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

From: GG
Date: 11-25-02
Subject: Reversal and autoimmunity

Does the autoimmune response [to vasectomy] resolve itself at some point with a reversal? Have you found anything to speed the process up?

Response: Most of the written research on the subject says that a vasectomy reversal will cause at least a temporary increase in autoimmune response in the entire body since the system exposed directly to sperm in the process of the surgery and the blood-testis barrier is breached again in a significant way. For myself, I found this to be true, but as time went on the antibodies in my bloodstream diminished. My guess is that this is common. However, the immune system continues to manufacture sperm antibodies after a reversal which will now cross the blood-testes barrier and attack the sperm and hormone producing cells in the testes directly, which is claimed by some to be the cause of early testicular dysfunction and "andropause," or “male menopause”, including such outward signs as “hypogonadism”, low energy, moodiness, and erectile dysfunction. Long-term inflammation and tenderness of the testicles is also common after vasectomy and even after reversal. The presence of these antibodies in the genital tract, and, in turn, on the sperm, is believed to be a major reason why men have difficulty impregnating their partners despite a "successful" reversal. Also, the scar tissue that forms as a result of the autoimmune processes is thought to be responsible for the eventual failure of many reversals since the vas and surrounding tissue harden and close off. For more, read Dr. Carruthers' book noted on the publications page of the web site. The only way I know of to mitigate this long-term autoimmune response is to use some form of testosterone therapy to decrease sperm production and, in turn, decrease the aggravation that the immune system reacts to. All other approaches treat the symptoms, not the cause. Actually, there is another way: remove the testicles, but that is really not worth discussing, even though my original urologist mentioned it to me numerous times. Maybe he was into that sort of thing. Dr. Carruthers discusses the use of testosterone therapy for vasectomized men and the success he has had in doing so, which reflects my own experience. There are also several medical journal articles from studies conducted by the World Health Organization about the use of various testosterone therapies to decrease sperm production. If you are interested, I can get you a copy.

From: JE
Date: 10-10-02
Subject: To reverse or not to reverse

Kevin, Thank you for taking the time to talk with me the other day.  I'm going through a real tough time right now and to find your website after the fact, just gives me one more thing to worry about.  I would like to know what percentage of men who have had a vasectomy experience problems from this procedure?  I have a brother in law who is in his 50's, had the procedure done 20 years ago, and has had no problems from it.  I do occasionally have a sharp pain on the right side which I thought would go away after a while, but after six months has not gone totally away.  Also, is an autoimmune response inevitable, just a matter of time?  Or is it a percentage who will have this problem?  I had my vasectomy done in Washington State, paid for by the state, but they sure don't give you any information other then it's a "harmless" and "simple" procedure. Not even the fact that a reversal is much more complicated and will cost ten times as much!  You mentioned you could provide me with the number for Dr. Neil Pollock in Vancouver?  I appreciate all your help, and your work with providing this kind of information.

Response: Dr. Pollock's number is 604/717-6200 at his office.  If that doesn't get you a response, I can give you a number for his exchange who will page him.  As far as statistics goes, it depends who you talk to.  When you ask many doctors they claim virtually no problems.  But if you want to know the real problems with Chevy’s, would you ask the dealer or the owners?  When vasectomy patients have been surveyed, which to me is a more accurate representation of the facts, the percentages run 18%, 33%, and even 50 % and more with what they considered significant complications and pain depending on what was asked and how.  You're not alone in your concern.  Don't be in a big hurry to run at a knife for a reversal.  This is what I looked like after mine: 

It might look like I was ready to play basketball, but such was not the case.  If you think this hurts a lot and takes a long time to recover from, you'd be right.  Reversal is a major surgery that can put you on the sidelines in more pain for a long time.  For me, it probably would have been better to do the reversal sooner than the eight months I waited on my original urologist's advice.  The research says all men will eventually develop "blowouts" somewhere in the testicles because of a vasectomy, and three out of four men (or more) will become autoimmune to their own sperm.  There is no way to predict how an individual will react to the surgery beforehand.  Some do just fine with no apparent ill effects.  Others get hit hard, as you well know, with no easy options for treatment.  I'd be glad to discuss the various healing options further if you want to call.

From: CL
Date: 10-10-02
Subject: Please spread this awareness

I discovered your web site yesterday almost 4 wks too late since my husband has already had a vasectomy and he is experiencing some post-surgery pain in one of his testicles. According to his urologist this is a common "reaction" of some sperm having leaked. Now we know better and sure wish we hadn't entrusted this individual to tell us the "truth" when we asked him if the vasectomy could affect my husbands' hormone levels, make him more susceptible to heart disease, or even more prone to testicular or any other kind of cancer. Of course his answer to us was "No,” and that we had nothing to worry about, etc., because all along he was mainly thinking of just fattening his wallet at the expense of my husband's future health. I know now for sure that had we been apprised of the multiple and potential health risks that this surgery would never have taken place. THEREFORE I URGE YOU, PLEASE, PLEASE, PLEASE, GO ON 'OPRAH' AND SPREAD THE WORD. I am pretty sure that she would love to help you put the word out.

Response: Thank you for your kind encouragement, and I understand your feelings about the disinformation process that often leads up to vasectomy. When I asked about what happens to the hundred million or more sperm cells a man still makes daily after vasectomy, I was told they are “just reabsorbed,” which is about one percent of the story. Let me know if I can help your husband and you in any way, i.e. discussing the matter and options, or send you a copy of my book on disk for your reference (no charge), or anything else. I know this must be very challenging for both of you. By the way, if it would be helpful to talk to another spouse about this situation, I'm sure my wife would be willing, and know of numerous others who would be willing to do the same. As far as Oprah goes, I've been waiting to get the final edition of the book published and available on the shelves and then plan to start the push for this and other publicity. Let me know if you have any contacts or ideas in this regard.

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