Pamphlet Analysis, and how soon is too soon for a reversal



I had my vasectomy on Dec 29, 2017. Have had mild symptoms similar to what you read about here. Achy feelings all the time. Epididymitis. Sore to the touch. Pain during sex. Ejaculation doesn’t feel as good.

I learned about PVPS literally the DAY after I got my vasectomy when I read the wikipedia entry on vasectomy. I had previously read other material from “official sources” and none of it mentioned PVPS in any acceptable way. My reaction was basically “Oh Shit. Wish I had known this yesterday.”

Here is an analysis I did of the pamphlet I was given at the doctor’s office during my “counselling” session:

I think I want to get a reversal, but I wanted to hear what you think about the optimal time to do it. I had an old fashioned surgery. They snipped out about 7 mm of vas and cauterized on both sides.

Is my best chance of becoming normal again to get a reversal as soon as possible? Right now my plan is to wait until my 1 year mark. Am I letting my testicles get damaged by waiting?

Any recommendations on the best doctors for reversal to treat PVPS in the Philadelphia area?



Hey @Ethan_Scruples. I read your write-up, and found it to be much closer to the truth than what you got told.

What you got told is the typical glossed over bs that many get told. Don’t feel alone far as being bs’d into making a supposed informed decision to have the procedure.

I would give it 6-12 months on the wait. If you can manage, make it to 12 months. You could still make improvements past 12 months. It might not be typical, but it does happen.

There’s already so much info on this site in regard to how long to wait, this, that, the other, and I’m not about to write up another big speil about the same ole stuff.

Everyone is different man. You are under no obligation to wait till a certain date by anyone. These decisions are completely yours. I shame nobody for what they do, how long they wait, or don’t wait, etc, etc. That stuff is completely up to you.

Just understand that there is a chance to end up in a worse predicament, and that recovery from reversal can, or could really suck. The procedure itself is not comparable to the vasectomy, and reversals aren’t always successful, especially long term patency. Long term patency is a crap shoot. Some guys reversals last, and some don’t.

Don’t make the same mistake twice, and be figuring out what you got yourself into after the fact should you decide to have a reversal. This is a big mistake that many get themselves into IMO. Vas to vas only, and have it done by the best surgeon you can get. Looking back, and having more regrets regarding your decisions is not recommended.

I have no idea far as who to contact in your area.

Good luck


This question you ask is valid and has been asked before. However, my understanding is that there are no stats or data to show that getting a reversal in under 6 months or a year improves your chances. The data that I’ve seen and been told is that you are best to get the reversal in the 1-3 yrs range.

Know that the reversal is no magic bullet, only 70% chance for real improvement, if that. Also, know the reversal is no picnic. The average window for seeing that improvement is 6 to 9 months post reversal, so I’ve been told.

Yes, and good point by Ringo on the possibility of having even more regrets after reversal. The urologists are dirtbags, don’t give them more business if you don’t have to.


One more thing @Ethan_Scruples, I recommend you read several of the reversal threads on here. I’d make a point to read the ones that are over 100 posts long, or in the ballpark.

In them threads, you will find just about everything you should consider, need to know, conservative treatments that do not require surgery, etc, etc.

Some reversal threads don’t cover a whole lot beyond one mans story, and they are worth a read as well.

Conservative treatments should always be considered first before surgery. Things that come to mind that may help you are, papaya seed powder, or testosterone replacement therapy (TRT).

Theres a dedicated “the original” papaya seed powder thread that’s “currently” 10-20 threads from the latest. I recommend giving it a read as well.


Thanks for your comments. I’ll hunt down the post reversal threads.

If the general opinion is that there is no advantage to jumping on a reversal right away, then I’ll go ahead and wait a year. I’ll do everything I can to reduce the discomfort in the meantime, since apparently chronic pain can imprint itself on your nervous system. Will try papaya powder.

I’ll also keep in mind that vasectomy reversal might not fix anything and could leave me worse off.


Many men apparently experience a deterioration over time, with new problems arising months or years after their vasectomy – whether that be epididymal blowout, granuloma, varococele, screwy blood chemistry, worsening pain, swelling… the list goes on. (But good news everyone – the link to dementia has never been proven!)

So the way I am thinking is not just “can reversal fix my problems?” but also “can a reversal reduce the chances of developing problems in the future?”.


Honestly, that’s a huge “maybe” that reversal could help with future problems. Reversal could also cause you to be significantly worse than you are now. I think waiting a year is a good plan. If the pain goes away, I think you’re better off controlling your health through lifestyle changes, as best you can, to minimize the post vasectomy changes mentioned above. The body can overcome most things if you give it the ability too. That’s not saying that there are outliers, much like a few of the men on here who’s bodies are having a hard time adjusting, but the majority of men don’t have these long term issues. Obviously, though, there’s no way to know which way things will turn out. PVPS is a tough situation. No really great options.


