post-procedural pains and complications. My wife has a
very low pain tolerance and the hysterectomy or tubal ligation operations
would have drawn out the number of cold showers that I was already taking,
since she "closed shop" until one of us had a procedure. Neither of us
wanted to go through any discomfort during a healing process, but I opted
to go through with it even after reading about a number of the associated
health risks brought on from vasectomies. The experience was no big deal.
Although, during the left vas clip-n-tie, the initial tug should have been
an indication that things weren't going to be the same. Regardless of the
numbing that had been done, it still felt like someone was “pulling the
blinds open" up and through my mid-intestines. Well, two months
afterwards, I too started feeling the "cattle prod" jolts from my left
testicle up to the mid-pelvic/intestinal region.
I called and informed the Urologist (who
was nearing his retirement) that performed the procedure about my periodic
pains. He was too quick to reply that is was not from the vasectomy that
he performed and suggested that I consult my primary doctor. I laughed at
his response; (1) because I knew it was from the vasectomy and (2) I don't
have a regular doctor that I visit. I probably should get one so that I
have all medical records in one place. Anyway, I've let another month slip
by, thinking that pains will subside. They only happen 1-3 times one day
and I may not feel anything for another 2-3 days. I've also contemplated
calling one of the other urologists (birth control specialist too) in that
office who was originally unavailable for the dates that fit into my
schedule. I've talked with a few friends who have had this procedure done
over the last number of years and they've not experienced any difficulties
"yet". In light of the experiences that others have expressed in the
forums, it's unfortunate that a number of doctors don't inform or admit
about any of this up front.
Being that I'm a fresh victim, so to say, I
appreciate your view and suggestions to this common "post-vasectomy pain
syndrome" that's not as fictitious as the docs want you to believe.
Response: First, I wish you well in your
healing process, and hope that your pain doesn’t become more severe.
Getting to a doctor who is familiar with post-vasectomy pain syndrome and
can offer you a good assessment and treatment options is the first step.
Let me know where you are and I will try to get recommendations for you.
Subject: Pain and reduced ejaculate volume following vasectomy.
In addition to prolonged pain following
surgery, I now experience a SIGNIFICANT decrease in the quantity of
seminal fluid discharged during ejaculation. While this is not painful, it
is uncomfortable and greatly diminishes pleasure (a sort of "dry heave"
effect). I did not see this condition listed as an effect of vasectomy in
the literature I have read on this site. Have you heard of others
experiencing this also? If so, what would the cause likely be? I have not
yet sought medical attention to this out of embarrassment. Any info you
might have, or a direction you might be able to point me to would be
Response: (from Dr. Lou Zaninovich) I
haven't personally had such a case. Most guys don't notice the absence of
the sperm and epididymal fluid, as it doesn't make up a large proportion
of the ejaculate. The average ejaculate is 3 mls. 0.2 mls comes from the
Cowper's gland; 0.5 mls from the prostate and most (2+ mls) from the
Seminal Vesicles. These glands do require androgens for their secretory
activity. I would be looking at causes of reduction in prostatic and
seminal vesicle fluids. It is worth checking for chronic prostatitis. Also
worth making sure
there hasn't been a drop in testosterone and other hormones. Cheers, Dr.
Subject: Difficulty reaching orgasm following vasectomy.
I have reviewed all of the posts this far
in this forum, and would like some guidance/recommendations, and am also
curious as too how "typical" our symptoms are. Case is as follows: My new
husband (age 49) had a vasectomy 5 1/2 years ago in his previous marriage.
Said marriage was already at a shaky point, dissolved completely six
months later, and his subsequent sex life/dating was infrequent. Our
recent marriage is his first post-operative attempt to have regular,
frequent intercourse, and it just isn't working. We had no problems prior
to cohabitation; however, we were both busy single parents and had "real
dates" at most once a week. Now his desire is present, he is able to
consistently achieve an erection (though not always as hard as it should
be), but he is frequently unable to orgasm. He says it feels like it is
starting, but then stops and nothing is ejaculated. There is no pattern I
can see on the success side in terms of time of day, after a meal, a
night's sleep, etc.- it is completely random when it will work. The only
consistent feature is that it is only possible every 7-10 days. He is in
good health, ideal weight, non-drinking and non-smoking, and has been
examined and pronounced okay. He was told it was an age thing, which he
won't accept, and neither will I based on my own personal experiences of
dating before him. He has also suffered several minor illnesses since,
colds and flus and such, after 45 years of never a sick day. We are at a
loss now on how to proceed. I have tremendous faith in herbal remedies,
and have used such myself with great success and avoided my 1st and 2nd
received opinion of necessary hysterectomy, but am afraid to try anything
with his problem which will result in more sperm with no where to go. Is
there a legitimate referral organization for a reversal practitioner?
