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Low T post vas?


#1

I remember reading somewhere on the web that a PVPS sufferer called to setup T treatments and the receptionist immediately asked if he’d had a vas. He was told that the bulk of the young men getting treated for low T at that clinic had had a vas. I need to track down that story/comment, but I believe that this is a common side effect of a vas despite what research has been done.

How many of you have low testosterone following your vas? If you had a reversal, did it recover to normal levels? Do you know what your levels were prior to your vas?

I don’t know what my levels were pre-vasectomy, but I tested low when being treated for PVPS. After my reversal, my levels bounce around a bit but they still hover around 100 points higher than before the reversal.


#2

If possible, I’d like to see some studies showing vas causes low T, because all I can find are studies showing there is no difference or it actually increases it. Plus, from reading posts on this forum and other sites, not all men with low libido after vas actually have low T, some actually have very high T.


#3

Immediately after my vasectomy (within a few weeks), I began having some shooting pains in my lower abdomen, and a waning libido. I went back to Uro who performed Vasectomy, and he said all is well. Still healing and Libido will return when healing is complete. A few weeks later, pain remained and I went back. After several visits being told nothing wrong, I convinced the Uro to do some bloodwork. Low and Behold, came back and my T levels were in the tank! I had it checked approx. 9 years earlier at a routine check up, and current levels were less than half of what they were then. Of course Uro steadfast that the Vasectomy had nothing to do with it. He wanted to put me on T therapy, which effectively shuts down your bodies own production and makes you dependent for life…a daunting proposal at 35 years old. He said that was all he could do to help. I was mortified and beyond pissed. Fast forward a year…I cleaned up my diet and started exercising. Found a good endocrinologist who believed my symptoms and would check t levels every 3 months. They have crept up now from 250 after the V to last check 650. Unfortunately Libido remains low, and erection quality is poor. Not sure what that’s all about…


#4

As a physician performing 6 vasectomy procedures weekly I would like to make a comment. The testicle has 3 different blood supplies only one of which could be compromised during a vasectomy procedure and that is the vasal artery. Typically during a vasectomy procedure the vasal vessel is bluntly pushed away from the vas deferens and not injured or compromised during the procedure. When the vas is divided, the blood supply to the testicle is not compromised and the production of T should remain unchanged. It should be noted that T levels changed constantly and are variable throughout the day. One would need to perform a study with many data points before and after a vasectomy on many patients with vasectomy procedures performed by many physicians in order to demonstrate any correlation. The points being brought up about T levels are certainly interesting and I plan to look into it further but anecdotally I cannot say that I have many patients calling me complaining of changes in the sex drive post vasectomy, but of course that does not mean that they are not out there. Thank you so much for this interesting discussion. Please feel free to visit the link above for further information regarding a vasectomy.


#5

@vasectomydr. Hi. Good to have a vas doctor on forum. Before vasectomy i was a healthy man. Maybe you can explain these symtoms i have and many others since this is a harmless procedure? Severe testicle pain, severe cord pain, severe abdominal pain, pinching in testicles, prostate issues? Just to name a few. Maybe just maybe you are very good at your job and have never hurt anybody but i can assure you plenty have hurt people be it intentionaly or not. How many vasectomys have you performed in your time? How many of your patients have ended up like me/us with PVPS ? Because if you say none i dont believe it, just what my surgeon said.


#6

Thanks for joining our forum Dr. Robbins. We always appreciate the views of urologists here.

I’m surprised that you haven’t heard from any PVPS patients. While I didn’t return to my original urologist who performed my vasectomy, I did visit another at random when my pain appeared and he immediately informed me my condition was not uncommon. My point being that you should have heard from at least a few vasectomized men either from your practice or from others. My family doctor, upon hearing of my issues, informed me that he had two other patients who also had PVPS. He also has other vasectomized patients (no PVPS) with sexual issues post vasectomy.

I believe you have an opportunity here to research this further within your own practice and strongly suggest a six month follow up with your vasectomized patients to see if there are any sexual issues to relate. Most issues seem to develop fully by the six month mark (others can chime in on this).

Again, welcome to the forum and I look forward to your contributions to the knowledge base here.


#7

@vasectomydr - I noticed your website actually mentions the 1-2% AUA figure. That’s a breath of fresh air in comparison to the 1 in 10,000 or whatever sci-fi numbers we were quoted.

