Remember,
this is not intended as a forum for medical advice, only discussion.
From: GG
Date: 11-25-02
Subject: Reversal and autoimmunity
Does the autoimmune response [to
vasectomy] resolve itself at some point with a reversal? Have you found
anything to speed the process up?
Response: Most of the written
research on the subject says that a vasectomy reversal will cause at
least a temporary increase in autoimmune response in the entire body
since the system exposed directly to sperm in the process of the surgery
and the blood-testis barrier is breached again in a significant way. For
myself, I found this to be true, but as time went on the antibodies in
my bloodstream diminished. My guess is that this is common. However, the
immune system continues to manufacture sperm antibodies after a reversal
which will now cross the blood-testes barrier and attack the sperm and
hormone producing cells in the testes directly, which is claimed by some
to be the cause of early testicular dysfunction and "andropause," or
�male menopause�, including such outward signs as �hypogonadism�, low
energy, moodiness, and erectile dysfunction. Long-term inflammation and
tenderness of the testicles is also common after vasectomy and even
after reversal. The presence of these antibodies in the genital tract,
and, in turn, on the sperm, is believed to be a major reason why men
have difficulty impregnating their partners despite a "successful"
reversal. Also, the scar tissue that forms as a result of the autoimmune
processes is thought to be responsible for the eventual failure of many
reversals since the vas and surrounding tissue harden and close off. For
more, read Dr. Carruthers' book noted on the publications page of the
web site. The only way I know of to mitigate this long-term autoimmune
response is to use some form of testosterone therapy to decrease sperm
production and, in turn, decrease the aggravation that the immune system
reacts to. All other approaches treat the symptoms, not the cause.
Actually, there is another way: remove the testicles, but that is really
not worth discussing, even though my original urologist mentioned it to
me numerous times. Maybe he was into that sort of thing. Dr. Carruthers
discusses the use of testosterone therapy for vasectomized men and the
success he has had in doing so, which reflects my own experience. There
are also several medical journal articles from studies conducted by the
World Health Organization about the use of various testosterone
therapies to decrease sperm production. If you are interested, I can get
you a copy.
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From: JE
Date: 10-10-02
Subject: To reverse or not to reverseKevin, Thank
you for taking the time to talk with me the other day. I'm going
through a real tough time right now and to find your website after the
fact, just gives me one more thing to worry about. I would like to know
what percentage of men who have had a vasectomy experience problems from
this procedure? I have a brother in law who is in his 50's, had the
procedure done 20 years ago, and has had no problems from it. I do
occasionally have a sharp pain on the right side which I thought would
go away after a while, but after six months has not gone totally away.
Also, is an autoimmune response inevitable, just a matter of time? Or
is it a percentage who will have this problem? I had my vasectomy done
in Washington State, paid for by the state, but they sure don't give you
any information other then it's a "harmless" and "simple" procedure. Not
even the fact that a reversal is much more complicated and will cost ten
times as much! You mentioned you could provide me with the number for
Dr. Neil Pollock in Vancouver? I appreciate all your help, and your
work with providing this kind of information.
Response:
Dr. Pollock's number is 604/717-6200 at his office. If that doesn't get
you a response, I can give you a number for his exchange who will page
him. As far as statistics goes, it depends who you talk to. When you
ask many doctors they claim virtually no problems. But if you want to
know the real problems with Chevy�s, would you ask the dealer or the
owners? When vasectomy patients have been surveyed, which to me is a
more accurate representation of the facts, the percentages run 18%, 33%,
and even 50 % and more with what they considered significant
complications and pain depending on what was asked and how. You're not
alone in your concern. Don't be in a big hurry to run at a knife for a
reversal. This is what I looked like after mine:
It might look like I was ready to play basketball, but such was not the
case. If you think this hurts a lot and takes a long time to recover
from, you'd be right. Reversal is a major surgery that can put you on
the sidelines in more pain for a long time. For me, it probably would
have been better to do the reversal sooner than the eight months I
waited on my original urologist's advice. The research says all men
will eventually develop "blowouts" somewhere in the testicles because of
a vasectomy, and three out of four men (or more) will become autoimmune
to their own sperm. There is no way to predict how an individual will
react to the surgery beforehand. Some do just fine with no apparent ill
effects. Others get hit hard, as you well know, with no easy options
for treatment. I'd be glad to discuss the various healing options
further if you want to call.
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From: CL
Date: 10-10-02
Subject: Please spread this awareness
I discovered your web site yesterday almost 4 wks too late since my
husband has already had a vasectomy and he is experiencing some
post-surgery pain in one of his testicles. According to his urologist
this is a common "reaction" of some sperm having leaked. Now we know
better and sure wish we hadn't entrusted this individual to tell us the
"truth" when we asked him if the vasectomy could affect my husbands'
hormone levels, make him more susceptible to heart disease, or even more
prone to testicular or any other kind of cancer. Of course his answer to
us was "No,� and that we had nothing to worry about, etc., because all
along he was mainly thinking of just fattening his wallet at the expense
of my husband's future health. I know now for sure that had we been
apprised of the multiple and potential health risks that this surgery
would never have taken place. THEREFORE I URGE YOU, PLEASE, PLEASE,
PLEASE, GO ON 'OPRAH' AND SPREAD THE WORD. I am pretty sure that she
would love to help you put the word out.
Response: Thank you for your kind encouragement, and I understand
your feelings about the disinformation process that often leads up to
vasectomy. When I asked about what happens to the hundred million or
more sperm cells a man still makes daily after vasectomy, I was told
they are �just reabsorbed,� which is about one percent of the story. Let
me know if I can help your husband and you in any way, i.e. discussing
the matter and options, or send you a copy of my book on disk for your
reference (no charge), or anything else. I know this must be very
challenging for both of you. By the way, if it would be helpful to talk
to another spouse about this situation, I'm sure my wife would be
willing, and know of numerous others who would be willing to do the
same. As far as Oprah goes, I've been waiting to get the final edition
of the book published and available on the shelves and then plan to
start the push for this and other publicity. Let me know if you have any
contacts or ideas in this regard.
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