Also, are there any well-received books on post-operative rehabilitation
to stabilize hormone levels, etc.? Thank you in advance for any help you
Response: (from Dr. Lou Zaninovich) “I
don't have all the answers here either. It is a fact that during
ejaculation there are rhythmic contractions of the vas deferens. The vas
is a thick tube with three layers of thick muscle around it and these
muscles contract vigorously, so it is not surprising that cutting the tube
in half would interfere with the natural progression of the contraction. I
still remain surprised that there are not more problems after vasectomy.
“YJ's comment on herbal remedies is worth following up. There are
conflicting reports but Yohimbine in some reports has been a great help in
dysejaculation. I recently read that cyproheptadine can also help.
However, another herbal remedy worth trying is Tribulus Terribilis. This
has proved to be effective and it does increase androgen production.
Again, it’s worth checking testosterone levels, especially in view of his
reduced immunity to minor illnesses. Yvette doesn’t' need to worry about
increasing sperm production as testosterone treatment will actually
decrease production. Again, check for chronic prostatitis. This can be
present with very few symptoms. Dr. Lou”
In subsequent correspondence, Dr. Zaninovich shared the following:
“I came across an article which follows on what I sent before. In summary
it was stated that:
“Chronic prostatitis is not a rare disease in male adults. Its causes are
still uncertain. The clinical symptoms of the disease are variable and
non-specific, but its effect on sexual function including erection
dysfunction and premature ejaculation are being emphasized by clinical
“In a review of 120 cases of chronic prostatitis which included bacterial
prostatitis and non-bacterial prostatitis:
The average age was 32.
85% of patients had complaints of various erection dysfunction and
25% presented with the main complaint being sexual dysfunction
“Note they say the cause is uncertain.
There was no investigation into how many of these had had a vasectomy. I
reckon that vasectomy increases risk of infection (Well, I not only
reckon, there is proof of this: you have blocked off a duct and you have
created a blind ended duct - in any other part of the body this is an
invitation to infection!).
“My contention is that in post-vasectomy
problem cases there is a lot of chronic prostatitis and or chronic seminal
vesiculitis, either bacterial or non-bacterial, maybe associated with the
immune reaction of sperm antibodies. The article is interesting in the
number of cases that had no other symptoms except ejaculatory problems.
Cheers, Dr. Lou”
Incidentally, YJ, your email address did
not come through on your original message, so if you would like to
correspond directly, send a message to me at firstname.lastname@example.org so I
can reach you more directly. Kevin
Subject: Thanks for the warning.
I'd like to thank-you for putting up this
website that shows the con side of the vasectomy issue.
I have been considering having a vasectomy for some time now, and all of
the information that I came across was always positive... probably written
by the Dr.'s who make their living doing this procedure.
The usual mention of side effects such as
those talked about on your website is that they are "rare". Ditto the
statement... "I trust doctors about as much as I trust a politician." But,
I still hadn't read, nor heard anything negative about the procedure... so
I was about to set an appointment to have the procedure done on myself.
I had one further question, though, that
never really seemed to get answered: "What happens to the sperm after the
tubes are cut? Where does it go?" This question seemed natural to me, yet
I have only gotten vague, or hazy responses to that question, nothing that
I was satisfied with. In researching the answer to this question I came
across your terrific website.
Your website answered this question
completely and in a way that I had not considered. But it is the best,
most logical, and most understandable real answer I have come across.
Knowing this answer, and seeing all the other information on this website
probably kept me from making the biggest mistake of my life. For my
health, the risks just are not worth it...
Thank god I found this website....
Please keep this information out there. All
men deserve to know this side of the story before undergoing a surgical
procedure such as this. Thank-you, thank-you, thank-you...
P.S. The nerve damage information is
something that I had never considered. This area of a mans' body has some
of the most sensitive nerves... Never before have I seen anything that
addresses these possible side effects. But it makes perfect sense. Thank
God I found this website.... Keep up your campaign.
Response: This is exactly why I created the
web site to begin with. I asked many of the same questions you did, and
was given misleading information in response. Unfortunately, I didn’t have
the benefit of the other side of the issue at the time, and like many
others made an ill-informed decision that has cost me dearly. The more you
can know about the real effects of vasectomy before the procedure is done,
the more likely you are to make an informed choice that is in your best
interest. Then you are less likely to be one of the guys writing in about
the problems he is having and how hard they are to cure, and ticked off at
the same time because he never knew it could be so bad. These issues
really are amazingly simple, but the shroud of deception that has covered
them for years needs to be lifted. That’s what our efforts in this
direction are about. Hopefully, in the process, more guys (couples, for
that matter) will be able to know what they’re getting into beforehand,
and for those of us who are already in the soup, we can help each other to
develop cures since modern medicine is hard pressed to do that for us.
