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Post Vasectomy Pain Forum

New guy...same problem


#1

It’s never a good sign when you are googling post vasectomy pain and find sites like this. Glad I did however. About myself…40 yo s/p vasectomy about 2 weeks ago. To get it out there…I’m a physician myself and have even assisted in vasectomies almost 2 decades ago as a medical student. Never once saw any complications. That is until my own procedure. My urologist used the no scalpel technique and just cauterized both lumens of my vas. Procedure went great. Little pain. I iced my boys for a couple of days and I was back to work on post op day 3. Well it all went down hill from there. From day 4 until now I’ve had severe pain in both testicles and what I can tell the development of sperm granulomas vs epididymitis. Wow. Im talking serious pain guys. Like someone is pulling on both guys around the clock. I’ve also got left inguinal pain and for a couple of days lower abdominal pain. Wtf? I’ve been on ibuprofen and Tylenol around the clock with some help. Today was prob my best day by I’m still having to walk around with a jock strap. Exercise or sex are far out of the equation. Hoping this is short term. Time will tell. Really regretting my decision sadly. Will keep you posted. Thanks all for advice in the many posts.


#2

I’m sorry you’re here. What type of physician are you if you don’t mind me asking? It fascinates me that medical professionals are unaware of the dangers and risks now that men are posting their horror stories on the internet. Many of us, myself included, believe there’s a cabal of silence among the urological community, perhaps not an out-and-out conspiracy, but a lack of courage to take action based on the evidence. Again, I’m really sorry you’re here, but to my knowledge, you’re the first MD to visit this or the preceding Yahoo site. I’m astonished that the medical community still tells the world that vasectomy is safe given the preponderance of evidence to the contrary. Any ideas?


#3

I’m a pediatric intensive care doc. Quite a different world than urology. Regarding your concerns about physicians hiding complications…? I just don’t get the reasons or benefits of doing that. Also not saying the % of post vasectomy pain reported is accurate either. But do remember…those many million men who have had an uncomplicated vasectomy aren’t online posting how great of an experience they had. It’s only the poor souls who’ve had complications who post in these forums…so your outcome data is going to be skewed.


#4

I think it’s conveniently ignored by those in the know and completely underrepresented to the rest of the world. I have a patient who went into complete testicular failure 5 years post vasectomy. He now gets yearly testosterone pellets. He also happens to be a physician and miraculously he doesn’t blame the vasectomy. He knows my story and he still doesn’t connect it. It’s mind boggling but that’s how benign this procedure is made out to be.

A little professional advice…before you start making appointments and looking for help, up your professional disability policy. My vasectomy problems have morphed into much larger issues that are just about to pull me out of practice. Disability saved my butt and you’ll quickly be denied if you start reporting chronic pain. Good luck.

@Rota


#5

In the US, I would have thought the reasons for hiding complications is obvious? :moneybag:

In the UK, I would have thought the reason that the profession hide/downplay the 1%, 2%, 13%, 17% (delete depending on which study you have read) risk of chronic pain is that PVPS is considered the lesser of 2 evils with abortion statistics being the other.


#6

@Rota thanks for sharing your story. Your obviously really early in this, so more than likely you’ll be fine. Hopefully being an MD helps you navigate any treatment you need better than a lot of us have experienced. Until things start to heal, do whatever you need to get through the days, and take it easy when you can. Good luck.


#7

@Kyvas Thanks and yes…would/will be easier for me to navigate the system, sadly that’s not at all fair. If anything from this experience I’ve learned there definitely are risks and a higher than reported population with morbidities associated with this “benign” procedure.


#8

re: hiding complication rates

I definitely think urologists are giving an inaccurate impression about how common this is. It doesn’t necessarily follow that they are consciously distorting the truth.

Several factors are in play.

Men are probably under-reporting the problem. Maybe they think they should tough it out. Maybe they do not believe the doctor can help them. The topic is embarrassing and they don’t want to bring it up with co-workers or friends because it makes things awkward. They don’t want to bring it up withe their wives. More than one man has found out the hard way that talking about this topic can be a real mood killer. It can make wives feel defensive or guilty. It can make wives worry that sex will aggravate their husband’s condition. There are many reasons why men would hesitate to communicate their problem loudly and frequently. Men tend to not want to go to the doctor and many times end up at the doctor’s office partly due to encouragement from friends and/or spouses. Well, if they are not complaining to friends and spouses, then this dynamic doesn’t happen.