I’ve said this over and over again, that if my vasectomist had told me about a 1 in 50 chance of chronic pain, I would’ve said no way, no thanks, I’ll use condoms.

To be honest, when I saw your username, I was kind of expecting a bash/denial fest directed towards PVPS guys. Thanks for not doing this.

While I appreciate your thoughts on T production post vas, you have to remember that after the vas has been occluded, the epi’s will become swollen and distended and irreversible changes do happen to the testes and epi’s. Most men are asymptomatic however. This is the $64 question when it comes to PVPS - Why are so many men ‘perfectly fine’ and then us lucky winners have horrendous life altering pain?

Perhaps the chronic pain that we’re suffering is lowering our T, but personally, I just don’t see how blocking off an organ that produces T, breaching sertoli cells, leading to an autoimmune response (sperm allergy) can’t cause some changes in T production.

The PVPS uro’s that I’ve spoken with at length have their own theories about what causes PVPS, but at the end of the day, they all say ‘we don’t know what causes it’ and ‘we also don’t know for sure what will fix it.’

There’s simply a lot that medicine doesn’t know, but it seems like doctors are too embarrassed or proud to just say ‘I don’t know.’


#8

The only thing on his site I would disagree with have to do with the quality and quantity of the ejaculate. Mine was noticeably different after I was restored to patency. It was thicker and more pearly/white and came out with more force after vasectomy reversal.

Also, I have only really spoken with a handful of people I know about vasectomy that have had it themselves. This is anecdotal and based on my 2 brothers in law, my best friend, and a respected management consultant I shared my situation with. My best friend is okay and so is my one brother in law. My other brother in law has had problems when he exercises. Especially hockey. He had to get a “ball bag” from his doctor to support his testicles. He has discomfort when he plays hockey too. After I told my management consultant friend I worked with about my 5 year saga of pain that led to my reversal he immediately said he lost all pleasure from sex immediately following his vasectomy and that sex was no longer part of his marriage. In fact, he said he ended up moving to another bedroom because he just lost all pleasurable sensation and interest in sex after his vasectomy. He almost seemed relieved telling me. This guy was the most buttoned down hard assed no nonsense consultant I have ever worked with. I have read this from other men in forums on the internet. He did not say he had any pain.

I imagine if I was one of the guys that was okay after vasectomy I would think the men here are a bunch of wimps or crazies and I would have no time for it. It happened to me though. It’s no coincidence that I suddenly started inventing cutout cushions, waking in pain at night, buying standing desks, special foam cushions, kneeling chairs after my vasectomy.

Any doctor that has posted on this board can’t claim any sort of plausible deniability that this condition


#9

be there for your patients if they have issues.

This^ - times a million.

The guy who butchered me totally abandoned me. Wear the support and take naproxen they said. Wouldn’t even make an appointment to see me. Not that it would’ve fixed the damage done.

I had to find a PVPS literate urologist through this site. I had to read about conservative methods to treat PVPS on this site. I was completely left in the dark, and although I saw two GP’s after this crap began, who had both seen PVPS before, they didn’t know what to do.

It’s a horrible feeling when doctors wash their hands of you and all you can do is bitch about it on the internet.


#10

@vasectomydr I commend you for posting on this forum. You will find that the first hand testimony/information on this site relating to pvp is worth far more than any article or textbook . Not to downplay scholarly articles or textbooks or scientific studies. Its a shame more vasectomists dont study or are aware of this site. My personal opinion after suffering debilitating pain for a year and a half, two corrective surgeries, still in pain is that 9/10 the problem is not with a vasectomists error but with the procedure itself. Some mens bodies just cant handle the unnatural change. I personally believe the practice should be outlawed. If i performed an unnecessary procedure where 1 in 100 or even 1 in 1000 of my patients will suffer debilitating lifelong pain my conscience wouldnt allow me to perform it. But thats just me. Everybody believes differently and thats fine. Before my vas I never dealt with chronic pain or any medical condition for that matter let alone even having to have a dr.s appt. I went from running 100 mile ultra marathon races to walking with a cane with the energy levels of a 90 yr old. Anyway, thank you for posting. Id recommend studying this site often.


#11

@Thissucks - I used to go for runs every morning. I loved it. Now if I run or even jog across the street, I get horrible stabbing pains in my sac, cords and stomach and it takes about a week to settle down to my usual pain level. Forget playing tag, soccer, football whatever with the kids, I just can’t do it. It’s depressing as hell.