Subject: Getting coverage for a reversal.
I am 39 years old and have had
post-vasectomy pain for 2 years now although there is not as intense pain
as before, it is still quite bothersome. I had a conversion to open-ended
vasectomy one year ago with little help to me. I am on Ativan, Serzone and
Ultram to manage my physical and emotional symptoms. I had acupuncture and
chiropractor treatment with minimal to no success. I read the long list on
this web site of the horrible potential consequences besides pain that can
happen. Can most or all these things be eliminated by a reversal? Seems
logical. Is there any way to get an insurance company to cover it?
Response: Insurance companies will often
try to claim that a reversal is not “medically necessary” and deny
coverage, even in cases of chronic post-vasectomy pain. My experience is
that you have to keep on them and keep working your way up the ladder, and
even threaten to sue, if necessary, to get coverage. Even a reversal does
not end the autoimmune response to vasectomy, which is why several men,
including myself, have tried testosterone therapy to mitigate the
reactions that continued sperm production causes. I’ve described this in
detail elsewhere in the forum, but the idea remains: mitigate the
autoimmune response, then put the equipment back together as originally
intended. I wish you well.
Subject: Vasectomy reversal to relieve six years of pain.
I have just done my vasectomy reversal 3
days ago. So far, I am lucky. The pressurized pain was gone the moment I
woke up from the operation. There is pain in the areas where the surgery
took place. But that is the last thing I am worrying about.
I am expecting a successful operation. I
want to express my appreciation to Kevin for having this Web site. I would
like to share everything about the nightmare following my vasectomy for
the last 6 years. My intent is to prevent this from happening to others
and help the other men to have a much better life. Thank God that I did
the reversal. Will tell more a month later to be sure.
Response: I’m glad that your experience
with a reversal for the relief of pain has been good so far. I had a good
amount of relief of the pressure associated pain as you mentioned after my
reversal, but the pain came back after a few days. This is what led me to
the use of hormone therapy to reduce my sperm production for the last year
and a half in an effort to reduce the aggravating influence of sperm
retained in the body. Interestingly, as my sperm count went down, the
autoimmune response I was experiencing decreased also, as did the
swelling, hydroceles, and epididymal cysts that had formed. For me this
has made evident the need to treat the nerve injury that has been the
major source of pain for me. However, I am convinced that many of the men
who have written to this forum are experiencing significant ruptures,
autoimmune response and pain such as you have described, and that the more
severe nerve damage pain is more rare, albeit harder to treat. If I had it
to do over again, I would have done the hormone therapy first for a period
of time and then had the reversal done to reduce the autoimmune reactions
in my body before having another surgery that causes those reactions to
increase. I hope you continue to experience good results from your
reversal. For reference of the readers of this forum, I had previously
suggested that DT contact Dr. Robert Kessler at Stanford University Pain
Clinic (650/725-5546) to consult about the possibility of a reversal. Dr.
Kessler subsequently performed the surgery.
Subject: Long-term complications after a vasectomy.
I had a vasectomy back in 1971. The
motivation was that I had fathered 6 kids by the time I was 35, several of
whom I had to pay child support for as a result of divorces. In my 60s I
began to have uro-genital problems including prostate cancer and currently
bladder cancers. I have been advised that I also have gallstones. I was 41
when I had my vasectomy. Until I had the operation I never had any
discomfort with the uro-genital system. Since then I have high sensitivity
to bumps in the groin. If a man was to ask my advise about vasectomy today
I would definitely say NO. In this day and age with so many birth control
options it's crazy for a man to take such a risk. I feel confident if I
hadn't had the procedure, I wouldn't be suffering today.
Response: Many doctors would blame the
problems you have experienced on factors other than your vasectomy, but
reams of research over decades has pointed to exactly what you are writing
about: links between vasectomy and the increased incidence of numerous
maladies, including several forms of cancer. The crime is that not only is
this data available, but it is nearly always withheld from patients prior
to the procedure because doctors just don’t think that this type of
information is a big deal or they try to dismiss it as invalid. That is
until the results of doing a vasectomy make someone an invalid, and then a
lawsuit might get their attention. It is a strange world we live in.
Thanks for sharing the truth of your experience.