Maybe another thing that happens is men get somewhat better over time, and stop going to their doctor, and the doctor is motivated to assume that the man eventually got back to normal. What really happened is the man got “good enough to get by” and also tried several times to get cured by the doctor and eventually it just wasn’t worth going back anymore. I had an experience a bit like this. I wrote a letter to the urologist who did my surgery and told her that I regretted my vasectomy and I had been in pain every day for a month, and thought I had been given the wrong numbers etc. Then I sent up follow up emails periodically. In my last email to her, I described continued pain and sexual dysfunction, and how I was still having problems after 8 weeks. I mentioned that ibuprofen seemed to be helping. Her email response basically said “Sounds like you are making steady improvement. Keep it up!” I dropped her and switched to another urologist. Now who am I in her mind? In my mind I’m 4 months post vasectomy and regret it every day and still have a burning sensation every day and sometimes in the middle of the night. In her mind I’m that guy that had a rocky time but made steady improvement and eventually stopped needing help.

There is some motivated reasoning that is going on. Urologists are just not going to seriously entertain the possibility that vasectomy is a fundamentally unsafe procedure that permanently damages 5% of the men who get it. They take it as a given that vasectomy is safe. That is what they were taught by the authorities they trust. They may have personally done hundreds or thousands of vasectomies. They are strongly motivated to make choices in their reasoning that try to steer around the conclusion that they should not be doing vasectomies.

The timing is also a key factor. Men tend to get vasectomies when they are done having kids. Median age is late thirties. Then tack on a couple of years for auto immune response to do it’s damage and you have men in their 40s. A man in his 40s has epididymitis. What’s a urologist going to ascribe that to? Was it the vasectomy? Was it the age? I’ve heard many of the medical people I have interacted with assure me that men come in with scrotal problems that are not vasectomy related. So this is a confounding factor and a handy scapegoat that makes it hard to see what is happening without large sets of observations. I’ve also noticed that doctors seem to be a bit grudging with how they acknowledge that since my problems started up a week after vasectomy they are “probably related”. Well what about men who develop problems 18 months after vasectomy? Urologists are not going to consider it evidence that vasectomy creates problems.


#9

The dynamics of a for profit healthcare system would seem to encourage downplaying risk to capture more of the market than a provider that is very up front about them.

The interesting thing is we have a new member that is a provider and even though he finds himself having severe pain is still downplaying the incidence of his outcome because his preconceived notions about vasectomy don’t match what he’s experiencing. Now imagine a provider that has never had a vasectomy dealing with a person complaining of chronic pain. Does anyone else see the problem?


#10

I think I see the problem here. You aren’t supposed to go in and chop tubes in your body in half without doing enough science to know exactly what is going to happen as a result for the rest of a person’s life. What we have instead is a very under-studied area, but we are just going to go ahead and chop people up and not watch carefully enough to know what the effects are a decade later.

My current doctor told me that vasectomies could not cause Low T because after all, vasectomy only severs ONE of the three arteries that supplies the testicle with blood. I told him that the structure of that argument was utterly unconvincing to me.

Consider – Hashimoto’s disease causes hypothyroidism by the mechanism of the immune system degrading the function of the thyroid gland. Would I take a doctor seriously if he said that he wasn’t going to test for hypothyroidism because only a minor artery in my neck had been severed and my thyroid gland appeared to have adequate blood flow?

The level of thinking I am being presented with is pretty disappointing.

Edit to clarify:

When I say “The level of thinking I am being presented with is pretty disappointing”, I am referring to my current urologist hyper-simplifying by telling me that clearly I cannot have low testosterone because I still have adequate blood to the testicles. I’m not referring to @rota questioning what would be the motive for doctors to lie about stats or whether this sub could give the wrong impression about how many men end up in this boat. As I said in my previous post, I agree with @rota that most doctors want to give reliable numbers – I just think that they are not properly motivated to correct a tricky mistake.


#11

Just to add point to all of this because I don’t want to bash @Rota for not understanding the risks even as a physician. Given the nature of my job, I’ve spoken to well over 100 MDs, NPs, PAs, etc since my issues started a year ago. I’ve been very open with what I’m facing, and people had notice changes, so I’ve presented my issues openly and haven’t been bashful. I was honestly hoping I could find some providers who were familiar with PVPS. However, outside of a few urologists, and a few pain docs, no traditional provider has ever even heard of PVPS. So, either the complication numbers are really low or urology is doing an incredible job of hiding the truth. The reality is that it’s probably somewhere in the middle. Men who have life changing issues to the degree that we do have got to be incredibly low or no man would ever get this done. I have a hard time thinking that something like this, if common, could be hidden so effectively for so long. That being said, I do believe that urology is being complacent by not doing proper research, and that many are being straight up dishonest about the true risk of post vasectomy issues. I’m not defending anything or anybody, but would like @Rota to continue being active on the forum.


