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My PVPS story and resolution


#1

This is my story from start to finish copied from the old yahoo PVPS message boards. Here is a table of contents view of everything in this post:

1. first post here which includes the history of my vasectomy and
subsequent pain
2. decided to have a reversal with Dr. Marks. Also includes posts about
first few weeks recovery after the reversal
3. a informal theory poll to see if there was any connection between
getting healthier, increased sperm production, leading to PVPS
congestive pain. Turned out there were a few members who
experienced just that.
4. questions about amount of sperm found during reversal procedure
5. 2 months post reversal update
6. 11 weeks/3 months post reversal update
7. 4 month post reversal update
8. 5 month post reversal update
9. 6 and 7 month post reversal update

I wanted to preserve this from the old site since it was stories like this that I found most helpful (all info from start to finish) in helping me figure out the best course of action. At the time of reposting this I am now almost 2.5 years post reversal and I would say I am 99% pain free [BIG knock on wood]. The biggest things I contribute to my success are going to a very skilled/specialized surgeon for my reversal and getting/staying healthy to keep my inflammation minimized as much as possible.

Introduction

Hello-

I have been researching about PVPS every since I have had my vasectomy (9 months ago) but I have to say that I don’t have the amount of pain as most of the stories I am seeing on here. The sad part though is that it is enough mild discomfort/pain that I cannot ever get more than a day without thinking about it. I have researched so much on the web that all the material I come across now (including this sites VERY nice collection of data in the files section) I am starting to recognize as having already read through. I spend quite a bit of times on other types of forums and try to do as much research before asking questions.

Let me start off by saying that I am the very stereotypical case for getting a vasectomy - 35 year old with 2 kids (2 and 4 years old) and definitely ready to NOT have any more kids. Between having that feeling and knowing a half dozen friends and co-workers who have had a vasectomy with no ill results I decided to get one with no indication from my vas doc of any potential for long term pain.

The vasectomy procedure itself was pretty uneventful and the most pain were the small twinges of pain of getting the locals. Things were generally soar and I only had a small 2-3" x 1" bruise on my right side. After a few days though it was a bit painful to get up from sitting since I discovered a small pea-sized hemotoma on my right side at the site of the vas def severing. Doc said it would take a few months (6-9) to heal and have the scar reduce away. I was about 1 week out at this point and having a nice hot soak bath every night helped but I pretty much plateaued for the next 2 weeks in pain and the size of the hemotoma. I also had some dull aching pain that generally got worse thoughout the day that was best described as ‘drawing’ pains like I could feel the vas defs being pulled/strained through my lower abdomen.

From here I need to add an, IMHO, important bit of information. It was around this same time that I also decided to get healthier by eating better and getting some exercise. At this point though I didn’t really look unhealthy as I was 6’3" and about 180lbs. But my cholesterol had been creeping up to 250 over the past 4 years of no/little exercise and eating out almost 15 meals a week. So I started off by juicing and I am not talking about the ‘Jack Lalaine’ type of juicing with some apples but 90% pure vegetable juices with everything from carrots, beats, wheatgrass, spinach, garlic, ginger, and about 6-7 other ingredients. I started drinking about 2 pints a day.

Now at this point I have to admit it could be a complete coincidence but the DAY I started drinking the juice 99% of the pains I described above pretty much stopped. And within 6 weeks my hemotoma went down to the size of a grain of sand or less and has stayed that way every since. I also made drastic diet changes of not eating out anymore - well 2-3 times a week and started preparing all of my own meals that were far healthier in general. I also started walking 30 minutes every day as fast/hard as I could. In the span of 3-4 months I had lowered my cholesterol from 250 -> 175 and I felt better than I had since college! Things
were great.

So to sum up the timeline so far:

  • vas in november of 2010
  • dull ache worse through the day and hemotoma from november - december of 2010
  • juicing/diet change/walking in mid december 2010
  • by march of 2011 feeling absolutely great!

Around late May I started to notice some pressure discomfort (wouldn’t call it pain per say) that would form in my testicle area after sex. At first I noticed it when i was on vacation and away from my diet/juicing regiment and attributed
it to that. But since June it has gotten more noticeable regardless of what I eat/drink etc. As recently as 1 month ago the feeling went from discomfort (that would last 2-3 days after sex) to occasional dull pain spikes that seemed to occur mostly within 24 hours of sex when i would get cold and everything down there would ‘tighten up’ more. At this point I would say the discomfort/pain for the 2-3 days after sex was in the 1-3 / 10 range. And the occasional spikes would get up to the 6-7 range.