#12

I think most of the anger comes from this. If you operate on a man and cause him pain and then deny him treatment and won’t even see him, that’s probably why some men go off the rails.


#13

I TOTALLY hear that!!! If i didnt have a family friend who is a urologist who was willing to acknowledge my pain and do whatever it takes to resolve the pain I dont know where id be today. My heart goes out to all the men on here who are not as lucky.


#14

Back to the main subject of this thread. I have seen no studies linking vas to low T. I’ve just seen anecdotal evidence and have visited one site that I believe was set up by a guy who made a living pushing hormone replacement therapy for men. Of course the men here that choose to have testicles removed to be in a pain free state will have issues and I believe @Aschiro had one of his testicles so severely damaged by his many pain relieving procedures it had atrophied significantly prior to removal.

I’m at the beach right now. I got up and drove down early with two of my kids. My wife is coming tomorrow. I told my boss I was working from home but am working from beach. It’s the beginning of my vacation. I have a hard time getting excited though because I’m having a lot of pain sitting today. It’s fairly excruciating after the ride down and sitting on the hard wooden chair in my kitchen. It’s crazy. Having trouble doing my IT job because I got a vasectomy and can’t sit without pain anymore. If I ever figure this out and become pain free you guys will probably never see me again but until then, thanks for letting me hijack every thread and making it about me LMFAO.


#15

@vasectomydr

You’re insight is a breath of fresh air. I’m one of those mid 300’s T level guys. No idea where I was pre vas but at 33 yrs of age there’s really no reason for me to be at those levels.

I’d be hesitant to assume what a vasectomy can and can’t do. I had a vasectomy on a Friday and by Wednesday I was blacking out with an intracranial pressure over 40 diagnosed via spinal tap. I’ve been battling for my health ever since.

There needs to be more research on the disposal effects of so many millions of sperm per day. Early research into artherosclerosis showed an obvious link that was somehow disproven via ultrasound. Perhaps the low T effects is secondary hypogonadism instead of primary. With sperm head and immune complexes measuring 5 microns and cerebral capillaries less than 3 microns, a vascular disaster is waiting in the wings. Compare FTD to vascular dementia, there’s seemingly no difference.

I am now given a cort stim test every three months after plasma cortisol levels have shown a steady decline. Mandatory 6 month MRI’s because my intracranial pressure puts me at risk for empty sella syndrome. If this was as simple as disconnecting a couple of tubes, it would’ve been solved years ago. Think big picture.


#16

@vasectomydr
How about a section on your site that tells folks with existing testicular issues and someone with autoimmune issues that this is probably not a good idea for you.


#17

Interesting that not much is being reported on this thread regarding lower testosterone after vas. Let it be me then. I had vas 18 months ago, still in pain from day 3 after vas (perineum, base of penis and leg) which is gradually getting better (started getting better at 9 month mark). I received my testosterone results yesterday and compared to 6 months ago total T dropped from 350 to 290 and free T is at 4.7 (about half of the minimum). I have very little desire for sex now and started developing ED, I am losing erections with my sexy girlfriend. I am feeling depressed and hopeless. Where is the end to this ordeal? I should be grateful that I am in bearable level of pain now. I am thinking about T replacement therapy, not sure if reversal is an answer for lost libido (low testosterone) and continuing pain.


#18

Hey Vincent.

I’m not sure how old you are but those number seem low. There are a lot of factors that can affect your T levels but low libido is kind of a concrete thing, you know?. Up until not too long ago if my wife got naked in front of me, even if I was not wanting sex, instinct would kick in and it just happened. It would be interesting to know what your numbers were prior to you vas but I guess we will never know that and most guys here will never know that. I think within a year of reversal I was at 465 at one point. I am 51 now and had a level in the 390’s last couple of tests. The level is just a number, it’s how you feel that counts. I would make sure you don’t have anything else going on by getting a complete physical. If you are not lifting or in shape you may want to try to build some muscle mass as that can raise T-levels too from what I’m told. Being in shape and having good nutrition and rest is important too. Please keep us posted as to what’s going on.


#19

I’m going to have mine checked soon @Vincent


#20

Thanks MikeO and jsh. I am 52 now. And yes, I don’t know what my levels were before vas. Total T 50 point drop in 6 months seems a lot though with obvious to me loss in libido and energy level. Good advice, I will go for a complete physical exam and start exercising more and eating healthier.