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

WARNING: This forum contains explicit photos showing the results of medical
procedures on male genitals. View at your own discretion.

From: JG
Date: 7-11-04
Subject: Reversal hasn’t resolved pain

I had my reversal 1 month ago. I still have a little pain on both epididymides. There are inflamed again. Is it normal because I had chronic pain for 2 years? Does it take time to get back to normal? Anyway I think reversal did not work. I'm going to see another urologist tomorrow, he told me on phone it’s urgent to have a nerve block (injection of Marcaine). He also told me if it doesn’t work he can remove nerve from the spermatic cord. What do you think? I will also meet a psychologist next week. I hope it will help. Could you talk to me regarding hormone therapy? Does it help you?

By the way, someone from Ottawa, Canada reached me last week; another one with PVP. You know, the new urologist I met told me it should be forbidden to do vasectomies. He sees a lot of patients who have PVP. Every time he meets someone who wants to have a vasectomy, he tries to discourage him. I think I will be in good hands with him... he takes time to hear me and explain what the problem is. The other urologist did not do that with me.

Response: I had very sore epididymides after my reversal with lots of inflammation for months. It only decreased after I started the testosterone therapy and my sperm count went down, and so did the swelling in my epididymis, spermatocele cysts, and hydroceles that had formed. They eventually went away but have come back every time I have gone off the testosterone therapy. For me, the underlying nerve damage from the original vasectomy and subsequent procedures has been the most stubborn pain to resolve even after mitigating the autoimmune/congestion/rupturing symptoms with the testosterone therapy, but many men get pin relief from a reversal if it is done correctly and they don’t have extensive nerve damage.

I'd avoid the nerve blocks that can do as much to injure you again as help you unless there is some compelling reason for them. Try to get the inflammation down or the vas may swell and/or scar shut, and then the reversal is for naught. I'm glad you have found a urologist who you feel can help you and who has the opinions he does about vasectomy. Try to find a good pain specialist to work with in addition to the urologist and psychologist, and an endocrinologist to help with the testosterone therapy would be good. You need a whole team to help sort through the problems this chronic pain creates. Let me know how you are doing.
From: CR
Date: 8-02-04
Subject: Alternatives to vasectomy

Thank you very much for your website. I have a couple of questions for you and I will try to be brief, as I imagine you get a lot correspondence.

Here is the situation. My husband and I will have been married 2 years in Nov. We found out about 8 months ago that he has a neurological disease that he will pass on to our children that is very serious. I have had cervical cancer twice, and it will be life threatening for me to have children, because I have had most of my cervix removed. Because of the cancer, I can't take any form of hormonal birth control. We have tried other things like a diaphragm, sponges, spermicides…. I am allergic to everything we have tried. We currently use condoms, but my husband, although he doesn't complain, can't orgasm with one on. We talked to our doctor, because obviously, we can't have children, and he recommended a vasectomy. I went online to do some research, as I always do, and came upon your website.

My questions are... You mention testosterone therapy to bring down sperm count, is this equal to a male form of birth control? Are there side effects?

Is it okay to have a vasectomy if the ends are simply not tied, therefore creating no pressure or buildup? To your knowledge, if you have a vasectomy, and the ends are not tied, the sperm floods into the scrotum, if I am correct. How do they get into the blood stream from there?

Have you seen any information about male menopause and vasectomy?

I appreciate your response, because to be honest, condoms really are just not the answer to our problems. There has got to be something better. Currently, we enjoy an active sex life, but I don't know how long that will last in our current situation. On the other hand, I don't want to jeopardize my husband's health.

Thank you again, and may God bless you and your wife and help you to regain your health. It may comfort you to know that you may have just prevented what happened to you from happening to another man.

Response: I can certainly understand your concerns. To be frank, I would be hesitant to have any kind of surgical sterilization for either of you, given your health histories. The minimum you could expect in regards to the vasectomy is a systemic autoimmune response with unpredictable manifestations that cannot be reversed once the reactions start. It may make a difference in overall health, or it may not. But you can't know ahead of time and you can't stop it after. Even an open-ended vasectomy causes an autoimmune response. All forms of vasectomy violate the blood-testis barrier during the surgery, which is what leads to the autoimmune response as sperm eventually spreads beyond the testicles and into the bloodstream. Open-ended vasectomy can also lead to chronic pain, but purportedly just less often than the closed-ended method. I have had lengthy conversations this week with a man in just this situation.

Several doctors have told me that Natural Family Planning is the best form of birth control, period; better than condoms, the pill, or even vasectomy. I was surprised at this, but further investigation had borne this out to be true (sorry about the pun).

Testosterone therapy has been tested by the World Health Organization as a form of male contraception with varying degrees of success. Many doctors now prescribe testosterone therapy for men who are having andropause (male menopause) symptoms such ad erectile dysfunction, low energy, and depression. In his book, Dr. Malcolm Carruthers has noted and increase in andropause symptoms in men who have had vasectomy. Other research backs this up.