It was around June/July that I also started to notice and pay attention to the pain more that the epididymis would go from mostly deflated (before sex) to very inflated (and larger, I think, then before vas) after sex (and it only takes like 30-60 minutes after sex to observe the change). From then on the dull pressure pain ensues for 2-4 days. I went to my doctor about 24 hours after sex last week (general MD who did my vas and has done them for the past 25 years) and he did diagnosed me with epididymitis (congestion/inflamation of the epididymis) and said that I was honestly the first person he had ever seen with this issue in all his years of performing vasectomies [yay - I am ‘lucky’ heh sigh]. He recommended me to a local urologist and I have an appt there in about 1 week.

My current frame of mind is this. In the last 9 months of doing research into PSVP I have felt the following:

  • VERY VERY VERY VERY bad regret for not doing just >< more research into a vas before having one - still have regret to this day … a lot.
  • along the way of looking how to fix this (mostly leaning towards reversal) I have come across so much information about the scary side affects that just adds to my regret and reinforces my desire for a reversal.
  • the pain honestly is probably liveable but it’s just a constant reminder of my last point (all the unknown and possible health issues related to getting a vas. Things like the book ‘If it’s not broken’ etc.)
  • I have reviewed all of the options I could find from nerve blocks (temporary), to denerving and epididimeology (removal of epididymis) but I REALLY REALLY don’t want to do any more harm to my body. Which as far as I can find leaves me with reversal.

Looking into the reversal I found the following 3 clinics in the western half of
the US that seem to have the best track record:

At this point I am leaning towards Dr Mark due to very good reviews from mostly this site and I have family in Phoenix which I could stay with for the first 2-3 days post-op as well.

At this point my main questions/concerns are as follow and I really hope the good people here could help me with them:

  • What are the rates of needing to do a vas-to-vas versus vas-to-epididymis tube connection? I have read that time since vas used to be an indicator but with the more recent no-scalpel method that almost eliminates the chance of pressure
    relief via a sperm granuloma potential forming that the chances of blowout/scaring/blockage (IE: vas-to-vas not being successful) are greater today starting as early as 6 months out. I just really don’t like my odds with the more complex non vas-to-vas procedure.
  • which leads me to my second concern that I can’t seem to find information on which is if they can’t do a vas-to-vas reversal and they have to connect the vas (Again from reading ideally as low to the epididymis which means as low on yoru testicle as possible) to the epididymis does that raise your testicle up? if so wouldn’t that put all the pressure of supporting the testicle on the vas and the delicate connection?
  • I have found VERY little statistics on the chance of reblocking occuring even after a successful vas reversal. The one stat that I found seemed to be a 1 in 7 chance of reblocking occuring. Does anyone have any further data on that?
  • is there more, less, or the same chance of further damage to say nerves and such in a vas reversal compared to a vas? It seems like no other than the fact the doc is working in that area for quite a bit longer but I am only considering what some of you call ‘super docs’.

Anyway I apologize for the long winded first post but I hope it is somewhat evident that I have done some homework and am trying to figure out how to fix this as quickly and most importantly as best I can. The other option I am also trying to weigh is whether to just try and live with the pain versus doing another operation and potentially having a worse outcome. I just don’t know at this point. I am trying to do as much research now and not make a decision for a few more weeks. I am just really at a point in which I feel that I need to start talking with people who have experience with this since I doubt the urologist will be of much help. Even my docs first bit of advice was to try antibiotics which I told him didn’t seem to work most of the time AND given the fact I eat about 1-4 raw garlic cloves every day along with about 1" of ginger root both of which have very high anti-biotic effects I didn’t think it was an infection. Also given that the epididymis flares/enlarges directly with ejaculation and is
not constant.

Thank you all for reading and listening.


Congestive epididymitis after vasectomy
Reversal didn't work
My story after 12 weeks
My PVPS story with reversal recovery journal
#2

Reversal with Dr Marks

Hello again everyone. It’s been a few weeks since my first post here but just wanted to let everyone know what has happened for the sake of helping anyone who has the great misfortune of dealing with PVPS.

