Dear Kevin;

"�I am an emergency physician�.

"I want to express my admiration to you for sharing your story and concerns with all of us in the article in the New Times. I want to tell you how sorry I am that you are suffering from this procedure. I am so impressed how brave you were to so honestly portray your life with your pain. It took courage to tell your story. I'm sure without a shadow of doubt that it will help lots of people in our community.

"I also had a vasectomy around 1985. I remember having a mild discomfort in my testicles. I also had mild pain with sexual excitement and with ejaculation for about the same length of time. I asked my urologist about it and he told me that it would go away soon. Little did I realize that it would take about three years to go away. Now I don't even think about it, but I sure did at the time. I can't imagine the suffering you go through. I am so glad you have learned meditation. I know your spirit has allowed you to get much closer to your wife over this. She sounds like a wonderful supportive person.

"I have been the 'medical' member of the only support group in this area for people suffering with all forms of chronic pain�. There is nothing like a group of loving supportive people outside your family who can listen without judgment to give you the kind of support you may not get in the circle of friends or family you have, even with a wonderful supportive wife.

"God bless you."

Response: This brings up several things for me. First and foremost, there are people in the medical community who exhibit incredible compassion and empathy for patients who suffer at the hands of other physicians. For this I am extremely grateful. Secondly, it can happen to anyone. This is not the only instance of physicians who have experienced post-vasectomy complications themselves. Numerous others are contained in the literature.
 

"I had a vasectomy in San Luis Obispo in late July of 1989, after the birth of our second son. I have felt for some time, as described by you in the New Times, that my life is spent wondering why I feel like someone planted their knee in my groin. I have been to general physicians, unnamed of course, who defied my description of the nagging sensations and limited pain. They diagnosed epididymitis, like you said, and discounted any very close inspection of my testicles which, in my opinion, (supported by your informative article) contain little cysts that weren't there before. To think that there is so little that we can do (surgeries that don't necessarily work?) to make us feel better is a terrible reality to stare at.

"This article made me think and made me write about how I feel. I know that it has not been 'all in my head', borne from some latent psychological trauma induced by the fear of being neutered, as alluded to by my now estranged spouse. I got a lot of valuable information out of your story and do sympathize and empathize whole-heartedly�but did not get much hope that something can be done medically to make me feel better."

Response: Thanks for your submission. I offer you, as I offer to anyone else suffering from or interested in this condition, my book that contains many of the available references and resources on the subject. Just ask. Beyond that though, I am committed to offering this web site and any other viable means of communication available to help each other make it through this circumstance. Personally, I have found this form of patient-to-patient communication to be an invaluable resource in sorting through my available options, and reinforcing for myself that it is not just "all in my head." Unfortunately, getting this through the heads of some doctors is difficult. Don't give up.
 

"Thank you for raising our public awareness. I too, underwent this surgery and wonder about long-term risk. I appreciate your courage."

Response:  Thanks!
 

"I was sorry to read the trouble that you have been having. I too had the procedure 6 or 7 years ago and have had some minor problems, especially the first couple years after the operation. Nothing to compare to your problems. What I just realized is that my discomfort has mostly gone away over the last couple of years.

"Maybe giving yourself time and dealing with it yourself are the best. I would be very reluctant to go under the knife again if I were you. Even when an operation goes well, it seems to take a long time before you really feel yourself again. Good luck."

Response: Thanks for your comments, and I have to agree with you in many ways. I have heard repeatedly from men experiencing post-vasectomy pain that they only started feeling better when they stopped having surgeries and stopped letting doctors mash on them all the time.
 

I have had several requests to post my feelings as to why doctors don't diagnose or discuss post-vasectomy pain and other complications more often, and why it is poorly publicized.

First, this is a highly personal matter and men tend to be embarrassed about it, thinking that there is something uniquely wrong with them, as their doctor may have told them. Mine sure did. I think they are trained to say these problems are one in a million, because I've probably heard that close to a million times.

Often, pain and other side effects will take years to develop after the vasectomy is performed due to the long-term development and action of antibodies, so doctors don't connect the events and diagnose post-vasectomy pain as something else, like epididymitis. In fact, congestive epididymitis is one of the early terms applied to this syndrome by medical researchers. It all stems from the fact that a man's body continued to produce sperm at 50,000 or so cells per minute and they have nowhere to go except to rupture out into the bloodstream where they were not naturally intended to be. The body reacts to this invasion; often subtly, but sometimes dramatically. Many of the men who have posted messages in this forum know about those dramatic reactions.

For some men, the pain only occurs during sexual excitement and/or ejaculation. For others like me, it's all the time and more when I attempt sex. Talk about refocusing your priorities. When men do get in to see the doctor about these types of problems, many doctors will mash on their sore testicles for a while and often tell them it's all in their head and go see a psychologist. Alternately, the doctor may say, gee, that's too bad, why don't we try cutting your testicles off and see if that helps the pain. I'm not exaggerating here. It's been offered to me and to others I know more times than I care to count. These are not options most men are willing to pursue, so they stop seeing doctors and find a way to live with the pain.

For those who pursue treatments, they are often remarkably unpleasant (to put it mildly), and most doctors are unwilling to report the results because it's an embarrassment, they don't want to believe that it's a problem, and don't want to make waves in the medical community. Even at this, in over 150 medical journal articles I've found (see the reference section) over 900 cases mentioned of significant post-vasectomy pain and complications. This research speaks repeatedly of the significant changes that occur in a man's body after vasectomy and the painful results that can occur. This is just the tip of the iceberg.