Does this answer your questions adequately? Understand that I am a bit biased based on my experience and that of so many others, but the medical research of three decades backs up what I am saying. It is just not popular with doctors who make a living doing these procedures.
From SJ
Date: 8-02-04
Subject: Snubbed by clinic that botched vasectomy

I really appreciate you getting back to me about such a sensitive problem. I went back to the doctor today because I'm still having pain accompanied by a slight fever which I've had for nine days in a row. I still don't have a straight answer about what is going on in there. He thinks it’s possibly a granuloma, however he is not certain. A urologist didn't do my surgery, just a GP. I haven't seen the one that did the surgery since right after when I went in to find out why my testicle was the size of a pear. The office has kept trying to schedule me with the guy who did the surgery but I've been able to avoid it by making last minute appointments as these problems have arisen. I asked them today to transfer doctors for me and I was told that if I was unwilling to go work this out with the doctor [who did the surgery] I couldn't be seen by anybody at that clinic anymore. I've never heard such a bucket of crap, but believe it or not that's what I was told. The doctor I saw today said that my option is to go have surgery to remove whatever the exact problem is. However I don't know what the exact problem is, I hate to have surgery just yet without knowing more. I told the doctor today that it seemed to me that the tubes on my left side where the current problem is were fused back together and in the middle is where the big sore knot is. He said yeah it could be but even if it is the tube most likely doesn't work anymore and I could give a sample. However that is not my concern at the moment if the tube is working or not, I'm still looking for answers of why this happened. They just don't want to say much for whatever reason and I'm still in shock about the response I got for not wanting to ever see the doctor who did the surgery again. The guy acted like we got into a fight in school and we should patch it up. I told him that this was not personal but rather I can't trust the guy as a doctor to do anything else to me after how the surgery went and what I'm going through now. I should explain a little about the clinic so this makes more sense. It's a clinic attached to Valley General Hospital in Renton, Washington. I have Medicaid insurance due to the fact that I am disabled and on Social Security. This clinic takes Medicaid insurance and young doctors come there to do their residency or whatever for three years. The particular doctor who did my vasectomy was just coming into the clinic at the time of my surgery, I'm pretty sure that my vasectomy was the first he ever performed. The doctor I've seen over the last six weeks about my current problems is his boss or the residing physician. I just think their acting strange about this whole thing. I felt very strange being cornered and questioned about why I want to switch doctors and it’s especially strange to me that he insisted I see this doctor only or go elsewhere, I've just never heard of such a thing. Anyway he ignored my fever, so I insisted he take blood and urine and he did, probably won't know anything for a few days. I'm no doctor of course, but my feeling is that the problem in my nut is causing my fevers since the fever showed up the very day this current problem did and hasn't left since. I'm going to try to get in to see somebody down at Harbor View Hospital in Seattle, Washington to see if I can get some better answers and if surgery is going to be required to relieve the pain. The only thing the doctor did today was send me on my way with another prescription for Percocet, which I don't even really want to take at all, but sometimes I have too because I can't do anything without some pain relief. I just wish I would have read your website before I did this; hindsight, huh. Any advice you can help me with is much appreciated, and I can't stress enough how much I appreciate you mailing me back. I thought I would hold off on the phone call until I get some better answers about what the heck is really going on down there. Thanks Kevin

Response: Start getting copies of your medical records and the surgical report to take with you to other doctors. You need to have your records and facts in a row. I'll send you a copy of my book on disk at no charge if that will help with the research and background. Let me know what you find in your test results. We can put out a message to the mailing list asking for recommendations of providers in your area who are good with post-vasectomy pain; I know of several already. I know of several other PVPS patients in the Seattle area who would be resources to help sort out a good provider for this problem, which it sounds like you haven't found yet. You may need to call Medicaid to get help pressing the clinic for a referral. Usually, the doctors are scared of the regulators, so don't hesitate to try that if you need to. By the way, I wouldn't let the junior underling doctor touch me either.

Keep your spirits up and call whenever you need.
From: JC
Date: 8-04-04
Subject: Autoimmune responses

The autoimmune section of your book concerns me. I am not sure I am being affected but it may be a factor. Certainly my response to humid/bad weather is profound and makes me suspicious. I guess my next step would be an immunologist? Thought I would talk to my urologist about this.

Is there any evidence that more immature sperm coming from testes (say epididymectomy patient pattern) might be less pernicious than from vasectomy patient (from cut vas w/ epididymis in place)?

Response: The indirect immunobead assay anti-sperm antibody blood test is what you want since you have not had a reversal done and presumable have no sperm in your ejaculate. Find a lab that is competent and does the test on site since long distance samples get fouled up often. In the absence of a hospital lab, many fertility specialists can do these tests in their offices.

My autoimmune responses made me feel like I had the flu and ached all over radiating from the genitals for days at a time on a cyclical basis. This subsided once I started testosterone therapy and returned every time my fertility has either deliberately or inadvertently. A good measure to use is to have imaging done of the genitals to assess inflammation and cysts of various sorts now. Then you can compare as time goes on and you try different therapies. I know the sperm fresh out of the testicle are less motile before they enter the epididymis, but as far as the strength of the antigens, I haven't seen any data. Hope this helps. I usually get better answers from my immunologist, endocrinologist, and internist than from my local urologist. Must have something to do with a vested interest in the truth. Be well.

From: LP
Date: 8-05-04
Subject: To reverse or not to reverse, that is the question!

Thanks for taking the time to speak with me yesterday - it was nice to talk with someone who has gone through the PVPS problem.  After we spoke, a couple of questions/clarifications came to my mind that I wanted to ask you so please answer only when you have some spare time.