To summarize quickly:

  • had vas on Novemeber of 2010
  • month of mild pain healing with small hemotoma on right side that cleared up after 4-6 weeks.
  • from January 2011 - June 2011 felt great
  • June 2011 started having pressure pain/discomfort in epididymis area after ejaculation
  • problem persisted through the end of August when I decided to have a reversal

A bit more detail about the 2-3 weeks leading up to the reversal. Since I identified the action (ejaculation) that lead to the 1-3 days of discomfort in the epi I chose to cut out pretty much all sex (which my wife understood God bless her soul). After about 5-6 days of abstaining things felt pretty good overall. So I decided to try things. Afterwards the discomfort came back about
50% as bad as before. I thought this isn’t so bad so then we tried again about 24 hours later = pressure pain back in full force.

At this point I was about 2-3 weeks out from my reversal (hadn’t actually planned it yet) and at that point I decided to stop all sex. After 5 days or so things were feeling better but not 100%. Then as each day went by some days were ok and some were not. I started to correlate the days I had 20oz or so of myvegetable juice the pain would be quite a bit more noticeable. And I also
started to experience a slightly different/new pain that seemed to originate from directly within the testicle. It wasn’t the dull ache of the epi but short bursts of vice clamp like pain twinges that would only last a couple of seconds and occur every hour or so.

During this time I had also consulted my original doctor who performed the vasectomy. He examined me gently and confirmed I had epididymitis and said I was the first person he had ever seen with this from a vasectomy (after he heard my history of pain since the vas) in his 25 years of doing them. He started off by suggesting anti-biotics but I kind of shot that down and he agreed for the following reasons:

  • if it was an infection wouldn’t I possibly have a fever/chills/sick? Answer was I didn’t have any of those symptoms
  • if it was an infection wouldn’t it be constant and not vary with ejaculations? The answer was it was not constant
  • On average I juice a thumb size piece of raw ginger root, 1 garlic clove (andalso eat up to 3-4 additional raw garlic cloves) every day which on their ownpack quite a natural anti-biotic punch

So after all of that he recommended me to a urologist as he was not one himself. He also suggested that I take Ibuprofen when I feel the pain come on to see if
that helps at all. So I scheduled the appt with the urologist (earliest I could get was about 1 week later) and tried some Ibuprofen. The Ibuprofen didn’t seem to do anything and I NEVER take NASIDS so I would expect to feel there effect.

A little before the urologist appt my wife and I had our phone consultation with Dr. Marks at dadsagain.com. From my research he seemed to be one of the top reversal micro-surgeons and from my initial contact with his office everyone seemed very friendly and happy to help. My wife and I used the full hour consultation and by the end my wife was fairly convinced that a reversal was my best option.
My appt with the urologist went well. He also gently examined me and said he didn’t feel any granulomas (which the reversal doc told me to ask about) but the epi was slightly enflamed. We discussed the options all of which I already knew
about. He did say in his 25-30 years of vasectomy experience he had about 5-6 guys develop PVPS. Most of them opted for the removal of the epididymis which I personally didn’t want to do since I didn’t want to cause more (un reversible) damage. He said he hadn’t really heard of doing a reversal to help alleviate the pain but agreed that I had done my homework and was aware of all of the options. He didn’t even mention the possibility of an infection or antibiotics.

At this point the pain was fairly consistent even in the absence of sex and so I made the appt with Dr. Marks and was lucky that he had availability for Sept 12th. As I had read about everyone at the office was VERY helpful and once I got them my flight itinerary they made all of the shuttle and hotel reservations - very helpful.

I flew down by myself as my wife had to stay and take care of the boys. Everyone was great and Dr. Marks said the procedure went very well. He said ‘your left side billowed’ out for a few minutes and your right side was also very congested with lots of sperm/fluid. After the surgery I was taken back to the hotel where I religiously iced and stayed off of my feet in bed until Thursday morning (reversal was on Monday). I never even took any of the pain medication only the anti-inflammatory meds. Thursday morning I flew back home with little/no drama.

Since then I have been avoiding lifting and working from home and kept icing regularly through day 5-6. The thing I noticed right after the surgery was all the pressure pain was gone and I felt a great relief. The only pain I had now was similar to my original vas - drawing vas pains mostly.

I am now 9 days post vasectomy reversal and am feeling pretty good. I still ice a couple of times a day and am taking the NSAIDS as prescribed.

The only concern I have but I realize it is VERY early in the healing process still is I am at the point where I can move thing very gently down there and feel the vas connections. And in looking/feeling around gingerly I have come to realize I may have either a sperm cyst or a spermatocele on my right side very upper part of the epi. It is very soft, squishy, and sensitive. I realize when
looking at it that I have had it as far back as I can remember post vasectomy. So I am pretty sure it is nothing new but I am a little worried about it pressing up against the healing vas-to-vas connection on my right side and also the possibility it may impede sperm flow through the epi?