Well said @Kyvas.

@Ethan_Scruples, I definitely would wait this out for a while. Right now you are in panic mode, not thinking clearly, not being completely rational, and you are “just beginning” to get your head wrapped around what you got yourself involved in.

Far as I’m concerned, there is no guaranteed way out of what you got yourself involved in. If there was, I’d say most all men with pvps would’ve took that road already.

I know of “few” that had a reversal, and have a victorious story to tell afterward. Some may tell victorious story’s afterward, but I’ve seen quite a few fall straight back on their ass again within a matter of years post reversal.

Keep in mind that I’ve had two reversals. The first was done by a self proclaimed reversal expert, and my second was done by a tried and true master of the procedure.

My first was a failure, my second lasted approximately 24-26 months.

I do personally know of at least one guy that had a reversal back in 2011, and far as I know he’s all good still.

That guy is probably the most healthy guy I know of. He lives, eats, drinks, supplements himself like almost no other. He keeps his systemic inflammation as low as humanly possible. I’d say 95-99% of men couldn’t hack living the way he does.


@Ethan_Scruples, far as I’m concerned, your just not bad enough to justify rushing into anything. If you had unilateral, or bilateral sperm granuloma, swollen epididymis, spermatocele, or anything going on that was destroying your life, I would have a different POV in regard to your case.

There are stories on this site of guys that had a reversal in the 2-6~ months post vas area, and have absolutely no regrets about it as of yet.

I know of other guys that reversed in the 2-6~ months post vas area as well. They had a rough time for several months post vas, but seemed to be improving. In all honesty, I think they just hated the disconnected feeling more than anything else, and wanted to be “whole again”. The men I speak of did pretty well, and had zero regrets about spending 10k+ to get where they wanted to be.


No really great options.

Yeah. I’m still processing this emotionally. Getting a vasectomy was the worst decision I have ever made by a long shot and it feels so ridiculous that if I had just happened to read the wikipedia entry on it I would have noped out.

I know it’s unproductive to think this way, but I really do feel like a victim of something isolating and especially terrible. You guys have been through this emotional journey.

  1. My father had a vasectomy and it seemed like no big deal.
  2. My wife suggested I get the vasectomy. We had just had a difficult experience bringing our second child into the world, and it seemed like my turn. This is apparently common, and creates a situation where you cannot share your problem with your wife without it seeming like you are blaming her.
  3. Men just don’t talk about this. Why would they? When would they? They certainly aren’t going to talk about it with their co-workers. Probably not with their friends either. Due to the time delay on some of the problems and the low intensity of the pain, many will never mention it to their clueless urologists.
  4. Most men don’t get this problem.
  5. Not enough research. Nobody knows enough to tell you what you should do.
  6. Doctor straight up tells you it’s a simple, safe procedure. Quick snip amirite? Done in 20 minutes.
  7. You’re supposed to trust doctors, not nutty online forums, right?
  8. No way to undo it. No reliable cure. You removed part of one of your organs that you needed…
  9. I have a history of ruminating and depression. So it’s not so great to have a constant aching reminder that my quality of life is permanently diminished.
  10. Sex is not enjoyable anymore.
  11. Don’t expect to get any sympathy or understanding from anyone. Nobody has heard of this because nobody has any reason to talk about this. Doctors will engage with you in a way that denies the reality of what you are experiencing. You will feel crazy and alone. You will stop talking about it and bury it, and occasionally read post vasectomy forums where the latest truckload of blindsided men are arriving to wonder aloud what the hell happened.


There are many traps in life and you happened to fall into this one. This trap is especially insidious because the ones closest to you were the ones who led you into the trap. Call it ignorance, call it injustice, call it the devil’s trap… Whatever it is you’ll have to work daily to forgive yourself and others. Just know you found a good forum and believe you will get better without surgery or nerve blocks.


