If It Works, Don't Fix It: Forum

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

From: PT
Date: 3/21/02
Subject: Erectile dysfunction and autoimmune responses following vasectomy.

Hi- thank you for your web site! I had a vasectomy 3 months ago. Since then I have experienced various episodes of erectile dysfunction. It gets better, then, I get hit with it again. It's real hard to try to sort out the psychological component. This has been extremely traumatic. I had no idea that a vasectomy could cause autoimmune problems. I was told that it was a 10-minute operation, I would feel a bee sting (pain killer) and some tugging (surgery), and that I would need a few days to recover. I was also told that my sex drive would remain intact. I was diagnosed 2 years ago with Hachimoto�s Thyroiditis (sp?). I am at a dose of Levothroid that has been keeping my thyroid levels within the proper range. I have asthma and allergies. I am 38 years old, very physically active, and in good physical shape. I am very concerned about increased autoimmune problems down the road- and I don't want this operation to increase my odds of a more serious problem.
Question: I have an appointment to go into my doctor to talk about my thyroid and this problem (though I have to talk around the "erectile problems" or else the insurance won't cover it!). I am going to request a new blood test for my thyroid levels. I want to test for the vasectomy problems with this too- I'll ask for testosterone levels, but what else? Mind you, this is your average HMO lab. I am still dealing with the trauma and trying to gather resources to decide what to do next. Any advice would be useful! Thank you very much

Response: I�m sure you�ve read other portions of this web site by now and know that autoimmune reactions after vasectomy are to be expected, and are not just some occasional occurrence. Also, the higher your sperm count before vasectomy (i.e. the more fertile you are), the more likely you are to have an autoimmune response when sperm inevitably ruptures its way into your bloodstream following the procedure. What isn�t known is exactly how your body will react to the barrage of sperm cells that the immune system perceives as an infection. Some men claim no immediately noticeable effect, while others become incredibly sick. What is certain is that a vasectomy surgery is a trauma to the genitals which the body is not very friendly towards. Doctors who state that this �minor� procedure has no effect on sexual function are either unfamiliar with the research on the subject or lying to get your business. Doing tests to determine hormone levels and the extent of the reactions your body is having to sperm antibodies is a good idea, but is a lot like shutting the barn door after all of the livestock run out. These are very difficult situations to unravel. I know this from personal experience, which is why we all should be told of these effects before the procedure. Now you must try to determine what medical approach helps you to feel �normal� again, which is a very trying process in which you will find few doctors who will give you the time of day. Read Dr. Carruthers book Maximising Manhood for a more in depth description of your options. You can access the book through the Publications page of this web site.

From: AS
Date: 3/14/02
Subject: Vasectomy against the wishes of a wife.

Can you please tell me why a wife�s opinion on her husband having a vasectomy doesn�t count? My husband had a vasectomy 2 weeks ago all the doctor performing the operation offered was a quick 5 minute consultation when I pointed out to the doctor that I was against this operation I was told my opinion doesn�t count and if my husband wanted the vasectomy then that was all that mattered. I had to leave the consultation room in tears, and at this point the procedure was carried out. This left me heartbroken and suffering anxiety attacks that I�ve never had before. I think that a wife�s point of view should count as it affects our lives to.

Response: I can�t imagine why a doctor would carry out a procedure where a couple is consulted about what is to be done but is not in agreement. Even if the law might allow this, common sense says it is not a good idea and is likely to cause problems for the couple and the doctor.