I have searched on this site and others and it seems like for the most part it should be beningn (if it is in fact a spermatocele) and I plan to have it checked out after a few weeks more of healing. Dr. Marks said I need to give things more time to heal down there which I completely agree with.

At this point I just need to try and not think about the soft lump (which like I said in hind sight I remember seeing ever since I had my vasectomy done) and focus on healing. I just pray that things continue to go well and I don’t scar up to create another blockage.


#3

Poll on what can cause the onset of congestive PVPS

I am curious since all of the studies I have read (and sadly there are not nearly as many as there should be given the number of vasetomies a year) seem to indicate a very wide range of time when PVPS symptoms can show up (basically immediately out to 20 years post vas).

So I have been thinking about that and one general theory I have read about here and other places that seems logical is the idea that the epi pressure pain is caused by large production of sperm. Basically more sperm than your body can absorb/break down. For me the onset of PVPS was about 6 months post vas. And if the high sperm production theory is correct I have my own follow on theory. My theory is if you have made any life/diet/health changes in the time (oh say 6 months - 1 year) before the onset of PVPS symptoms.

For me I made HUGE changes right about the same time as I had my vasectomy. Before the vas (and especially the 4 years prior with starting to have kids) I didn’t exercise at all (not even walks) and ate out 75% of my meals (bad but at least not fast food). My cholesterol was going up every year and the year my doc recommended a statin I took charge of getting it down. I radically changed my diet and started exercising everyday. As a result I got my cholesterol under control and felt great. But the irony was I think in becoming healthier I also ramped up my sperm production. Dr. Sheldon Marks (a reversal specialist) gives out a guide to diet/supplements to take to increase mens fertility. Looking through his list I did a LOT of those things in spades along the way of becoming healthier.

So I am wondering since some didn’t have any problems months/years after their vasectomies was there any other changes that occured recently that might have affected your health/sperm production? From my research and talking with Dr. Marks the following things can lead to greater sperm production:

  • losing weight (I guess overweight men produce more estrogen and less
    testosterone)
  • stopping smoking
  • eating healthier
  • taking more supplements
  • changing underwear type
  • fewer hot baths/hotubs/etc
  • exercising more
  • eating less soy products (heard that lots of soy can inhibit sperm production)
  • stopped psychotropic drugs (also heard from someone that being on those types of drugs can inhibit sperm production - anyone confirm?)

Or any other changes that you may have made to yourself at all before the onset of congestive epi PVPS.

I realize this may be a futile effort to try and quantify some things that may affect PVPS but I can’t think of a better place to try and ask for some data.

*** The results of this post were 2 men decided to get ‘healthier’ 5-15 years after no-issue vasectomy and after dropping weight, eating better, exercising they started to suffer from congestive PVPS


Whats the Oldest someone has been afflicted with pain after being fine for years
Spermatic Cord Block
Pain at site of vasectomy eight months after vasectomy
New member, pain starting 3 years after vasectomy
#4

questions about amount of sperm found during reversal procedure

So I just received the paperwork from Dr. Marks office for insurance reimbursement purposes and I found it interesting that it contained very detailed descriptions of the procedure.

Most interesting was the descriptions of the amount and type of sperm (parts) found on each side. I was wondering if it was indicative of anything at all?

left side
"copious volume, white, watery, rare whole sperm/cc, non-motile, 60 million sperm with partial tails/cc, 140 million sperm heads only/cc"

right side
"mild becoming moderate volume, murky, watery, 8 million whole sperm/cc, non-motile, 4 million sperm with partial tails/cc, 3 million sperm heads only/cc"

I was really surprised at the disparency between the number of sperm found between the two sides. I am 99% sure I have a spermocotele on my right side so I am wondering if that is possibly where a lot of the sperm were ending up which might explain finding less sperm and less pressure on the right compared to the left?

Anyway just wondering if any others here got a report like this from the reversal procedure and how it compared.


#5

2 months post-reversal

A big knock on wood but I am almost 8 weeks post reversal and no return of the congestive pains. The post surgery pains have been very linear and I think/hope I am over the worst.

I have had a couple of times when I ‘pushed’ myself physically a bit to far and things down there let me know. Then they were soar for 2-3 days after but recovered.

