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

Vasectomy Forum Through 12-31-01

Please note; for several of the messages posted to the forum during this time period, a malfunction kept return email addresses from showing on the posted emails. If you would like to correspond further, or would like to be added to the mailing list, please email us at sadsacks@dontfixit.org or post your name and address to the mailing list.
 

From: MC
Date: 12-31-01
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
 

From: AC
Date: 12-8-01
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. Thanks!

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.
 

From: BA
Date: 12-06-01
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 greatly appreciated.

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. Lou
 

From: YJ
Date: 12-5-01
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 can offer.

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 andrologists.
�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 premature ejaculation.
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 sadsacks@dontfixit.org so I can reach you more directly.  Kevin
 

From: JB
Date: 12-4-01
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...

JB

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.
 

From: RS
Date: 11-25-01
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.
 

From: DT
Date: 11-23-01
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.
 

From: WW
Date: 11-22-01
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. 

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