#12

I am not going to beat about the bush with this and i have no gain what so ever. I have been seeing after my reversal a new urologist in Australia that treats cancer patients. He does not do vasectomys. Since my Vas i have Scaring, cysts, hydrocele and swelling all common symptoms of vasectomy he sees this every day. Before Vas i have never suffered any testicle issue… My reversal surgeon seen it as well with his own eyes. Yes my reversal surgeon took out both testicles at my request to see whats going on. These are common signs of vasectomised men. Why is all this not stated in paperwork before vasectomy,? Because its hidden bullshit. This really upsets me the lies. Its like a money printing machine here in Aus, My open ended vasectomy cost $800 selling their bullshit open ended gives no pain.If we were told the truth they would not be trading their porsche/Benz/BMW every 2nd year from the money they churn over thats why. Even after my reversal i am by no way normal far from it.


#13

Guys I have not posted in a long time. I’m 9 months post vas. It is only now I can say all my pain and discomfort has gone and I’m pretty much back to normal. It’s difficult to say or for what reason I’m better but I started papaya seed powder 4 weeks ago and acupuncture 3 weeks ago. I am also back jogging with no side effects. It could be natural healing also but I’m just glad to be pain free again. It just shows this thing can takes many months to heal. I felt really down over the last 8 months and know there is lots of guys out there that still feel shit and really worried that pain will never go away. I would say hang in there and be positive. My nightmare is hopefully gone for good and i can get on with my life again. I still regret getting Vas but what is done is done. Take care guys :muscle:


#14

Again, I’m sorry you’re here and certainly admire your career vocation.

On my original consult, my vasectomist told me he’d never had a man have a problem. Then, 8 months later when I returned with massive scrotal pain, he proceeded with every urological test known to man in a quest to prove it was my kidneys, bladder, prostate, pudendal nerve, etc. I wasted thousands.

Then, absent any other cause, he said “go see Dr. XXXXX. He’s the guy I send my pain patients to.” Huh? You told me you never had a guy with complications.

Here’s the motivation. Six vasectomies * $2,000 = $12,000 revenue on a Friday. That’s an upper middle-class income for a month.

Data isn’t skewed, it just isn’t compiled anywhere. There’s no “Big Data” initiative enveloping a dangerous procedure like vasectomy. No incentive to spend money, but lots of financial incentive not to. Add in the feminist community who believes it’s a man’s duty, and you have two powerful group’s seeking silence.

The only place I’ve seen pamphlets warning about the dangers of vasectomy were on a Roman Catholic church’s bulletin board.

I hope you can help us, and I don’t mean to besmirch the entire medical community. My GP is fascinated by my story. He has my data online showing my post-vas/pre-reversal T-levels at 285-325 and current T-levels at 656-764 despite being 12 years older. With my permission, he now tells every patient of my story who asks about vasectomy. Guys here like @Choohooo and @Acschiro have contributed mightily here because of their medical training.


#15

Well written @raising4girls

I had a similar experience. When I asked about chronic pain he told me he’s had one in 30 years (he does 30-40 vasectomies/week). He went on to say that guy was easily fixed with an epididymectomy. That should’ve been the first red flag but I’m much more informed now.

When I called back with pain, the nurse was quick to refer me to their chronic pain urologist like it was no big deal. I asked how often they send to this guy. She literally laughed when I told her that he said he’s only had one chronic pain guy in 30 years. Come to find out it was closer to 2-3 per week. A meeting with their pain urologist resulted in an Rx for lyrica. Thanks. Could’ve written that one myself.


#16

And for the record… I’m not sure how much my professional background has helped. I’m simply uncovering literature that was published one to three decades ago. Why it continues to go ignored is beyond me. One “harmless” verdict doesn’t overturn three “harmful” papers.

Found another one last night.

“These findings suggest that vasectomy may cause a reduction in testosterone levels by minimizing the conversion from testosterone to dihydrotestosterone in the long term.” 1995!