I am going to schedule another SA here 4-5 weeks after my first one (which was two weeks ago now). Overall I am still very cautiously optimistic since I was pain free after my vas for 5-6 months to me that is the same time it is going to take post reversal to make sure the pain doesn’t return.

I will try and keep updates coming each month for a while.


#6

3 months (11 weeks) post-reversal

Just wanted to update my status at 11 weeks post reversal. I had one SA done 6 weeks post-reversal and it came back with 95 million sperm / ml. Now 11 weeks post-reversal the numbers are almost identical at 96 million sperm / ml.

So [knock on wood] things are still flowing well!

Just a side update on the overall reversal recovery. Around week 7-9 I was in a bit of pain but realized by now that most of that was brought on by my nearly daily ‘self inspections’ of my right side vas-to-vas nodule. After realizing I was probably inducing my own pain I stopped touching anything down there and since then ~2 weeks things have been feeling much better. I still inspect the nodule on my right side about once every 5-7 days very lightly and it is continuing to get smaller. Now from a size of a BB down to a pimple I would say. My spermatocele (still unconfirmed by urologist) seems to be the same and very possibly a little bit smaller even [fingers crossed].

Since my first SA at week 6 I went from 3x 200mg ibuprofen throughout the day to a homeopathic anti-inflammatory medicine from week 7 to present. I think I am going to start weening myself off of that once the nodule goes completely away on my right side (hopefully in a couple of weeks). The daily pain levels are very good 0-1 mostly. With no pain/discomfort from morning till early afternoon. Then from mid afternoon to evening I get a little discomfort on my right vas-to-vas side area. But overall that has been improving every week as well.

Still am not doing any exercise which I really miss (my daily walk/jog) but I feel that it ‘aggravates’ the right side vas-to-vas site with the scissor action in that area. I think I may try to get back into some upper body resistance training here in a couple of weeks since lately I don’t feel any discomfort when tensing my mid section.

So here is to hoping things keep going well!


#7

4 months post-reversal

The last month has been interesting to say the least. Overall things are still going well and I am healing more and more, but there have definitely been some setbacks this past month.

So about 3 months post reversal I was taking a few epsom salt bathes which REALLY helped heal up my right side vas-to-vas nodule/homatoma that I had slowly healing since the reversal. I saw the same progress in one week that previously took 4-5 weeks - simply amazing. Plus all my late afternoon aches that I would get were gone … this lasted about 7-10 days then …

I had one day of not wearing my new ‘good supportive underwear’. It only took one day of wearing some boxer briefs that were less supportive and some of the aches and nerve twinges came back. Then about 2 days after that I did a bit of extra physical exertion and it compounded the situation.

After that it took me 3 weeks to get back to where I was 3 months post reversal. So it was a 3 week regression of sorts, to be expected as Dr. Marks told me ‘ups and downs’. Now [BIG knock on wood] I have had the best two days I have had since the reversal. I went for some slow walks around the neighborhood completely pain free during and after! In the last 2 days I also stopped taking the pro-trauma and the anti-inflammatory tincture I had been taking and so the last two days I have not been taking anything for pain and the pain has stayed away 95%.

I just want to stop and say I seriously still thank GOD every (evil congestive) pain free day I get now.

The main ‘pain’ I have at this point and for the last 3 weeks was a slight twinge pain on my right side vas-to-vas which at the reconnection site itself doesn’t hurt very much. But it seems to ‘tickle’ some nerve path that runs right up my right side and into my neck just below my jaw on the right side. It causes me to tilt my head to the side trying to relieve it. It only comes and goes
throughout the day with more in the afternoon and evening. But like I said that
is even been getting better and again if I had to live with that for the rest of my life I will consider myself VERY VERY lucky considering where I was or where I could be. I wonder if it’s just part of healing now that the nodule of scar tissue has healed there is less ‘support’ of the vas-to-vas reconnection site so any slight moving/twisting/bending of that reconnection would seem to cause more nerve sensations? Just a thought.

My spermatocele definitely hasn’t gotten any bigger and I am fairly confident it is getting smaller - another THANK GOD moment of reflection everyday. The only odd part about it though is the manner in which it is getting smaller. I was expecting an overall reduction but it seems that it is less wide but just as tall as it originally was up to and after my reversal. In fact right after the reversal when I really started paying attention to things down there it looked like one bigger mass with a line down the center kind of pushing into the center and making it look like two separate bubbles (if that makes sense). At this point it looks like one of those bubble/spermotoceles is almost gone (hence the half as wide) but the other is still there.