From: SJ
Date: 3/10/02
Subject: A painful success story

I'm a guy who views himself as always "doing the right thing." I agreed to have a vasectomy in July of 1999, and share my story in the spirit of the fact that I wish I had this information [from this web site] before making an almost irreversible decision.... My symptoms over the last 2 1/2 years: I had a vasectomy in July, 1999. I planned to leave my job in August to join an internet start-up (I knew that my position was about to be eliminated as a result of re-organization and downsizing), and figured that I might as well have the insurance company that I worked for pay for this. I followed all post-surgery instructions to the letter. I lay on the couch for 2 days with an ice pack on. I didn't experience the post-surgery discomfort of some men. Within a couple of weeks, I developed a lot of discomfort related to what I felt to be pressure in my testicles which was centered in the epididymis. I went back for my post-vasectomy checks and the urologist told me not to worry about it, that the pressure would "eventually" go away. I tried to find information about the pain I was experiencing, but there was nothing in the local university's library, and very little information on the web. The only references I could find to post vasectomy pain on the web indicated that it was "extremely rare" (that 1% number again) and "usually" went away after six months. Over a period of months, this pressure developed into almost constant pain. The epididymis on both testicles swelled to ~10 times their normal size - the epididymis on my left testicle swelled to the point that it was almost the size of the testicle itself. I felt that I had clamps attached to the back of my testicles. In retrospect, this isn't surprising. We had taken a healthy organ producing millions of cells per hour and closed off the only outlet for these cells. One urologist admitted to me that they do this surgery expecting that men's testicles will stop producing so much sperm, and mine didn't. Nothing seemed to help. I took both over-the-counter and prescription anti-inflammatories. I constantly felt like I had just been kicked in the balls. On top of that, I would occasionally experience intense flashes of pain that I speculate were the result of ruptures in the epididymis as it became so pressurized that it couldn't cope, in spite of its increased volume. It was especially "interesting" in that this usually occurred in the midst of sex. Needless to say, that was the end of that sexual encounter. I was definitely having the ruptures as I developed granulomas, caused by sperm entering the body. Our sex life virtually ended. I frequently found myself curled up in a fetal position with my hands between my legs saying to myself, "I hate my life, I hate my life...." I began to drink excessively late into the night - at least my balls would quit hurting after 4 or 5 drinks - and I was unemployed - so no reason to get up in the morning. I spent most nights on the couch in the basement. After about six months, I finally found some relief - the pain went away! The research I was seeing on the internet said that the pain "usually" went away after 6 months or so - I felt that I had a new lease on life. After about 2 weeks it came back - worse than before. The pain settled into cycles where it would last months, then go away for a week or so. At first, during the times when the pain went away, I felt almost "normal," with virtually no discomfort. During most of 2001, even in times when the cycle of pain was gone, I experienced a level of discomfort that was constant. While it wasn't the intensity of the pain I experienced before, it only went away after I went on testosterone therapy. After about three months of testosterone therapy, I talked with my doctor about a reversal. He agreed with me that, since I had responded well to the testosterone therapy, that I would probably respond well to a vasectomy reversal. I had the reversal in mid-January, 2002 - 2.5 years after having the vasectomy. My doctor had warned me that, given my history of pain, I might not respond well and have a lot of pain as a result of the surgery. It was amazing. The pain I experienced after the first 3 or 4 days was no worse than the average day since the vasectomy. I was pretty sore the first few days - a reversal is much more invasive than the original vasectomy - but Percoset helped! The biggest problem I had is that no one warned me that Percoset tends to cause constipation, and I developed hemorrhoids - more painful than the post-surgical pain. I recommend a Metamucil chaser with Percoset! I am now about six weeks post-vasectomy reversal (March 4, 2002). Our sex life is good again - it's more pleasurable than before the vasectomy! I am emotionally healing as my body continues to heal. I still have a low level of pain in my left testicle that is especially noticeable about one day after sex, but it's something I can live with given the hell I've been through. I hope that this goes away over time as I continue to heal. While I have done a good bit of secondary research on vasectomies and post vasectomy pain over the last couple of years, I am struck by the lack of primary research on the subject. Most of the research that is being done is in Europe or Canada, where the urologists aren't financially incented to continue to cut (I'm in Atlanta, GA-in the US). Most of the articles you find are from the British Journal of Urology. I am certainly not a fan of socialized medicine - my career over the last 15 years has been in the HMO industry -but the urologists in Europe have done some research while those in America seem to refuse to recognize the problem and are not doing the research.

Research in the '80s and early '90s indicated that the incidence of post-vasectomy pain (PVP) is about 15 - 20%. More recent studies find a higher rate of incidence - closer to 30%. Conclusions in the later studies I have seen is that of men surveyed 4 to 5 years post-vasectomy, about 1 in 3 have chronic pain, about half of these indicating that the pain affected the quality of their life, with about a third (~10% of the total) indicating they would not have had the vasectomy if they had the decision to make again. This research, combined with other research published in the medical journals, indicates that somewhere between 1 in 20 and 1 in 10 regret having had a vasectomy. If I had known this before my vasectomy, I certainly would never have made the decision I made.