I suggest the following:
Do a lot of research yourself. It will be tough to read but try to take the emotion out of it.
Go to different urologists until you find one that diagnoses you with PVPS then just go to the general doctor and educate them on PVPS. Remember once the urologist diagnoses you with PVPS they are pretty useless until it comes to reversal time. Why give them extra business.
Go to at least one pain management specialist. Let them get your business instead.
Get compression shorts
Get on Naproxen for a month, then maybe Celebrex or Mobic
Get on Amitriptiline 10 to 40 mg/day.
Refrain from sex, yes, do it. Only ejaculate maybe once a week.
Create a computer file where you document your pain and activities everyday to see if and what helps or exacerbates the pain. It will be a puzzle to figure out.
Dont try to tough out the pain. Get ice packs from Amazon in which you can cut into shape and put into your underwear. Keep icing.
Take hot baths
and also take vitamins B12, B6, C
and also take anti inflamatory herbs like ginger and tumeric, lipoic acid, st. johns wart…papaya seed def worth a try too.
some of your pain might be congestive, but at least some of your pain is likely nerve pain too.
You may also want to go on Nerve medicine gabapentin or lyrica.
Also learn from internet on how to do pelvic floor exercises.
If when the pain eases up don’t ease up on your conservative treatment plan. for example don’t have a sex/jerk off fest. Don’t stop taking the meds or herbs.
You don’t have to do everything all at once but weekly/monthly keep adding something to your plan.
Believe that everything you add is helping you more and more.
Your goal for the next six months is to reduce inflammation, calm the nerves, reduce pain, stay positive and try not to ruminate in anger.



You just got it done. You are still healing. I would wait a good year before doing anything unless you are in excruciating and disabling pain. You might get to the point where you don’t even think about it if you give it time.
I would find a swim center or gym where you can use their spa/jacuzzi spa and do that and take NSAIDs and give it 6 months and reasess. The fear of blowing out is overblown. You will be fine for the time it takes to see if things settle down.


@Ethan_Scruples I was at my worst physically and mentally @ 6-8 weeks after my vasectomy. Everything you are thinking, based on what you wrote above, was exactly what I was thinking. As the pain continued, and my doctor’s were useless, I was spiraling out of control mentally. However, at a year, things are much better. Not great, but better.

Everything @crotalus97 said is spot on. I will add to that in a couple of ways. Find a healthcare provider that will listen to you and offer some help. My GP and my original uro were worthless, condescending asses. I was eventually able to meet with a very understanding urologist. Although, he said he couldn’t explain why I was hurting at such a high level, he at least acknowledged there was an issue and offered some medication recommendations. I also found a great Psychiatric Nurse Practitioner, who had dealt with a man with PVPS before and was very open to helping with the anxiety, depression and sleep. I’ve actually seen a couple over the last year, and I believe very heavily that since they don’t have an ego, and seem to be more open to new research, NP’s are very good resources. I’ve also since found a GP, that although has never heard of PVPS, was willing to look up some research and offer some help. Third, I talk about this a lot, but go to a Pelvic floor PT. EVERYTHING in your pelvis is going haywire. They can teach you ways to get it to calm down. Probably won’t make it go away, but I believe they can help make it more manageable.

More than likely you are going to be fine. Just realize that you are in the lowest of lows right now. Things will improve. Good luck.

Also, I see you’ve written some stuff on Medium about Bitcoin. Really wish someone would have told me to buy some 5 years ago. Haha. It would have been nice to have thrown a few thousand at it.


Thanks for the perspective. :slight_smile: I’m glad this forum is here, and I hope that over time the risk of PVPS becomes common knowledge.

Since you bring it up, I’ll mention that I think Bitcoin is here to stay and is still under-priced for the role of a global “digital gold”. It’s an experiment that could fail though so invest accordingly.


I read your story and it sounds like I wrote it!

I first read about PVPS on Wikipedia a day or two after the reversal. I remember a horrible, sinking feeling in my stomach, along with outrage.

I agree with your analysis of the pamphlet. It was basically what I was given as well, and I was livid when I read the actual stats regarding incidence and severity of PVPS.

I also have a history of ruminating and depression. My current issues are amplified by the anxiety they provoke and the time I waste thinking about what I’m going to do going forward.

And, I’m a bitcoiner :–)

Anyways, no really useful advice from me. I’m two years out from my vasectomy, strongly considering a reversal at the moment. My issues have always been in the form of feelings of pressure. They started a few days after the vasectomy and peaked shortly thereafter. Although they got significantly better over the next 9 months or so, they’re still present after two years and haven’t been improving.

Hope you’re keeping on and staying strong!


It’s interesting to hear from someone with such a similar experience, and this board is very valuable for helping us see that we are not alone.

For me, vasectomy has so far been like a bruise that doesn’t heal, physically or mentally.

Plenty of people have things happen that are far more tragic than what has happened to me, but recognizing this experience as a kind of a tragedy helps me feel like I have understood why it tastes so bitter and maybe gives me an improved chance of healing emotionally.

Here are a couple of things I am reminded of, but which are far more tragic:

Pregnant women who took Thalidomide and gave their children birth defects.

Young girls who are given clitorectomies.