Thinking back to 3 days before the reversal I was sitting at my desk and I was having a VERY painful congestion day on both sides. In the middle of the afternoon I felt a sudden relief of pain on my right side and what felt like the sensation of liquid running down my right inner thigh. I thought crap did I just have a blow out on that side? But I dismissed it since I couldn’t figure out a
way in which the fluid would beable to escape the sack surrounding the epi along with getting from my scrotum up to and down my leg. But thinking back I now wonder if the sudden relief of pain was the formation of a second spermatocele close to the first one. Anyway just a way out there thought.

Overall I am feeling cautiously optimistic at this point. I will have another SA at the 6 month mark unless I have a return of the pressure pain then I will have one sooner. I would like to point out that I still carry out Dr. Marks instructions to the letter and that mostly includes ejaculating every 24 hours. Up to this point I have done exactly that and feel that it has been very instrumental in keeping the pipes open and flowing to this point. I also know things are getting better because I am just starting to get a day here and there where I can get to the end of the work day without even thinking about any pain that I have felt that day.

This definitely has been a very long healing road - much longer than I expected given how much healthier I am now than compared to when I had the vas originally. There are some days when I have to admit it’s frustrating not being able to exercise yet the way I used to, but like I said before and will say again I consider myself so fortunate at this point to have as little pain as I
do compared to some the others on this forum. This forum has been such a huge help and support system for me I don’t think I can ever repay everyone on here.

I figure posting my story is as good of thanks and support as I can give back.


#8

5 months post-reversal

I just wanted to type this in since I am using my entries here both for areference for others and somewhat as a journal for myself.

So like I mentioned in my 4 month update I had some ups and downs. Stupid mejust couldn’t leave things alone down there so I basically repeated what I went through in December through January (2-3 weeks of a rough patch). I am now about 14 days into not touching ANYTHING down there and the the past 10 days have been great - back to 90-95% pain free most days with ability to walk without feeling anything twinge/get irritated down there on my right side. So from this point out NO more touching - not ever hopefully.

A couple of notes about the past 4 weeks that kind of tie in with some other recent topics here. About 2 weeks into my 3 week relapse I noticed one day that a LOT of my nerve pain I was experiencing up through my right side neck/jaw area was due to me tensing up my shoulders and upper body. I was hurting for so long that my body got into this constant ‘ready to catch’ the pain mode, which was a big cause of my upper neck/jaw nerve/pain issues. Once I realized this and made a concerted effort to relax my upper body was a big turning point in the pain and discomfort starting to subside.

I also noticed that the most uncomfortable times for me is when I get my core body temp up with some physical activity (like running errands) which causes my scrotum to really distend fully = more tension on the vas-to-vas reconnection sites = a bit of off-and-on pain on BOTH sides. But I don’t really mind it because it reminds me that my left side is still not fully healed which makes me feel better about my troublesome right side. I mean I had my reversal in mid September and since then it has been pretty cold this winter = me being cool most of the time = scrotum not fully distended much at all. I am a pretty thin guy and without much physical activity I don’t warm up and/or stay warm very easily. Even though I am wearing the good underwear, which do help out a lot, it seems I still get a reminder about once a week like this - again not a big deal.

One other thing that I felt that was new/different at the worst of my relapse was a feeling like 50% pressure pain on my right side. By 50% I mean it feels kind of like the old pressure pain I used to have pre-reversal but not quite. Anyway I do have a feeling that it may have been the vas-to-vas reconnection site being inflamed and closing down a bit causing some potential back pressure.
I would feel it maybe every 2-3 days during the 2nd/worst week but it would only last for 10-30 minutes at one point in a day. And at the time my epi didn’t feel congested so I am pretty sure it wasn’t congestion but almost similar enough to freak me out a bit.

Overall though I think this is my longest run of low/no pain which is great and I am still thankful everyday. I have tried some new anti-inflam meds which I take sometimes after work which seem to help some but they are pricey:

  • New Chapter - tumeric force
  • New Chapter - zyflamend

I have read other people trying these and they do seem to take what little edge I develop by the end of the day off nicely but again they are pricey. But I don’t experience any side affects with them like I do with NASIDs.

I have my 6 month SA coming up here in a few weeks and will report back on that.


#9

6 and 7 months post-reversal

Sorry I missed my 6 month post-reversal update but I honestly have been so busy ‘getting back to my life without PVPS pain’ that I just haven’t had a chance to post about it.