  • Testosterone therapy - to your knowledge, are there drawbacks to trying it? I think you had mentioned that it could be damaging to the health of the prostate and that there might be some moodiness issues...?
  • Is there a difference between autoimmune, nerve and congestive epididymitis pain, i.e., does one problem's pain manifest itself differently over another? What clues are there (if any) that might indicate nerve damage?
  • Are the chances of success via reversal lessened over time, i.e., I've heard that waiting too long to reverse can form scar tissue which would impede sperm/fluid flow post reversal...?
  • Does reversal only help those that had a closed ended vasectomy? I heard that even with an open ended vasectomy (mine), the ends close up so it kind of becomes closed anyhow....
  • Ever heard of reversal making the PVPS worse (long-term)?
  • In my case, my PVPS has gotten better over the past year or so but it is still far from healed. Have you heard of these problems resolving over time without further surgical intervention? Seems most people must undergo a second procedure (usually reversal?) in an attempt to cure it. However, I guess on the other hand we really wouldn't hear much from those that do get better without any other operation/procedure even if it takes a couple/few years.... ?
  • You said your reversal improved your pain by maybe 20-30% but you said initially that your pain got worse, presumably from the procedure itself.  I guess my question is if you were to do it over again, what would you do differently?  Did your pain get any better during the period from the vasectomy to the reversal or was it continually painful with no improvement whatsoever?  I think you mentioned that you would have tried the testosterone therapy prior to reversal.  I'm also not sure what other procedures you've had done.

Thanks in advance for all your help - I really appreciate it.  I am trying to learn as much as I can so as to not make any more mistakes....

Response: Your questions make sense.  Here's my best response in brief, and I'd be happy to discuss anything again over the phone:

  1. Testosterone therapy initially raises your testosterone for a few days or weeks until your body starts to make less.  Moodiness and acne are two potential side effects that were mentioned to me.  Ask for the package insert for Androgel at your pharmacy to get a complete list, but in my experience, any side effects pass quickly if you keep the dose moderate.  I used 5g/day of Androgel which proved inadequate to suppress my sperm production in the long run so I have had to raise the dose to 7.5g/day.  I've only heard of prostate aggravation in men who already have prostate issues like prostatitis.
  2. My experience of the autoimmune pain is that there is a feeling of pressure and fullness, and inflammatory pain in the scrotal area.  The nerve pain is sharper and extends up into my groin, often aching, and often manifesting as tearing sensation when I walk.  Also, the nerve pain tends to get worse throughout the day as I move about, while the autoimmune related pain seems to comes and go for no good reason, also accompanied by flu-like whole body aching.  Sharp spikes in pain seem to be nerve related.  These types of pain can have an additive effect and really peg the misery meter.
  3. Most of the literature says that 10 years is about the limit for a reversal without significantly reduced chances of success, but then that is talking about fertility, not pain.  I know of a guy who had no PVPS who had a reversal done for fertility and had consistent pain after, so the risk is real, but supposedly rare, whatever that means.  I had the best fertility specialist I could find do my reversal and still had lots of pain after.  The plumbing was all OK and I was fertile again, but the electrical system (nerve) was really sensitized.  A reversal is major surgery, with all of the risks, and costs associated with that, plus you end up fertile again if everything goes right.  If I had it to do over, I would have started the testosterone therapy before the reversal to get my sperm count down and minimize the inevitable significant autoimmune response that will happen because of a reversal where lots of tissues are exposed to sperm antigen directly.
  4. You're right about the open-ended vasectomy.  The idea is to cause a granuloma to form at the cut end of the vas that will bleed off pressure build up in the epididymis.  This didn't help me much after I had my vasectomy redone as an open-ended, so I wound up with a reversal anyway.  Either way, systemic autoimmune responses occur due to sperm getting into the blood stream where it was not meant to be.  I'm sure no doctor would tell you to inject your sperm into your veins, but that is in fact what is happening after any vasectomy once the blood-testis barrier is violated.
  5. I've had lots of other procedures, medications, and therapies of many varieties.  Overall, soothing therapies that are less traumatizing are better in my estimation since your body has already received a big insult from the vasectomy to begin with.

Hope this answers your questions adequately.  Let me know what else you want to discuss after the book arrives (It's in the mail tomorrow).

From: JG
Date: 8-06-04
Subject: Getting better after reversal and nerve block

I had my second injection of Marcaine this Monday and I don't have any pain on my left side.  Now I don't have any inflammation and the urologist told me the epididymides are okay.  I talked to my urologist about testosterone therapy and he don't trust that and he is afraid about side effects.

In three weeks I will have another injection on my right side.  I don't understand why you are talking injection is not good for stopping the pain ?

Please you can add my stories on your web site and also add the urologist Jacques Simard from Quebec as good urologist.

I still have pain on my left leg.  Maybe I had a sciatica problem at the same time... now I see an osteopath to help me.  Thanks for everything and I will always be there for supporting you.

This is a picture of my groin after the surgery.  You can see small scar the urologist did.  I think he did the job properly:


Response:  As long as we’re comparing, I'll attaching two photos to illustrate my point.  The first is from after my reversal, the other from after one of the nerve blocks I had done later as you have.  I think you'll see why I am cautious about recommending any invasive procedures.  "Simple" procedures can have dramatically negative outcomes.  There is no telling beforehand if you are going to end up with a little “ouch” or a big one, like these:


Regardless, I'm glad you are doing better, on one side at least.  Can you get me the phone number, email and address for Dr. Jacques Simard so I can add him to the list.

From: C
Date: 8-09-04
Subject: Bodies at war with themselves

Again, Kevin, thanks so much for your reply. I just want you to know how much I really appreciate it. The past few days have been incredibly enlightening. I am a volcanologist, and while I don't specialize in medicine, I am well versed in the basic scientific process. I am amazed that vasectomies are considered "no risk". The fact that 60% - 80% of men show antibodies afterwards, even if they don't show obvious symptoms of autoimmunity, means that there bodies are at war, and the effects will be seen somewhere, at some time.

My father-in-law has been suffering from andropause symptoms for several years, and just recently I did some research for him on estrogen dominance in men, because he has hot flashes, weight gain around the middle of his body, and a number of other symptoms. Finally, when I started researching vasectomies, I began to wonder. Well, we had them over for dinner and I told him that I knew it was embarrassing to talk about, especially with me, but did he have a vasectomy? YES, he did!