There is even less research about the treatment of post-vasectomy pain. One study I saw indicates that approximately 1 in 100 men with a vasectomy actually go through a reversal in an attempt to deal with PVP (as opposed to those who go through a reversal for fertility reasons)- usually at their own expense as this procedure is not usually covered by insurance. That's quite a different message than any of the urologists (and I've seen 4 in the last 2.5 years) would admit until I saw the one I have seen for the last six months. He said I had "classic" symptoms of PVP, and suggested a rather structured treatment plan consistent with treatments that I have seen in my own research. Interestingly enough, the majority of his practice is in infertility. Quite a different message from "it's mostly in his head" - what the third urologist I saw told my wife. Her response was, "I think that the problem is a little lower than that." She immediately went to work trying to find another urologist for me. She called all urologists in Atlanta mentioned in one of the "best of ..." books, including some at Emory. They all declined to accept me as a patient. She found the current urologist I am seeing by talking with Kevin, who referred her to someone he had talked with in the Atlanta area, who had been treated by my current urologist.

The urologists in the US (and evidently other countries, based on the stories I'm seeing on the web) continue to ignore this as a problem. The guy down the street had a vasectomy a couple of months ago. He was on the table and told the urologist that I was taking testosterone injections due to PVP. The urologist laughed, said he had never had a patient with a problem, could not imagine what the doctor was thinking that put me on testosterone, and continued to cut. My neighbor went back a month or so later with several problems - infection in his incision and testicular pain. The doctor said that he could just remove the testicles and the pain would "probably" go away... a commonly used scare tactic used by the urologists mentioned by all four of those I have seen. The most unkind interpretation of this is that they want us to quit "whining," go home and keep our mouths shut.

Given my experience and the research I have found since having a vasectomy, I cannot imagine a situation where I could in good conscience recommend this as a risk any man should take. Once the cut is made, there are very few options. While I appear to have a good result from a reversal, the research indicates that only about 80% of those having a reversal due to post vasectomy pain have a good outcome. While this sounds positive, the Medical Director at my HMO (where I am the Marketing Director) told me that you really want 90+% success rates for surgeries like this...which underlines the fact that the decision to have a vasectomy is a potentially life-changing one that is irreversible in many cases. Other men who go through this see urologists who insist on removing the epididymis, a surgery with even less success than a reversal and which is even more disturbing - once the body parts are gone, they can't be put back, and the resulting pain has virtually no resolution. Ultimately, orchiectomy (the removal of the testicles) is the only treatment left for some men - a surgery which brings about even more complications.

I hope that my story brings information to men who are considering a vasectomy so that they can make a more informed decision than mine. If I had known what I know now, I certainly would not have agreed to have a vasectomy. I also hope that my story offers hope to men who are going through the hell of post-vasectomy pain. Stick with it. Find another doctor. Find one who will admit that post vasectomy pain is a problem for some men. If your doctor recommends orchiectomy, run. Try testosterone therapy. If you can't find a doctor who will prescribe this, keep looking. If you're in the US, there seem to be only a couple of urologists whose practice encompasses the treatment of post-vasectomy pain. Dr. Michael Witt, in Atlanta, GA [see provider section of the web site] is my doctor. I thank God for him, and recommend him to anyone who finds himself in the unfortunate position I have been in.

Response: Couldn�t have said it better myself.

From: RC
Date: 3/10/02
Subject: Desperate after long-term post-vasectomy pain.

BRAVO!!! I am so glad to see a website informing of the possible dangers of vasectomy. I had mine in September 2000 under local anesthetic and I have been through some very painful experiences but the pain I suffered during the procedure was indescribable maybe. P.O.W's who have been tortured could understand. The local would not work no matter how much they pumped in and it took nearly one hour to complete the surgery. I still believe something went wrong on my left side 'cause I heard the cauterizing machine used around 6 or 7 times (once on the right side)
I was in bed in terrible pain for around three weeks, eventually returning to work where I found that most physical exertions aggravated and inflamed my testis and vas. Each time I went to work I had to spend a few days in bed! I was given various anti-inflammatories which did help some. After around six months I saw a different urologist who said that the lumps were sperm granulomas and booked me in for excision. In the mean time the pain had gotten progressively worse a constant aching interspersed with sharp sudden pains yet some days there was no pain. In November 2001 they finally did the surgery by removing the left testis though the upper groin. I was not allowed to see the surgeon afterwards and no-one would tell me why I was only cut on one side. All they would tell me was that they removed 2 granulomas which they believed were caused from a reaction to the silk that was used to tie the vas. The surgeon who did the first one says he has never used silk ever, also he does open end they said there was a granuloma on each end. Any-way they cauterized it up closing both ends with no stitches. So now my left side was OK but I had to wait until Feb2002 to get the other side done. Well I didn't have to wait that long for the pain to return to the left side- all I had to do was lift something heavy. I was given nerve cell suppressants which has stopped the sudden strong pain after ejaculation but hasn't helped with general pain.
FEB 2002 -Back to hospital for excision of r/h granulomas. This time they cut down the centre of my scrotum to remove and I picked up an infection which I am still trying to kick after two weeks. I think it has also made my pain worse than before I now have a lump 3 times bigger than the one that was taken out -it feels almost like I have 3 balls!! Also the stitches in my scrotum dissolved nearly a week ago and there's a hole in my sack that won't close up. So in summary, I desperately need some help. The life that I had is over and as you well know it's a terrible feeling looking down the barrel of a lifetime of pain and bullshitting doctors not to mention years of hard work and training wasted if I can't get back to work. What do you consider are my next options both surgically and/or drug wise?
p.s.-I was against vasectomies for a long time but the more I looked into it the more I was converted by the fact that apparently nothing ever goes wrong. So keep up the good work in getting the word out-I warn everyone I can and have put 4 or 5 men off it. If only I saw your website when I was researching the subject. If I knew the risks there is no way in hell I would have gone in. Can you recommend anyone in Australia that knows a lot about this subject?