So to catch up here is the timeline since my 5 month post reversal update:

  • about 1 week after my 5 month update I continued to lay off touching/looking at things down there on my right side. This of course helped, like it had back in December and February. But this time I after things started feeling much better I haven’t looked down there since.

  • month 6 I felt better then ever with I would say 95% pain gone. I still get the vas-to-vas connection site sharper, but VERY intermittent and short, pain maybe once a week on either side but those times are rare. I also had my 3rd SA done and the numbers still look good. This time my volume was about 4.5 ml total compared to my first 2 which were around 2.4ish ml. So that threw off my sperm count / ml from 95-100 million / ml down to 55 million / ml. BUT the total was about the same. To summarize the SAs roughly from memory:

  • 1st - 6 weeks post reversal -
    total sperm count 240 million with around 30% motility

  • 2nd - 12 weeks post reversal -
    total sperm count 260 million with around 50% motility

  • 3rd - 24 weeks post reversal -
    total sperm count 215 million BUT with like 75% motility

I was told by the SA analyizer at Dr. Marks office that ‘the pipes are wide open’ with motility indicating the overall health of the sperm (higher is better) and that the total numbers vary quite a bit (FWIW I started taking hot baths 2x a week after the 2nd SA so that is one bigger thing that changed) and the higher numbers on the first two SAs could have been due to decompressing
(blowing all the pent-up old sperm out of the system).

I also finally had a urologist visit to see what I thought was a spermotocele was all about. A groin ultrasound later showed everything to be normal and upon inspection the uro told me what I was looking at and seeing on my right side was just my epi. The way things are situated down there I can’t really see my left side since the epi on that side sits in the middle of the scrotum where as my right side the epi is on the right side so I can see it easier (kind of hard to describe). So that is also good news. I can say though that for the first 3-4 months the epi was getting smaller = deflating from the built up pressure I guess.

  • month 7 overall at this point I could not be happier. The last month I have been able to move and live life at full physical speed with very little to no pain and I haven’t been taking any meds for pain now since about 3 months post reversal IIRC. I can’t believe I am not 7 months post reversal. It’s been a LONG and painful journey starting with the onset of the pain 3-4 months before the reversal. I have days now where I do not think about this whole PVPS at all which I cannot describe how great it is. I say this to give hope for everyone who is going through hell right now - there is hope!

My only concern now is scaring over at the re-connection sites. Does anyone have any info on the chances of that happening after a reversal? I only was able to find one bit about it that said something to the effect of there is like a 2-5% chance of scarring occurring every year up to 5 years post-reversal. I don’t know if that is the same chance every year or accumulative? I would assume the longer you get post-reversal the less chance there is for scarring closed? Another way to ask the question is what is the most critical time after the reversal you need to worry about scarring occurring? Or is this just something reversed guys are going to be prone to for the rest of their lives?


#10

Hi David, I really appreciate you posting this information again, it’s great of you to do. I’m in a similar boat to what you were going through and am leaning towards a reversal in my near future so it’s great to read a success story. Gives us other guys who are going through it hope.

One thing I’ve often wondered is the chances of scarring as well with reversal and if there is anything that you can do to minimize the chances of this happening, or if it is just completely random per person. The idea of living a healthy lifestyle only makes sense as a possible way to ensure they stay open.


#11

Thanks for doing this David. I might do the same thing as I kept pretty good records of updates throughout the whole recovery process. I’m 15 months post reversal and still have a ways to go – hoping for continued healing – congrats on being at 99%, that’s great to hear…

Kja – in regards to scaring… I assume you mean the vas scarring over at reconnection site basically putting you back to pre-reversal state. The guy that did my reversal told me roughly 5% of his reversal patients end up scarring over – this statistic includes both normal and pain patients. Some of the docs recommend having sex daily after restriction time in order to keep things flowing and reduce chances of scaring. I’ve also heard that regular sex can inflame things early on which could also increase chances of scaring over… Some level of sex and anti inflammatory meds along with anti inflammatory diet seems to be the best route…


#12

Just wanted to give an update here about 2.5 years post reversal.

I experienced something that another old time member on the old yahoo forum talked about and I coincidentally seemed to experience the same thing at about the same amount of time after the reversal. His username was ridealskin (or something approximating that [heh]).

