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


Do you use any supplements @Ethan_Scruples?


I take papaya when I think of it. Probably 1/2 tsp 3 times per week. I tried taking 1 tsp every day but my stomach hurt.


I would love to know if there’s a particular active component of papaya seed power that could be extracted and taken by itself. Maybe it would be effective without causing some of the side effects.


Day 222

I visited a new urologist recently who has helped out some other PVPS patients. He pressed on my epididymis and vasectomy location and asked if it hurt. Mostly it didn’t – but hurt a little when he pressed on one of the vas sites. He also ordered an ultrasound. I guess nothing looked abnormal with that.

He prescribed me doxycycline and naproxen to take for 10 days. He told me to take it easy and not pick up anything over 20 pounds during that time. He also prescribed lyrica for the pain. Hopefully that will not make me a zombie like Elavil did.

He offered to give me a testosterone injection to see whether it makes a difference or not, or to ‘get me into a better place.’ I didn’t agree to it. If the testosterone made me feel better, then what good does that do? I’m not interested in TRT, so it would just be frustrating. Maybe someone here can give a counter argument to why I should have gotten the shot.

Things aren’t changing much. Sometimes I can forget about the problem, but I get reminded many times during the day because of discomfort or grunting when bending down to pick up a pencil. I stopped taking papaya about a month ago, partly because I wanted to see how things are doing. Pain seems to have increased a bit. I feel a definite burning sensation when I wake up. It comes and goes through the day. One person described the backpressure sensation as being like the roar of an HVAC system that after a while you cease to notice until you get a reversal and it’s suddenly quiet. I like that metaphor. Sometimes it gets worse and feels like someone is pinching my spermatic cord between their thumb and index finger. Frequently I have feelings that are not pain exactly, but more like being tired, swollen, warm or bloated in the groin.

I mentioned that I move differently and have perhaps weak core muscles now. He said I had trained myself to avoid the pain by moving differently, and that in a while we could focus on fixing the resulting muscle strain but for now let’s focus on the inflammation and pain.

I mentioned my decreased sex drive and how sex has gone from once a week to once a month. He didn’t really comment on that.

I didn’t bring up Dr. P, but my urologist mentioned that he knew about Dr. P and his theories on wallerian degeneration, which my urologist did not find very persuasive. I said that knowing what I now know about the relevant physiology, it seemed shocking that more men do not get chronic pain. If the epididymis gets blocked and swollen, won’t that hurt? He seemed to understand my surprise, but affirmed that the fact is most men don’t get the pain.

I left somewhat disappointed. More antibiotics, anti-inflammatory and nerve pain medicine. No new info. I don’t know what I expected. Probably I partly wanted him to say “My goodness! You should get that reversed!”


I have tinnitus, had it for about 5 years now. There are days and weeks where I totally forget about it, just to catch it every now and then, and I say to myself, oh yeah, I got that.


@Ethan_Scruples This made me laugh but honestly that is probably how most of us feel with no direction from Dr’s and coming up with are own path.


How am I supposed to not look like a total freak to my wife? Urologists have closed ranks and are repeating the party line that vasectomy is safe, and this almost never happens, and if it does it isn’t that bad, and you just need to take some ibuprofen and maybe you could benefit from a little visit to the psychologist.

How am I supposed to explain why I want to spend $10,000 of our money to get this thing reversed, and wear condoms or ask her to keep her IUD longer than she wants to, or put her at risk of getting pregnant?

How am I supposed to not look like a selfish asshole or a nutty hypochondriac if no doctors will back me up and recommend a reversal, but instead just furrow their eyebrows and say this is really weird since vasectomy is so safe and all, and they don’t know why I should still be in discomfort at this point? Really? You guys are going to make me go fishing for doctors until I find one that will tell me the unvarnished truth?

It’s a maddening betrayal from people in a position of public respect and trust, who have supposedly taken on the responsibility of assisting people who are in pain.


Personally, I don’t care what doctors think anymore. They work for me. I’m the client. Also, I don’t care what my wife thinks when it comes to my health (and I’m very cautious about everything else she pushes for). I finally realized that I have to lookout for myself. Men are always alone. It’s part of the path we walk despite the upside down crap we’ve been force-fed all of our lives. All men should follow their gut, not what their doctor or wife says.


I definitely don’t care what doctors think and have always considered them my employed counselor rather than having any authority over me.

With my wife, though, I do care what she thinks of me. Of course it is important for me not to be grossly selfish, but it is also important to not be perceived as grossly selfish on the basis of widespread fudging of the truth by the ‘experts.’

This institutionalized malfeasance injured me once by hiding the red flags that would have caused me to reject getting a vasectomy.

Now it can injure me again by forcing me into a situation where all I can say to my wife is “Who are you going to believe about this? Me, or all the trained professionals?”