We sat down with your website and a few others and you wouldn't believe all the things that he has that I believe can be attributed to his vasectomy. He is always sick with something. His doctor told him the hot flashes were due to his high blood pressure. What a joke.

So, what do we do now? He doesn't have problems with pain, although he has had three granulomas over the years, but they worked themselves out. He shows obvious immune system damage, and he is well into andropause. I know testosterone therapy helps with the andropause, but what about his immune system? Obviously, you can't go back and stop what has been done, but are there ways to boost the immune system, so at the end of the day it has enough reserves to fight sperm and do its regular jobs?

Needless to say, my husband canceled his appointment for his vasectomy. The Natural Family Planning method is a nice idea, but unfortunately is based on the woman's cycle. My body is incredibly screwed up, and charting anything with me is virtually impossible. There are two things I am going to look into: The hot water bath idea and RISUG. I am more than capable of doing sperm counts at home, so I think we are going to experiment with the hot water method and see if we can get my husband's sperm count down while still using condoms. I don't think it could hurt to try it out. Have you spoken with anyone who has tried it? Had any success?

Also, RISUG looks really interesting. Have you read about it? It seems to be a harmless method. Sperm die when they pass through the charged polymer. The vas is not compromised, so there is no immune issue. It is also not blocked, so no buildup of pressure i.e. pain. I am currently looking for the toxicology studies, because that is the only problem I see with the whole issue. But, in my mind, if I have to vacation in Delhi, then I have to vacation in Delhi! I refuse to sacrifice anyone's health for American pharmaceutical companies.

Just three weeks ago, a study came out that said the Depro Provera [progesterone] shot damages a woman's immune system and can lead to autoimmune diseases like lupus and other things, as well as increasing the chances of a woman getting HPV, the virus that causes cervical cancer, 100 times. I was on Depo for 3 years, and I just got through with my second surgery! I kept saying to my doctor, gosh, I feel sick more than I ever did before. I have developed allergies I never had before. I have these horrible back pains I never had before. No one put two and two together. We are killing ourselves.

Hey, like I said, thanks for being so wiling to talk about all this, and spread the word. When I put "vasectomy complications" into Yahoo, yours was the first website that came up, and the first negative thing I read about "risk free" vasectomies. You forced me to dig a little deeper, and I am glad for it. Thank you so much!

Response: I'm sorry to hear about your father-in-law's condition, but, unfortunately, it makes sense that these things would start happening. Testosterone therapy is a good way to reduce, if not eliminate, a man's sperm count so as to minimize the autoimmune responses that will occur. Unfortunately, without doing a reversal, it is impossible to track the total effectiveness of this approach for sperm suppression, but other factors like energy level and immune system responses can be measured. When a successful reversal is done, normally the autoimmune responses will be contained to the genital tract since sperm will no longer be rupturing into the bloodstream. That's the best way I know to minimize or eliminate sperm antibody reactions, and after the reversal, sperm counts can be measured conventionally. I know in my case, every time I start to become fertile again, i.e., the testosterone therapy becomes ineffective for some reason, I start to have autoimmune symptoms in the genital tract and extra pain. I've been able to verify this with various forms of imaging that showed recurrence of granulomas, epididymitis, hydrocele cysts, and spermatocele cysts. When I get the testosterone therapy correct again, these symptoms have repeatedly gone away. In short, I know it works.

The information I have read about the RISUG (Reversible Inhibition of Spermatozoa Under Guidance-say that 10 times fast) is mixed, however, keep in mind that anything (like surgery or injections) that has the potential to break the blood-testis barrier is likely to lead to an autoimmune reaction. The concept of RISUG is novel: Instead of cutting the vas, a fluid with the consistency of honey is injected into the vas (under local anesthesia, I hope). After a few minutes the fluid coalesces into a soft plug.

Here’s the interesting part: “The plug is loose enough that sperm is still allowed to pass through the vas, but the plug is polarized and carries a negative and positive charge. The charges in the plug disrupt the negative charge on the membrane of the sperm, which renders it incapable of fertilization. The study in India has shown that it has been 100 percent effective for as long as 12 years, and researchers feel that its effectiveness should continue for decades. Toxicology studies have shown the RISUG fluid to be safe and non-toxic, and there have been no problems reported with any part of the procedure” (Williams, 2002).

Notice the phrase, “no problems reported.” I think I’ve heard that before too, but the idea at least has the possibility of reducing such phenomenon as epididymal blowouts, continued autoimmune responses to sperm in the bloodstream, and injuries from overzealous surgical methods. Williams continues: “What makes RISUG even more exciting is that the effects can be reversed in about 10 to 15 minutes by, once again, exposing the vas and then injecting sodium bicarbonate [baking soda] to ash the plug out of the vas and down the urethra.” A 100 percent success rate is claimed once again for the reversal technique. I still take the attitude of “Looks dangerous; You go first!” and won’t run to have it done, but then, I may be just a bit jaded about medical claims by now. Problems with many types of procedures can take decades to become recognized. Claims of rare problems are inconsequential if you have the problems. By the way, the RISUG procedure costs the patient the equivalent of $10 US. Our health care system could probably take a few examples from them.
From: FC
Date: 8-12-04
Subject: Grape-size lump and pain

I hope you can offer me some advice. Two months ago I had a vasectomy. Day before yesterday, I did some heavy lifting and the following morning I woke up with intense pain and a swollen testicle, I also found a lump about the size of a grape just above my testicle. I went to my doctor (who performed the procedure) and he said it seemed like it might be a sperm granuloma, but he wasn't sure. His advice was that it would probably heal itself and that I would probably have no further worries. Please advise.