So to sum up. I was 95% pain free 6 months after the reversal and enjoyed that status for 2 years. Then I started to feel a vague kind of pain in the general epi area. It started a bit subtley one day around a 1-2/10 and peaked around a 3-4/10 about a week later. The pain was vaguely similar to pre-reversal but not really. I would say it was 80% a general just ache / burning pain and 20% congestive pain (like pre-reversal). But there was one big difference there wasn’t a correlation between ejaculation and the pain.

Before my reversal I would ejaculate and the epis would get really tight/full/painful about 30-60 minutes later and stay that way for 12-48 hours. After which the pain would start to subside. But this pain didn’t have a trigger like that. This pattern was, regardless of ejaculation timing, wake up and feel fine. Then around noon would start to feel a little something and by late afternoon the pain would be the worst (2-3/10). After 2 weeks of that I went and got had an SA done (last one was at 12 months post-reversal). The results came back good at 160 million total - about 80 million/ml - 70% motility. After doing some research I read that because of many variables both in the male and lab tech SA’s can vary as much as 50-60% and my most recent results put me well with that range. Ok that is a big relief.

After talking with my reversal surgeon (Dr Marks), the main person at the fertility clinic where I get my SAs done, and a local urologist I was diagnosed with epididymitis (ok). The best guess at the cause was a couple of mornings in a row my wife and I had some couple time (which is not when we usually do that). And I even remember thinking I really had to pee but waited until after. I guess it can happen that the pea from your bladder leaks out (due to the various physical nature of sex) and leak back down the vas-defs and that can cause this.

Luckily after about 4-5 weeks of taking some naturopathic anti-inflams the pain diminished and was gone. I think I now know what it is like when guys say they have epi pain but it doesn’t seem to be linked to ejaculation.

What strikes me as odd is the other member on the old yahoo forum had the same issue and his subsided after being on anti-inflams for 6-8 weeks IIRC the pain eventually subsided.

I do have to admit shortly before I had the SA and while in the peak pain time I was very worried and thought I was scaring closed. This experience instantly brought me back to the hell I was in mentally. During the first 1-2 weeks of this I was constantly feeling my epi to see if it felt full/inflated (which it didn’t) to try and ease my mind but this got me into the vicious cycle of - feel it ok it feels ok - but then later I was in more pain from feeling around down there - etc.


#13

Are you sure when your scrotum is warm that the testicle is being pulled up? Does this cause ticking feeling above the spermic cord? Into the groin right under the public bone? I worry if mine won’t be short as well. I heard some urologists pull on the vas deferense on the testicle side. I wonder how much of that is true. If it makes a difference. And I wonder if the vas deferense can get longer in time?


#14

I am sorry but I am confused. I don’t recall ever saying that when I am warm I think my testicle is being pulled up. I would actually say I have experienced the opposite of that.


#15

@David, can you say what the natural anti-imflamatorys that you took were?


#16

I used the following:

While they don’t pack the anti-inflam punch of NSAIDs they also didn’t give me any side affects either - tradeoffs.

I also took a tincture my naturopath doc made for me which I am sad to say I do not know all that was in it.


#17

Just wanted to give a big personal thanks to David for the phone call the other day, for keeping it factual and real, and for sharing in so much detail on this forum. Im sure you have helped more people than you know!

You are a good dude, you know I will continue knocking on wood for ya!


#18

Heads up that we can actually run some basic polls within the forum.

The syntax to do it is over here:

https://meta.discourse.org/t/a-better-poll-feature/28008


#19

David - thanks for the insight and sharing. Did your insurance company cover any part of your reversal? What was the price point with Dr Marks?


#20

No unfortunately not. It was interesting on my first filing for insurance reimbursement I supplied all the paperwork and research showing the effectiveness of reversal in cases of PVPS.
They reimbursed me around $1400 dollars towards my $2000 deductible for out-of-network. To them the ‘average’ price of a reversal was around $2000-3000 I guess and I think they are used to paying as little as possible towards the reversal.
At the time I was quite upset with this and filed my 1st petition (I think that is what is was called?) and they came back and said oh sorry - the first response from us was an error. We should have given you NOTHING.
So I filed a second petition and nothing really came of it. I was ready to go in front of a small doctors tribunal (next step) but I was getting better at that point and didn’t care as much anymore - I just wanted to get better.
Luckily [knock on wood], it’s now been 4 years since my reversal but IIRC it was about $8700 for just the surgery. After I figured in flight, hotel, food, cab, misc I would say it was closer to $10k.
Good luck