Response: (From Dr. Lou Zaninovich) I am a General Practitioner [in Australia] who after 25 years in GP has spent the last 5 years specializing in Men's Health. I am at present printing a 60-page book titled: Vasectomy: Before & After, which you would find very interesting. I am sorry to hear you are having so much trouble. I can't treat or give you advice without seeing you professionally but can I say just to give you some thoughts for your consideration: Sperm granulomas occur in more than 70% of all vasectomies but in many men they don�t cause any pain at all. I don't know why this is but I suspect the painful ones are those that get inflamed either because of inflammation due to the reaction with Sperm Antibodies or because of infection. The anti-inflammatories you had did help so perhaps it was just inflammation, but if you have infection as well then this must be tackled vigorously and for a long period e.g. minimum 6 weeks. If I can be of any help please email me,

Kind regards,

Dr. Lou

From: RW
Date: 3/9/02
Subject: Testicle the size of an orange.

I am a new victim. Just had surgery two weeks ago no problems at all until now. My left testicle is swollen up to the size of an orange. My urologist was out of town and the nurse just said "that is just part of the side effects, take a couple of Motrin and it will go away in a couple of days." I really did not like that answer so I made an appointment with another urologist and they did a CBC and ultrasound. Determined that I had an infection. Drained the site for fluid to use for a culture and gave me antibiotics and told me to sit it out for a couple of days. My question: Is this typical? Does this forecast trouble down the road? They said that it would take 2-6 weeks to clear this up. Anyone out there who can relate to this? Thanks.

Response: Many, many men tell stories like this, which makes the claims of a 2-3% complication rate laughable. When surveys are actually done, complications rates of all kinds are much higher. I only hope that your more severe symptoms subside and that you have no residual problems. The lack of sensitivity to these kinds of issues that abounds after the procedure is done astounds me.

From: GK
Date: 3/8/02
Subject: Blood in semen after vasectomy

I am curious. I had a vasectomy four years ago and now occasionally have almost, what appears to be nothing but blood in my seminal fluid. Quantities have been reduced in volume of fluid and occasional pain in my right testicle occurs. I have spoken to my Dr. about this and since no blood has been detected in urine, he seems unconcerned. Is this what you would believe is correct procedure, or should I be concerned. Just asking.

Response: From Dr. Lou Zaninovich, �I have read the question sent in by GK.

We do see blood in the seminal fluid (Hemospermia) every now and then. In most cases, about 60% no cause is ever found and nothing needs to be done about it. However, occasionally it may be a marker for other problems, in fact the following article by Kochakarn W, Leenanupunth C, Ratana-Olarn K, Viseshsindh V in the J Med Assoc Thai 2001 Nov;84(11):1518-21 is a study of the problems. I quote:

"Hemospermia: review of the management with 5 years follow-up.
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

OBJECTIVE: To review our experience with hemospermia and a long-term follow-up.