Response: Be a bit more specific about the lump. Does it feel like it is attached to the vas? Does it float freely or seem to be attached to the testicle? Did you check for any lumps before this or is this all new. How's the pain now and how would you describe it? Several months after vasectomy is the typical time the significant autoimmune response starts when the ruptures in the epididymis or vas have become significant and granulomas form. Call me if you'd like to discuss this in person.
From: Mentor Corporation
Date: 8-16-04
Subject: Testicular Prosthesis

You had called Mentor previously regarding physician information to place on your website. Unfortunately we cannot provide information to other parties. What we can do is direct these patients to us, specifically to our Patient Services dept. who would be more than happy to direct the patient to right place or you can have a link to our website. Our 800 number is 1-800-Mentor-8 and our website is http://www.mentorcorp.com/ . The following is a list of Physicians in Calif. who have been involved in our clinical studies with our testicular prosthesis.

Dr. Paul Turek
1600 Divisidaro Street, P.O. Box 16951600
San Francisco, CA 94143-1695
(415) 353-7348

Dr. Alex Weinstein
Urologic Specialists of Santa Barbara
504 W. Pueblo Street, Suite 102
Santa Barbara, CA 93105
(805) 687-7719

Dr. John Kowalczyk
1127 Wilshire Blvd., Suite 1515
Los Angeles, CA 90017
(213) 977-1176

Dr. Victor Ching
San Antonio Urology Medical Group, Inc.
1175 East Arrow Highway, Suite E
Upland, CA 91786
(909) 985-9737

Dr. Laura Crocitto
City of Hope Nat'l Med. Center, Dept. of Urology
1500 E. Duarte Road
Duarte, CA 91010
(626) 359-8111ext. 63030

Response: This is a maker of a saline-filled testicular prosthesis product used by a number of doctors. Many men have expressed an interest in this type of product when chronic post-vasectomy problems have led to the removal of one or both testicles. I hope you never have to seek this kind of information, but if you ever do….
From: DR
Date: 8-24-04
Subject: Vasectomies should be banned

The biggest lie that a urologist can tell his patient is that a vasectomy does not cause any effect to a man's sexual functioning, WHEN IN FACT IT DOES!!!

I emailed you before about the burning sensations in my erections ever since my vasectomy. I do not have an infection but the urologist has informed me that I’m having too much sex after a vasectomy. Ever since the vasectomy a redness has formed on the tip of my penis and that is the indications of having too much sex according to him. But he is completely ignoring the fact that I’m having 60% less sex compared to before the vasectomy, and now with painful erections. It makes me wonder if my urologist did extra damage to me other than the vasectomy. I also experience a sharp and burning pain when I rub the lower shaft of my penis where the incision was made. I wonder if my urologist damaged the tissue around this area? Is there a vein near the lower shaft of the penis that fills up with blood during an erection? Based on the burning sensations that I’m experiencing, is it possible that my urologist cut into this vein, because there was bleeding during the vasectomy and no bleeding during my reversal..

I had the reversal in Dec.2002, by Dr. Sheldon Marks in Arizona. He did an excellent job and the surgery went very well, although my burning sensations either remained the same or slightly improved….

Maybe in the future, urologists will perform a microscopic reversal, using microscopic instruments only that will not damage the tissue, thus allowing the vas to heal immediately. But then again, in the future the government will finally realize what an inhumane surgery vasectomies really are and will finally ban it.

Response: I don’t know what to tell you about the burning, but I know the scar tissue that forms after vasectomy can cause lots of discomfort around the base of the penis because I experienced this myself. Erections stretch the tissues a lot, and if there adhesions that have formed, it will hurt, believe me. When it hurts to have sex you will probably not be having sex as much. Reversals are even more invasive than vasectomies, so the opportunity for tissue damage is quite real.

I have heard good things about Dr. Marks before, and his web site is one of the few medical sites that tell the truth about what vasectomy can cause. Microscopic reversal is the gold standard for reversals now, but it is still major surgery. Let’s hope for some intervention by the government, or just good old common sense to stop the misinformation and injuries.
From: PN
Date: 8-26-04
Subject: Shingles after vasectomy

I have a question for you, and maybe your book addresses this. In all of your research, have you ever found anyone to report "shingles" as a body's response to a vasectomy? I am just curious, my urologist thinks I'm nuts, but two months after my vasectomy I developed shingles for no other obvious reason. You talk about auto immune reactions, and shingles is linked to the immune system from what I understand. Just thought I would ask. Thanks.

Response: In short, yes. Shingles (Post-Herpetic Neuralgia) is believed to have a significant autoimmune component according to many sources, and the autoimmune cascade following vasectomy is well documented. Can this cascade manifest in reactions such as shingles (which is a miserable condition)? This is a common sense question. Doctors who have a vested interest in performing the procedure will deny it, but you would be well advised to begin working with an immunologist, pain specialist or other specialist without the bias that often comes from urologists.

Many comparisons have been made between the type of post-vasectomy pain many men including myself have experienced, and the pain associated with shingles. Both my book and Dr. H. J. Roberts' book discuss these issues extensively. Let me know if I can be of any other assistance.

By the way, my internist told me to watch for shingles symptoms myself based on some reactions my body is having. Evidently, he doesn't rule it out, but then, he doesn't do vasectomies either.
From: SF
Date: 09-08-04
Subject: MS and pain years after vasectomy

I heard the last moments of your talk on KCBX – NPR radio earlier this year and was interested in what you said and what I missed. Thank you for offering a replay on your web site. I haven't listened to it yet, but will in the next few days. Perhaps my question will be answered when I listen to the replay, but in case it isn't I felt I should contact you direct.