Clearly, something changes @raising4girls . Your experience has me seriously considering a reversal


#17

Rota,
Thanks for your honesty and hopefully your pain passes. As for the numbers I believe they are mostly underreportrd. I am a chiropractor and have unfortunately been given the diagnosis of RSD of the testicles due to my vasectomy and have burning numbness and tingling from the waist down. Before the vasectomy I bet I had seen a MD 1x in 15 yrs. i have been very open and vocal in letting my patients know why I have missed over a year combined in practice over the last 4 years. By doing this I have had 5 patients tell me that they have constant pain due to their vasectomy. 4 lucky souls day theirs is a 1-3/10 daily with a bad week here or there. 1 is a truck driver and has a 4/10 constantly has seen multiple urologists and told he is fine. Just last week I had a patient that I have seen on and off for 20 years. I hadn’t seen him in 4 years and he presented with right sided testicle pain, burning pain down inner thigh and lower back and said the pain was so bad he almost went to the ER over the weekend. After listening to him the first question I asked him was when he had his vasectomy. He was dumbfounded and asked how I knew. I then dig deeper into his complaint and he said he had the vasectomy 2 years ago and has had on and off testicular pain in the right ever since it. I asked if it was aggravated by leaning backwards and he goes how did you know that I have to reach above my head and arch backwards at my job repetitively about 1x a week and that day my testicle always hurts. Classic signs of genitofemoral neuralgia testicle pain inner thigh pain aggravated with extension of the spine. I asked if he had seen his urologist about it and he said a couple of times and was always told he had epididymitis and given antiobiotics and he said they never helped. This is why it’s underreported the patients that have milder forms of pvps just deal with the pain after they see their docs a few times and are given no answers or told they have epididymitis or something else non vasectomy related. And a lot of the urologists are just not adequately trained to deal with someone when they have complications from the vasectomy and either try and give them a bs diagnosis, ignore the problem and hope it goes away, or the good ones refer to pain mgt because they know they don’t have a way to treat it. The patient gets to pain mgt and they diagnosis the with some type of chronic pain syndrome or the good ones diagnose the neuralgias when present but now instead of it being called PVPS or a complication of a vasectomy it is just labeled genitofemoral neuralgia. Lastly who would they report their complications too? It’s not like there is a United States medical urology board tracking the complications. The numbers we see in the literature are from studies doctors perform tracking down a percentage of men that have had vasectomies and asking if they have had any problems. Once again here the researchers are asking questions that some men don’t relate to the vasectomy because they’ve been told countless times they have another condition. Unfortunately there is really no way to get accurate numbers. How many people go into the hospital to procedure a or b done and develop an infection, pneumonia etc as a complication and on there death certificate it doesn’t say they died from the procedure it says they died from pneumonia etc etc etc. The only way the numbers will ever be able to be truly tracked is if we go to a single payer government ran system where they can track the numbers. But As someone said earlier it will not matter at that point because the cost of labor delivery obgyn appts etc are way higher than PVPS will ever be and a single payer is all about saving $$$. Even though your a MD and like me will find it easier to navigate the system if your problems worsen or just don’t get better I’d stick with seeing urologists that are well versed in PVPS and unfortunately in the US they are far and few between. Id would get in contact w Dr. P in Florida if you have questions and I’d make sure you find a good pain mgt doctor immediately to determine if it is nerve related and if it is start getting blocks to make sure the pain doesn’t centralize. That’s when you go from a minor nuisance to the rest of your life will never be the same.


#18

Thanks everyone for their responses. I’m about 3 weeks out now and my pain is no longer constant but only hurts if touched (or if my dog or smallest child kicks me in the nads). I prescribed myself some cipro which seems to have helped (I was having epididymal pain and pain up my entire spermatic cord up into my bladder). Thank God that is resolved. Still have sperm granulomas (I assume they are) that are very tender to the touch. Oddly enough, maybe bc I’ve been walking so unnaturally post procedure that I’ve thrown my back out. I’m so over this. Told my wife I regret my decision and no way in hell would I recommend it to anyone. As several have mentioned previously…I do think men definitely underreport their pain post op so the numbers are not as accurate. I did read up on this quite a bit before hand and oddly enough in a physician doctor group on FB this was a large thread and there was discrepancy in PVPS percentages between the urologists and the pain medicine doctors. One of the Pain docs quoted upwards of 10%. This should have been a bigger read flag. You live you learn.

Rota


#19

To Aschiro’s point, every country OUTSIDE the United States lists are much higher percentage when it comes to vasectomy and chronic pain. There was a paper published last year showing post vas chronic pain as high as 18%. Of course not all of those have life changing pain but it’s a far cry from the 1-2% that the AUA currently lists. Glad to hear you are doing better. Be careful taking Cipro for too long. That can open a whole other can of worms!


#20

Can you share how you took papaya seed? How did you mix it? How much did you take? I just got some and I’m ready to start taking it. Do you think it contributed to your recovery? How long did you take it for? Any intestinal issues? Thanks…