MATERIAL AND METHOD: Medical records of patients with hemospermia treated at the Division of Urology, Ramathibodi Hospital between 1993 and 1995 were reviewed. Clinical presentation, investigation, diagnosis, treatment, outcomes and long term follow-up were noted. RESULTS: Sixty-eight patients were found and completed follow-up to 5 years. The mean age was 40 years (range 28-62). Physical examination including DRE [Digital Rectal Exam] and urine examinations were done in all of the cases. Special investigations such as PSA, TRUS, IVP and cystourethroscopy were performed in selected cases. Prostatitis was found in 27.9 per cent, tuberculosis in 4.4 per cent, sexually related causes in 5.8 per cent and idiopathic [no known cause] in 61 per cent. No malignancy was found in this study. Hypertension was found in 7.3 per cent of the patients. Thirty-two per cent had recurrent episodes of hemospermia. Specific treatment was used only for prostatitis and tuberculosis. No specific treatment was used for the idiopathic group.

CONCLUSIONS: Hemospermia is a benign condition. Most of the causes were from idiopathic and inflammation. Only simple investigation was needed and treatment was recommended depending on the diagnosis and no specific treatment was needed for idiopathic cause."

In GK's case, seeing he has had a vasectomy, I would not be surprised if the problem is chronic prostatitis [inflammation of the prostate gland]. He should have the seminal fluid examined microscopically and cultured to determine if there are any bacteria.

Cheers, LOU

From: SD
Date: 3/7/02
Subject:

I had a vasectomy in September 1997. I experienced pain immediately on the right side, and 12 months later I had an exploratory op to try to find the problem after what was thought to be a granuloma failed to clear up of its own accord. The op produced no positive result. I was told nothing was found that was thought to be causing the pain, apart from a slight swelling, which was removed. For the next 2 years I was on Amitriptyline pills which eased the pain, which has always been uncomfortable rather than excruciating, now and again I thought it was easing only for it to come back again. Finally, I went to my GP who referred me back to the hospital. In March of last year I had an epididymectomy. It is different now, there is a slight tender part which I feel when I drive and when I lie in bed particularly on my right hand side. I saw the surgeon recently and he has told me to see how it goes, he thinks it will heal but to come back if it doesn't. I don't think it will heal; it's been too long now. What I would like to ask you is - I am only 47, I do not want this to disrupt the rest of my life, and as I live in the UK, do you have any branch of your surgery in the UK or anyone you could refer me to for the correct diagnosis and treatment. Also, reading through the forum, which I wish I had known of all this information earlier even a fraction of it and I would never have had this op in the first place, does the fact I have had an epididymectomy mean that I can�t have a reversal if this was deemed the best action? If not, why? As I have read of people having an epididymectomy who have not had a vasectomy how is this so? Thank you

Response: Once an epididymectomy is done, the parts are missing and you cannot have a reversal done by nature of the anatomy. As far as someone to see, Dr. Carruthers has a practice in the U.K. and has written books on the subject. If I was there, I would go see him, and have considered doing so even though he�s on another continent. I truly hope your situation improves. I know what it is like to have repeated harrowing genital surgeries only to remain in constant pain.

From: SA
Date: 3/5/02
Subject: Vasectomy-diabetes connection

I came across your website today. I can tell you much about my vasectomy - but - probably what I am most interested in is the association between a vasectomy and diabetes. If you know of a web address where this is dealt with in detail, it would be appreciated!

Response: Check out the web site for the American Autoimmune Related Diseases Association. They have information on over 80 autoimmune diseases, how they tend to run in families, and what treatments are available. Beyond that, you may want to read Dr. Roberts� book on the subject of vasectomy. See the Publications page of this web site.

From: AD
Date: 2/24/02
Subject: Vasectomy pain after testicular cancer

I had my vasectomy done 6 weeks ago. The vasectomy was performed in the urologist office. The doctor was dressed in scrubs and the nurse, his wife, was coming in and out during the procedure. She was not wearing gloves, scrubs or washing her hands and was still assisting in the procedure. At one point she grabbed a tool from the wall, a burning tool and started to use it while commenting how fast that tip burnt: She did not like that one. The doctor told her he preferred that one. While lying there, this was going on and I didn't have the presence of mind to say anything.

I was in intense pain from day one. Like someone is kicking me there and the pain goes up into my abdomen. Also the whole left side of my testicle hurts. I also have a lump the size of a pea in my scrotum. I was back at the urologist�s office 3 days post-surgery. He said he thought it was an infection and I would be fine. He prescribed Cipro and Percocet. That did not stop the pain. I went back to his office 4 days later for my week follow up still complaining of the pain. He said the swelling was down and I was fine (wrong). I went to my family doctor 2 days later and he was astonished by the lump and swelling, sending me to another urologist who was also astonished. This urologist was going to operate 4 wks post-surgery if I was still in pain. But after talking with his colleagues they agreed surgery was probably not the best course of action since a year ago I was diagnosed with testicular cancer and had my right testicle removed. Since I only have one, they are concerned. At this point I have been diagnosed with PVPS and the 2nd urologist was able to give me little to no info on a course of action and has referred me to a urologist at the University of Maryland. I will be seeing that doctor this Thursday.