I had an unremarkable vasectomy about 25 years ago. No pain, no problems. The last 5-10 years I have quite a bit of pain, but not in the testacies. My pain is in the urethra and shaft. My question is, have you heard of other cases experiencing pain in these areas possibly caused by vasectomy?

I must also tell you I was diagnosed with MS 40 years ago. Very slow progression, currently I am disabled, but independent. Since MS affects one's nerves, I thought my pain was due to MS. I began to think of the post-vasectomy pain syndrome after hearing you speak.

Any clue you may be able to offer will be appreciated.

Response: The fact that MS, Post-Vasectomy Pain Syndrome, and numerous other disease states have a significant autoimmune component can’t be ignored. How these relate for you is very difficult to say. Could autoimmunity cause a painful inflammatory reaction like you describe? Given what you have seen on this site from myself and many others, what do you think? These are complex bodies we are given, and the problem is we tend to want to tinker with nature, which always has a consequence.
From: JR
Date: 09-11-04
Subject: Hanging low and numb

I just came across your website and I was amazed. I have been searching for info on disfigurement after vasectomies. My husband got a vasectomy a year ago, and since that time his right testicle hangs extremely low and he has much numbness in the area. It was never like this before and we suspect the doctor cut a nerve or something that has caused this problem.

While he can still function normally, the appearance does bother him greatly. Have you ever heard of something like this happening before? It is almost like they cut off something that would cause it to hang normally and it is just disconnected in there.

Response: There is a lot that can hang differently after a vasectomy. Many doctors say there is no change, but so many of us know otherwise and have said so that it is obvious. The biggest concern would be if there is damage to the spermatic cord(s) and/or if scar tissue adhesions are forming that are going to cause long-term problems. The numbness is the biggest question since that usually indicates some form of neuropathy, i.e., cut nerves. Has he had any kind of imaging done to check for damage? A Neurography is an MRI of the nervous system, which may be something to pursue if you need to.

You didn't mention any other changes, but many vasectomized men have noted altered sexual sensations, muscular gripping, erectile dysfunction, decreased pleasure and other concerns. If you have any concerns about immune, hormonal, pain or other issues, let me know and I'd be glad to discuss the matter further. In the meantime, I've had a lot of men tell me they have had to permanently change to tighter briefs or even jock straps every day for years following their vasectomies. I tried this myself, but the additional pain the tight briefs caused in my case was prohibitive, so I just move slowly now.

By the way, three out of four men have a longer spermatic cord on the left, so that testicle usually hangs lower. Was that the case for your husband before?
From: TS
Date: 9-14-04
Subject: Thanks

I know you probably don't have time to get to every email, but I just wanted to commend you on your efforts to get the word out. I myself am experiencing pain years after the fact (on a course of antibiotics and anti-inflammatories for epididymitis right now), and am HOPING that it doesn't become a recurring issue. Thanks for your work, and the resource. God bless...

(From a subsequent message) I had my vasectomy 2-1/2 years ago, and just started having epididymitis. The course of antibiotics/anti-inflammatories took away the acute pain, but I still am faced with aching...my doctor who I met in urgent care a few weekends ago said "he sees this all the time." I wonder how much of this epididymitis he runs into is actually related to men with vasectomies?

Response: One of my goals is to get to every message and respond as best I can. These issues are important, life-changing matters for all of us, and someone needs to give it priority. If that is supposed to be me for now while others learn and join in the chorus, that's okay.

What we don't get told before the vasectomy is that every man who has a vasectomy will have "congestive epididymitis," which often turns painful. The patient surveys show 18-50% or more of men with chronic discomfort at some level, frequently severe, because of their vasectomies. That's why your doctor sees it all the time. At least he recognizes it and is willing to admit it. In cases like yours where there is a late onset of pain, often reversal is the ultimate solution to relieve pain, though this should not be considered lightly. We can always discuss the possibilities further when you need to.
From: G
Date: 9-15-04
Subject: Pain, swelling, and a bent penis

My name is Greg. I have a question that hopefully you can answer, but first let me explain what happened with my vasectomy experience. I had the procedure and on the way home to recover I began to feel pain and swelling in my scrotum. The swelling became very intense to the point that I could feel them pushing on the inside of my legs. At first I thought that this may be normal after the procedure. By the time I made it up to the house I was waddling like a duck. I laid down on the bed and told my wife "Call the doctor; something’s not right here ". The doctor said to meet him at the emergency room. He told me I had a hematoma. I was still swelling and by the time I got to the hospital and my scrotum was softball size. The doctor arrived and said it's been 25 yrs since he's seen anything like this. I was not very reassured at this point. He's said an artery was cut and he would have to open me up and connect it to stop the bleeding. They knocked me out and brought me into surgery.

I woke up sick to my stomach and in severe pain. I had a tube sticking out of my scrotum for drainage and had some kind of scrotal support (jock strap) on wrapped up in bandages and gauze. I was in bed for nine days straight in agonizing pain. Just to make it to the bathroom was a task of a life time. I would begin shaking uncontrollably to the point I was calling for my momma. I'm 39 yrs. old and my mother past away 11 yrs. ago. That ought to tell you something. Anyway, you get the picture.

Here's my problem. Later on my wife and I tried to reinitiate the intimate side of our relationship. After I gained a state of full arousal I had intense pain not in my scrotum but in my penis. I did not have surgery on that part but did have had a lot of blood pushed into the penis area from the swelling. Several weeks later after the erectile pain began I now see that after our intimate session is completed that my penis is bent to a certain extent somewhat close to the head of my penis. I have also felt little knots about the size of a BB in my urethral tract close to the head.