I think part of what makes this disorienting is that this is the first thing that has ever happened to me that is actually bad. I’m a white male, living in the world’s richest country, living in a democracy, employed, living after the invention of antibiotics and vaccines and have never had a serious injury. My expectations might be calibrated a little high, historically speaking. Christopher Hitchens said after he got throat cancer that he briefly wondered “Why me?” and then chastised himself and said “Well why not me?” Well, why should I expect to get through life utterly unscathed?

Partly the emotional turbulence stems from the strong sensation that it didn’t have to happen. If only I had known. If only I had looked at the right website a day earlier. If only my urologist had given me the most accurate statistics. If only more men talked about this. There is the sense that several things lined up just so to achieve the bad outcome. But this is just a part of what makes a situation a tragedy.

Then there is the outrage. It is proper to be particularly angry when a doctor fails to fully live up to the position of trust they are in. There was a far more extreme version a number of years ago where a doctor was telling healthy people they had cancer in order to sell them chemotherapy and his services. Or consider the pharmacists who were letting medicine get moldy back in 2012, resulting in patients getting fungal meningitis. We are right to be outraged, and the outrage is meant to be energizing and motivating. But in this case, the outrage has nowhere constructive to go. I wrote my urologist a letter expressing my frustration.

Then there is the sexual politics. A quick survey of online media turns up plenty of examples of people reacting to reports of vasectomy pain with some variation on the theme of “Well, consider the risks women take with childbirth, and the pain a woman must endure even with an uncomplicated delivery?” That is the slap we get treated to instead of sympathy? I get the impression that there is a quick semi-subconscious calculation happening that goes like this: Women have it bad. They are the ones who must put up with the aggressive and violent behavior of men. They are the ones who are asked to mess with their hormones, or risk getting pregnant. They are the ones whose health is jeopardized by pregnancy. They are the ones who must suffer during delivery. If men sometimes have pain from vasectomy, how are we supposed to even care about that, considering what most women go through? If men are told the REAL statistics and the consequences of PVPS are made vivid for them, they are going to choose not to get a vasectomy – selfishly refusing to share any of the risk and through their inaction putting it all entirely on women. Vasectomies are not in the MAN’s best interest, but when you consider the available alternatives, vasectomies are in the best interest of the man and the woman considered together. If men need to be duped into taking their fair share of the risks of having sex, then so be it.

Anyway, I understand what you mean when you talk about the mental drain this causes. I think about this frequently through the day. My work is suffering. My ability to focus on my children is suffering. It stresses my relationship with my wife. In fact, the irony for those who wish to protect women by advocating vasectomy in a dishonest way is that the wives of men with PVPS suffer terribly. Regardless of the real imbalance in the world between the lot of men and women, doctors should effectively communicate to men the risks of the surgery. Even if they sign a piece of paper, men cannot really consent to a surgery if they are being systematically mislead about it’s consequences.

One trick I learned this week is to sleep with a pillow between your knees. It seems to prevent the pain that was coming and keeping me awake in the middle of the night.


I agree that the fact that the original vasectomy was elective makes it that much worse.

Even though I know that I wasn’t appropriately informed by my original urologist, I still blame myself for having it done.

One thing that’s helped me is sleeping with an electric heating pad on my junk, kind of rolled up between my legs. It doesn’t really make the discomfort go away, but the sensation does distract me from it.


I still blame myself for having it done

Not me. I’m taking zero personal responsibility for this. To me this is just a bad thing that happened, like getting hit in the head at the park by a stray baseball.

You can’t evaluate the safety of every elevator you get into. You can’t research the compounding pharmacy of every drug you take. No man is an island and we rely on our culture to give us an ambient sense of what is safe and what should be investigated further.

We especially rely on professionals and hold them to a higher code of conduct than everyone else when they are acting in their professional role. I am not the person who is best qualified to decide whether vasectomy is safe. The person with the best qualifications told me it was safe – that there was a 1 in 2000 chance I would get some minor occasional aches and pains. Gave me a pamphlet specifically written to make me feel satisfied that I understood the risks even though I hadn’t.

I was doing the right thing. I was getting my body modified to protect my family from another risky pregnancy. My whole culture tells me that vasectomy is no big deal. I could not have been more shocked to find out that vaccines actually DO cause autism, or that getting your wisdom teeth out causes heart disease.


Yeah, we all hear or heard these points, but the reality is that pregnancy is a natural (or God-given if you’re religious) act. Women’s bodies were designed to give birth. Sure, it’s not pain-free, but there’s no logic that men should be mutilated because women do something natural to the survival of the species.


@raising4girls I agree with you and want to emphasize that I’m not endorsing the line of thought that I articulated there, nor would I endorse any identity politics. I think they cause much more harm than good.

But even if if I grant someone their position that men should strongly consider vasectomy, the notion that it is ok that men do not get all of the relevant information because the ends justify it is more than unethical – it’s predatory.