What astonishes myself and my wife is we were not informed of any risks or complications prior to the procedure. We were just told - no big deal; a couple days off your feet, and you will be back to work. I wish I had done more investigation prior to surgery rather than after. Had we known all the possible complications we would have decided not to have the surgery.

I am 33 and do HVAC for a living. It hurts to lift, sit, stand, walk and move around in general. It is totally affecting my work and home life because by the time I get home I hurt so bad I just want to lie down and try not to move. I am having trouble picturing an end in sight especially after reading your articles (no offense). I have a 2 and 4 year old at home who don't understand why I can't play with them or they can't sit on my lab. I am already 40% disabled from a previous back injury (been a bad few years) this is just one more wrench in the works that I don't know how much longer I can deal with it.

Any opinions or suggestions would be greatly appreciated.

Response: Wow!. First, I find it strange that a doctor would do a vasectomy after you have already had one testicle removed because of testicular cancer. Your system has already been traumatized numerous times by the injuries you mention, and yet, they cut away. The later urologist�s decision not to do surgery sounds wise. Do whatever you can to take it easy on yourself and let your body heal. That means diet, exercise, and appropriate medications. Consider testosterone therapy since your levels may be compromised by the missing testicle and reduced function of the remaining one after the trauma of the vasectomy. I hope you can find a male health specialist who can help. God Bless.

From: JZ
Date: 2/22/02
Subject: Six years of pain, especially during sex

I had a vasectomy about six years ago. The surgery went relatively well as I experienced some nausea and the post surgery pain but it subsided after about three days.

My first bad or unexpected experience occurred during intercourse about three weeks after my surgery. What I experienced since was a sharp pain when ejaculating for the next 3-4 four months. This too eventually subsided, but then I began feeling an uncomfortable pressure in my scrotum. I learned later that these were in fact what are more commonly known as granulomas. When I discussed this with the doctor he told me not to worry as that was normal and the pain would subside in time. This was the second thing that I experience that the doctor neglected to inform me about, and the first time I experienced anger.

To date I still have the ache on my right side near the spot of the incision due to granulomas. My left side seemed to subside but recently I have now been experiencing what is know as an enlarged epididymis and the throbbing pain that goes along with it.

I realize that the pain is not going to go away. My sex life suffers from my fear of holding back on ejaculation because the quicker I ejaculate the less acute the throbbing will be later. My attention span suffers because I cannot concentrate like I used to.

Now having said all that, my greatest frustration is that the urologist and my physician do not recognize my condition as serious. The best offer I could get from my urologist was that he could do a reversal and my physician suggested that he might be able redo the vasectomy and do it as an as the open-ended style. I am still trying to convince my HMO that this reversal is not for the wish of more children but to relieve my chronic pain symptoms. I am not sure what to do because my doctors are only saying that a reversal or the open-ended vasectomy may help but there are no guarantees. I just don�t feel like I am getting the facts. Any suggestions or advice would be appreciated.

Response: This is another tough situation. More surgery is risky. Pain specialists have told me that surgery to relieve pain caused by surgery has a 50-50 chance of working at best. That is not adequate motivation to let someone cut on my genitals. Try as many non-invasive options as possible; preferably ones that treat causes, not just symptoms. See the other responses in this forum for ideas to ask for.

From: EH
Date: 2/19/02
Subject: Dull ach for three weeks after vasectomy

I had a vasectomy three weeks ago. I still have a dull ach and am concerned. How should I bring this to my doctor without looking like a total idiot? Your advice would be appreciated.

Response: Take a copy of the information on this web site into him and let him know that you are concerned that you may be developing post-vasectomy pain syndrome. If you need copies of the medical research articles to prove to your doctor that this problem exists, let me know and I�ll get them to you. Most sources say that the longer you wait to deal with this problem, the worse it gets. Try as many non-invasive approaches as possible. You may eventually want to pursue having an open-ended vasectomy to relieve congestion, pressure and ruptures if you determine that is the cause, or consider a reversal. If your doctor makes noises like he/she thinks you�re a complete idiot, find a new doctor. If you need a name of someone who has dealt with this syndrome before, let me know. Best wishes to you.