It's been six months since my surgery. If you have any information that may help me understand this. I would greatly appreciate it. I cannot find anyone who has gone through this type of hell with a vasectomy so it's hard to deal with some of these issues. Thanks again and thanks for putting together this site.

Response: A bend in the penis is often attributed to scar tissue adhesions from some type of injury (like surgery) or other inflammatory processes. If you’ve looked at this site or read any of my book you know about the scar tissue that vasectomy can cause because of the autoimmune responses to the procedure. You are not the only one to mention physical changes in his penis after vasectomy. Just read some of the other entries in the forum. You will probably have a tough time getting a doctor to relate vasectomy to the penis issues, but what does your common sense tell you? You were fine before. After the surgery you swelled to the size of a baseball, required more surgery of a highly invasive nature, and now are seeing changes in your genitals. I know where I would place my bet.
From: JM
Date: 9-20-04
Subject: What to do now?

It has now been 22-1/2 months since the hell began. If you recall I had the vasectomy reversal which did not help. I even tried 29 of Connie Haber's photon treatments and 12 surgical nerve blocks with no help. The pain continues to be so bad that I am still on Methadone three times day along with Vicodin chasers. The depression has been so bad at times I have thought about terrible actions repeatedly.

I have now lost my primary job as well as my consulting business and have been reduced to staying around the house & doing anything I can to help the pain. I wear an external TENS unit throughout the day & Lidoderm patches every night.

My wife & I went to an extremely good medical malpractice attorney today since the two-year mark was approaching. I had been screened for the past three weeks by their nursing staff to see if I had a case & finally got a chance to actually see the attorney today. He listened to our case with a lot of the info I learned from you & he has accepted the case at this time.

I advised him of your book. I attempted to purchase 2 of your books on line today but could not make an effective internet connection to complete the process. Could you please send me two books as well as the book on disk. I will be happy to provide you with my credit card numbers or send you a check to cover everything.

At present the doctors suggest yet another surgery where they would implant an internal TENS-style device into me with leads going into my spinal cord. There are significant complications to this. The other surgeon would like to place an internal pain pump into me, and still my urologist believes in denervation. None can agree. In the meantime, I have pain every second!

I can only thank my wife for helping me get through each day! At present I live literally only for my child as he does need a father growing up. And I cannot forget my wife. She has been so patient and was excellent today with the attorney.

I would like to print out the appropriate articles that you believe would be valuable to my attorney. I am aware of your legal case & quite honestly feel for you in every way. I would appreciate ANY suggestions in any areas that you deem appropriate.

Kevin...I can't live with this much pain each day. How do you do it? I hope you & your family are hanging in there. I look at you as the worlds leading expert in this hell! Hang in there...& please get back to me if you can. Thank you in advance!!!

Response: I'm so saddened to hear that your condition continues at such a severe level. This pain is brutal to live with. Of course, I will put two hard copies of the book and one copy on disk in the mail to you. I hope it helps. In the chapter on legal issue associated with vasectomy, I reference an article from several years ago about a man from Pennsylvania who won a significant (over $4,000,000) judgment in his case. That is probably the best place to start since it is in your state and your attorney may be able to contact the attorneys for the man and/or obtain copies of the medical records.

As far as the medical situation is concerned, remember you are talking to surgeons who are trained to cut. The old saying that, "When all you have is a hammer, everything looks like a nail" needs to be remembered. The problem is our bodies don't like being cut, especially cut repeatedly on sensitized tissues, especially on the genitals. All of the procedures proposed, at best, will block pain signals, not solve the underlying problem. The possibility of complications and more pain is quite real.

It has been almost two years since my last surgical procedure, and over five years since the start of my post-vasectomy pain. It has only been in the last year or so that I have really begun to feel a moderation in pain levels, mainly because I have been diligent not to allow my pain levels to spike significantly and re-traumatize my nervous system. This has been the hardest situation to be patient with that I ever could have imagined, but the alternatives are just too risky given the history so far. Based on my experience with surgery, another surgery to undo the damage of all the others is just not a realistic expectation. Many doctors have told me this is the case and to wait it out. In general, these are not surgeons making this recommendation, though, with the exception of one urologist whose opinion I value highly and who has been very honest with me.

I'd like to talk further and see what we can brainstorm. I completely empathize with your suffering. I only wish I could help more. Please call anytime.
From: TH
Date: 9-26-04
Subject: Wishes he had known

I've just found your site after having had my vasectomy last week. I wish I had found it before the procedure - I think I would definitely have thought twice about it then.

I was wondering if you would be kind enough to let me have a copy of your book…. Do you have the electronic version on line somewhere I can download it? I don't have any specific issues yet, but one thing that would be a comfort is knowing what percentage of men actually contract PVPS in whatever form. Most of the medical sites that have any studies show a very low incidence but I'm not sure I believe the figures.

The biggest issue for me would be if this were to affect my sex life with my wife. I've read stories of guys having pain during intercourse and ejaculation (including your problems of course) and I think this would severely affect us. I guess I'll just wait and see what happens but I will admit I didn't even really consider the complications angle before getting it done. My doctor was very good and explained the risks but the only mention of pain was the possibility of the "blue balls" syndrome at about 3-6 months.

I appreciate your time and wish you all the best.

Response: I don't have the book as an e-book yet, but will do so as soon as it is available from the publisher. I can send you a hard copy or a copy on disk depending on your preference. Let me know an address if you want me to mail either to you, or you can order a hard copy through the publisher by going to the link at the top of the home page of the www.dontfixit.org web site.

You are wise to guard your health now that the procedure is done. Too many of us find out the truth too late, and it is hard to bounce back once the problems start. Let me know if there are any specific issues you want to discuss….