I have no doubt she takes my side in this, but it must be hard for her not to harbor doubts at some level.

And all of these problems were completely avoidable, if urologists just adhered to the basic level of honest disclosure that should be their legal obligation and which they should have no problem with. My urologist probably only made about $600 bucks from my operation. I would rather she just pointed a gun at me and demanded $10,000. Both of us would be in a better situation.


totally agree man, women use what’s between their legs,
I would stand up now and be as nasty and sarcastic as she was,
I would never have a vasectomy now knowing how I had to live with the pain for 26 years with everyone saying it is all in my head.


Ethan, I hadn’t thought of it that way, but I totally agree that being robbed of $10K at gun point would have been a good trade.


I’ve never actually had a doctor try to convince me or my wife that I wasn’t suffering due to the vas, so I can’t say I’ve been in your position. Also, and not to hijack, I know my wife cares for me as yours does for you, but I’ve severely hardened through this and react strongly when the strong willed, “pushy” side of her comes out to manipulate me. I recognize that’s how I ended up hurt. Her idea, but I paid the price. There’s the rub. You can’t forget because you are reminded every single day.


I’ve never actually had a doctor try to convince me or my wife that I wasn’t suffering due to the vas

I really can’t say I have either in any major ways. It’s a little subtle.

For example, none of the doctors I have seen have spoken with my wife. But if she goes online and checks out webmd for example (yes, probably not real doctors but it’s a cultural problem that urologists are not correcting) she will see this page:

The procedure is very safe. Complications aren’t common, but if they happen, they can include swelling, bruising, inflammation, and infection. These are almost never serious, but tell your doctor if you have symptoms.

The procedure will not affect your testosterone level, erections, climaxes, sex drive, or any other part of your sex life.

So what is my wife supposed to think when I tell her that all this stuff happens to me that webMD unhesitatingly says do not occur?

Mayo Clinic does a better job:

Delayed complications can include:

  • Chronic pain (rare)
  • Fluid buildup in the testicle, which can cause a dull ache that gets worse with ejaculation

However, I don’t think vague, bland description does a good job. The writers of this are simply not engaging with the subject in an adequate way.

They say Chronic Pain is “(rare)”. Ok, how rare? I’ve heard doctors say that 1% is very rare. Is that what normal people think of when they see the possibility of chronic pain syndrome as a result of an elective surgery rare?

Then they say “fluid buildup … dull ache”. No mention of (rare) here. Why not? I thought chronic pain was (rare)? Is the “dull ache” not pain? Is it not chronic?

No mention of the dull ache being a constant companion. No mention that it gets worse when you sit down, drive a car or walk. No mention that there is almost nothing you can do about it except take painkillers.

[A vasectomy will not] Affect your sexual performance. A vasectomy won’t affect your sex drive or your masculinity in any way other than preventing you from fathering a child.

Ok, well, Mayo clinic was doing so well here. Saying it won’t affect your masculinity is meaningless. If you have problems with sexual performance, or your sex drive falls off a cliff then… what? This is pure coincidence? “You may end up with pain in your testicles and sex may be painful, but there is no possibility that this will affect your sex drive or performance.” It’s just preposterous on it’s face. And what is a wife supposed to do with this information when her husband complains that his sex drive is affected by vasectomy? She is being confronted by a medical community that says it definitely isn’t the vasectomy. So she had better start doing a little sleuthing to figure out what it really going on here. Talk about a set up for relationship anguish.

I could go on. The internet is bursting with statements by doctors reassuring men and their wives that vasectomy is safe and doesn’t cause all of these problems that the science says post vasectomy men do in fact complain of.

Personally, the doctors have not ever indicated that they do not believe my complaints. They have all taken all of my complaints at face value and been serious about them. Nevertheless, all of them have taken time to defend the procedure. One uro said that since the cord block was not fully effective, that strongly indicated that this was not a result of the vasectomy and he wanted to do a cat scan to fish around for anything else that could be wrong. All of them repeatedly defended the procedure and reiterated that the vast majority of men don’t have trouble like this.

There is a huge difference in tone between these two possible reactions by doctors:

Reaction 1: Vasectomy is a safe procedure. I’m sure time will get you straightened out. The vasectomy really isn’t expected to do these bad things. Have you tried ice and anti-inflammatory meds? It has only been 8 months – give it time.

Reaction 2: Vasectomy is a surgery that leaves some men permanently disabled and gives up to 10% of men permanent aches and pains and can hurt your sex life. I hope you are not one of them, but I see you have some of these problems right now. I definitely think reversal or other surgical options may be appropriate – but let’s give these other conservative measures a try, since they have less risk, and we may luck out. If you want to bring your wife in here I can talk to her and then she will know at least one doctor who thinks your desire for a reversal is warranted.


