Thanks to all of you for the input. My symptoms seem to come on after intense encounters with my wife that result in a long session with lots of anticipation. A few days later I notice a knot in the tail of the epididymis. I assume this is a local blowout due to increased pressure. I have localized tenderness at the knot. I have not experienced constant radiating pain as of yet but I am sure this could become an issue if thing progress. The area becomes tender and requires support when being active to avoid further pain.
I don't like the thought of an epididymectomy either. Seems too invasive and may leave me with a situation where the pressure backs into the testes resulting in pain there as well. (That is just my logic).
I read at blockages and blow outs of the epi can lead to failure of a vas-vas reversal due to the lack of healthy sperm making their way back to the semen flow in 75-80% of cases. Would this not also hold true in open vas conversions? SCOTT - when your doc did your conversion did they test the fluid at the converted end for sperm? (Just curious - glad it is working for you!)
Seems like the open ended conversion vs. a vas-vas or vas-epi reversal would be the best options. I am not concerned at this point about the restoration of fertility. We will just make other arrangements in that department if need be.
Are any of you familiar with Dr. Silver at the infertility clinic of St. Louis? I guess he pioneered the microsurgical techniques for reversal procedures. I sent him an email.
I don't understand how the neuro-blockade option offered at the Pur clinic would have benefit in my case. Do you have any insight there? They wanted $200 for a phone consultation.
Again THANKS to all of you for your input. It is much appreciated!