Incidence of PVPS ranges from nil to 50% or more depending on who you ask and how you ask the questions. Many guys talk about that constant blue balls sensation which is a nuisance at minimum. Others have periodic pain that needs treatment, while a smaller percentage experience life-altering pain and consequences. Statistics are of little use, however, if you are one of the affected ones, because for you then, it is 100%, with some really lousy choices of treatment, as others have mentioned in addition to me.
From: CB
Date: 9-27-04
Subject: Cattle prod in the testicles

Your website is very informative and I wish I had read it prior to my vasectomy nearly three years ago. I had an in-office scalpel procedure. When the left side was done, it was uncomfortable, but the pain was what I was expecting, but when the right side was done, it was excruciating. I even told the doctor that he may not have numbed it enough so he "numbed" it some more.

Well, the pain never went away. There was significant bruising and sensitivity on the right side. I walked bow-legged for months and the thought of my kids accidentally hitting me in my now overly sensitive area was unbearable. I called the urologists several times and was told it was normal and sometimes it takes up to six months to go away. It didn't.

In the meantime, I developed a cyst that I later found to be a sperm granuloma on the right side. The doctor said no problem he would take care of it in the office with a small procedure. Well, I was not about to let this butcher touch me again so I went to another urologist who was nice enough to put me under for the procedure. The pain still did not go away.

Several months later, the cyst returned and was removed again, but the urologist sealed the vas properly this time so it would not reoccur. He had to do the same on the left side last year when one developed there.

The pain migrated from my testicles up into my groin with sharp pains that nearly double me over and took my breath away. Not only is it uncomfortable, but it is embarrassing when it does happen. It is like someone sneaking up on me with a Taser and zapping me without warning. It does not matter if I am sitting, standing, active, or inactive; it hits without warning. My urologist felt it was related to the vasectomy but since he was part of the same group the butcher was in, he did not elaborate.

He sent me to a pain specialist who agreed it was related to the vasectomy. He conducted a nerve conduction test and found the ilioinguinal nerve was damaged. Apparently the damage to a lower nerve progressed upward. After several nerve block attempts with no results other than numbing my leg once, I was sent to another specialist out of town. He performed a radio-frequency ablation of the nerve which provided some relief for a few months. The procedure was repeated again with no results. He then attempted a phenol injection to kill the nerve and only made the pain worse. He then sent me to a specialist in Atlanta. He is trying me on some meds and a TENS unit but I am not having any relief.

My next step he says is to implant a device to block the nerve signals. It is experimental and the device is the size of a pager. Not something I really want to do. Going through airports is bad enough without something like this setting of detectors. My questions to you are, have you heard of this happening before, is it more common than I am led to believe, and do you know of anyone who has had good results in correcting the problem?
By the way, all the pain specialist doctors have prescribed every form of anti-seizure medication with no results. Thanks for any help or guidance you can provide!

Response: We need to talk. This is exactly the kind of scenario I experienced during my vasectomy and with repeated procedures causing repeated and increased pain. I know exactly what you are describing. Give me a mailing address and I will send you a copy of my book with the info about nerve damage included and then we can talk about why I decided against more surgery, spinal stimulators, anti-convulsants, etc. and have paid more attention in the last two years to my doctors who encourage me to be patient and allow my nervous system to desensitize over time.

I had the spinal stimulatory recommended to me too after trying numerous medications. Aside from a hockey puck-size device that would be implanted in your butt and wires up your spine, did anyone mention that the device needs to be cut out every five years or so to replace the batteries, and that the wires can break. I know of several men this has happened to.

Everything offered you so far has been intended to block or mask pain signals, which, (you have found out the hard way) will find another route, just like you would if you were driving home and the road was blocked. The best solution is to find a way to calm the sensitized nerves so they don’t think a four-alarm fire is going on all of the time. Read Explain Pain by Mosely. You can find the link to this book in the publications page of the web site.

Please feel free to call anytime, even if is just to have an understanding ear.
From: GS
Date: 9-30-04
Subject: How long does the rupturing go on? Just visited your web site. Very interesting. I had a vasectomy 12 years ago at age 38 and have been asymptomatic (I think that means no symptoms, all seems well…. Quick question: I've been told that my body has been gradually reducing sperm production because of the vasectomy and may now not produce any sperm. So it seems to me that "blowouts" and otherwise overflow of millions of sperm would not occur. If you could take a second and respond, I'd appreciate it; I want to be informed so I can inform others, and I anticipate this question.

Response: Research says that your body will continue making sperm throughout your life, though typically in decreasing volumes from your 30's on. That can still mean 100,000,000 or more sperm cells a day later in life. That’s a lot of cells with strong antigens on them. The blowouts that occur usually start within a few weeks or months after vasectomy and the autoimmune responses that follow have been shown to occur for 20 years or more; actually for as long as has ever been tested. Autopsies of vasectomized men have demonstrated that the inflammation, scar tissue and degenerative processes vasectomy causes are life-long. The doctors who have researched the subject have often observed an early male menopause as a result replete with such symptoms as testicular atrophy, erectile dysfunction, low energy, etc.

It's not a pretty picture, and sharing this information is one of the major reasons I wrote my book and started the web site. The real question is how to best maintain your health and avoid or at least mitigate the self-destructive processes that are set into motion when this primary physical channel of our creative energy is blocked off. I'd be glad to discuss the matter further, and can get you a copy of my book to give you more detail and references if that would be helpful to you.

There is a larger issue of learning to admire and respect the integrity of the bodies and energies we are given as men. This is something that has become more and more apparent to me as I have done my research over the last five years. It is also something we are not given good examples of as a rule. So change is needed on many levels.


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