Well said, Ethan. I’m angry at the “system” too.


so true, I am sure some men just suck it up, but when ED sets in that’s when the wife takes notice, when she realises that her play pole don’t work, good luck with that


Day 232

Took Naproxen and Doxycycline for 10 days. Also started up the daily papaya powder and got in some icing in the evening.

Burning sensation seemed reduced during the day. I still think there was a night or two in when I woke and felt very uncomfortable burning for a while before falling back to sleep.

After the week of meds, sex is still quite uncomfortable.

This morning I started up Lyrica. 50mg 3 times per day. I took one pill this morning and felt a little dizzy and a little foggy. Those side effects were pretty mild. I did a fair bit of walking today and capped it off with a 3 hour drive. A real stress test! Walking around I didn’t notice any pain, so it seemed like maybe the Lyrica was doing it’s job? How long do you have to take Lyrica for it to start being therapeutic?

Interestingly, I forgot to take the mid day Lyrica before starting the car ride and by 4PM the testicles were burning VERY strongly during the car ride. That’s about 7 hours after I took the Lyrica, which has a half life of about 6 hours so I wonder if coming down off a Lyrica gives you heightened nervous system sensitivity? Maybe just a coincidence and the walking and driving were responsible by themselves.

Anyway, my balls were screaming at me in the car like they were being cooked. No other part of my body seemed to be in pain, so that seems like evidence that the pain nerves down there are still in a very different situation than the pain nerves anywhere else.


Day 237

I’ve been taking Lyrica since Sunday. It has been very effective at reducing the level of discomfort! I would not say that I’m back to normal, but it probably eliminates 90% of the pain for me. I can walk, I can push a stroller, I can go on a long drive. No big deal.

Side effects have been very mild. I had some dizziness and tired feelings the first couple of days. Now I don’t seem to. It also has a noticeable affect on anxiety. Onset is very fast – like within 20 minutes of taking the pill. It feels like the same effect on anxiety that you get after you drink a beer, which is not a big surprise since alcohol and Lyrica both boost the effects of the inhibitory neurotransmitter GABA. I can understand why people might get addicted. I’m taking 50mg pills 3 times per day, which is a low dose. Lyrica has a short half life, and I can feel pain starting to creep back up after 6 hours or so.

Lyrica is quite expensive and not covered by my insurance – but they offer a manufacturer’s coupon that brings the price down to maybe $25 per month? Don’t take my word on that. Also, I heard that the patent on pregabalin is expiring this year so maybe there will be generics soon.

I’m happy that Lyrica has such a noticeable effect as it shows me (and my doctors) beyond any doubt that I really was in significant pain.

Unfortunately, my interest in sex has basically dropped from low to zero since starting Lyrica. So I’m not sure how that’s going to go when my wife wants to get intimate. Hopefully I can get in the mood when I need to.


Are you planning on staying on this regiment for a while @Ethan_Scruples and see how you progress, or are you considering next steps too?


My prescription is for 3 months. I think I will probably finish that prescription, then stop Lyrica and see where I’m at. If I still have pain and crappy sex, I’m sure I’ll still be thinking about getting a reversal.

I’m happy to take the Lyrica short term for a couple of reasons:

  1. I want to wait until the 1 year mark before I decide whether or not to get a reversal. If Lyrica can keep me more comfortable while I wait, then good.

  2. Pelvic and core muscle dysfunction can result from moving weirdly to avoid pain. Minimizing pain may mean that I can recover from pelvic muscle problems and head off new ones.

  3. My doctor told me that chronic pain can alter/sensitize your central nervous system, making the chronic pain even more difficult to treat. So preventing the pain can help avoid this issue.

I don’t really want to live the rest of my life taking Lyrica. I haven’t checked out the long term risks much but I’ve heard the drug can inhibit synapse formation. I worry that taking a drug like this could impair the function of my brain in some way eventually.


Hi Ethan,
I got my vasectomy October last but have not contributed until a few days ago.
I just got a reversal and is currently resting.
Regarding lyrica I have a couple of inputs. I went on gabapentin about two months after the vasectomy. First 3x300mg which did have a good effect on the pain.
Gabapentin and lyrica have similar structure except lyrica is faster absorbed and about 6 times more active (hence usual dosages are 50mg and 300mg).
Unfortunately the effect slowly decreased and consequently I increased the dose until 8x300mg.
Turns out at this level most of the drug is cleared from your body without having much effect. I also encountered a bad 4-5 day diarrhea and after that went down to a single 300mg before bed.
That has helped me sleep better.
At the high doses I found a bad interaction with alcohol. Basically a single or two glasses of wine would give massive hangover.
In hindsight the explanation for declining effect could be compensation by the body so that more receptors become available.
Anyway, glad to hear you have found some relief!