Waffling Over Reversal


Hi all,

I had my vasectomy 2.5 years ago. I started to have an uncomfortable feeling of pressure starting less then a week after vasectomy. This feeling would come and go, and could sometimes be quite excruciating. It peaked within a few weeks, and over the next six to nine months got quite a bit better. I’ve tried testosterone therapy, which I feel helped a little bit; and gabapentin, which didn’t help at all. Unfortunately, after about a year, thing stopped improving, and I’m considering getting a reversal.

I’m still very unsure about it, however.

My symptoms are relatively mild, just an uncomfortable feeling of pressure in my testicles. It can be fairly uncomfortable, I feel a great deal of anxiety about it, and I hate wasting mental energy thinking about it; but on balance, I’m not in excruciating pain, just uncomfortable in a way that I would rather not be, and in a way that I find distracting. I don’t have what feels like nerve pain, pain on contact, nor pain during or after sex. Since my symptoms are mild, the possibility of making things worse feels very real and scary.

I can’t know for sure, but I think that my problems have all been related to congestion. I haven’t had what I would describe as pain, just a feeling of pressure which can be quite intense. Given this, my hunch is that if my reversal eventually failed, I would be back to square one.

I’m curious, has anyone out there felt like their PVPS was due mostly to pressure/congestion and had a reversal that hasn’t helped?

Also, in a conversation with one of the people who works for Dr. Marks, I was told that often PVPS patients who go for a reversal that eventually fails still don’t return to the same level of pain. I see how this could be the case if nerve damage is the issue, since a reversal does get rid of a small portion of the vas, but I’m highly skeptical that this could be the case if congestion is the issue, since it seems like the eventual steady-state should be the same. Does anyone have a take on this?

Anyways, thanks for reading. Your responses are greatly appreciated!



i think i was you. i had a reversal 6 months ago with Marks. It made me worse. I (at this point) regret it. I wish I had waited. Granted, it had only been 9 months since my original vas, but since you are in the situation you describe, my opinion would be to wait. I honestly didn’t think that the reversal could make me worse, but it did. Dr. Marks has expressed a lot of surprise over my situation and has told me that he’s never seen anyone respond like I did. Frankly I find that quite misleading and have lost some of my opinion and regard for him. Unfortunately I think he’s peddling an expensive product and I honestly wonder if he told anyone of my results after they happened. Meaning, did he tell new people “well yes, one guy recently is far worse after reversal.”

All that to say, I’d continue pursuing natural remedies if I were you.


Hey Alex. Your story is very similar to mine. I am just over 1.5 years out form vasectomy, not your 2.5, and I’d say that my pain hasn’t been as obviously congestion, but it definitely can be that at times.

For the most part it is 0-2 level pain… I actually think its still VERY VERY VERY VERY slowly improving… not sure how.

I am also in Texas (Austin) and also went to see Lipschultz. I also did TRT for a bit (which interestingly I think did help my testicle pain in a way…).

I have of course considered reversal the whole time, but keep putting it off so to speak. @jsh was just getting his done as was a different user who lives in Arizona. JSH’s outcome is of course “scary”. The other guy is doing better, though it hasn’t returned him to normal yet. These are just 2 random guys, so not sure why I’m focusing on them, other than last time I seriously though lets do this was around the time they both made the decision apparently to move forward.

My next step is papaya seed powder. I just got that in the mail yesterday and am starting today. Only on the board today to see the recommended dosages…

feel free to reach out…


@jsh, wow, I’m so sorry to hear that. After the reversal, did your original symptoms change at all? Were they worse after the reversal, or were the original symptoms better, but you had new ones?

As you say, a reversal is an expensive and potentially lucrative procedure, and like you, I often worry about the conflict of interested there.

@jerbear, yeah, it’s very hard to stay objective. When you hear one or two stories they definitely color ones opinion, even if they don’t reflect the average.

I’m thinking about doing the papaya seed thing as well. I hope it works out for you!


for the most part after my reversal, my original symptom (congestion type pain on the right side) improved, but I got more painful cord pain on the left side. However, unfortunately in the last week my right side has had some congestion type pain come back on the right side too. My last SA was pretty good, but who knows. Its all so complex and nobody seems to really know how anyone will respond to this kind of procedure very well.


I think you should focus on this.

I would try something like papaya seed or investigate hrt to see if that helps before doing anything drastic like reversal.


@MikeO Sorry, I don’t follow what you mean by identity politics.

Yeah, definitely agree that trying HRT again and papaya seed might be the way to go for now.


I’m approaching 1 year post reversal and the jury is still out on whether I made a bad decision or not getting the reversal. My first two months after reversal where atrocious, then it got better for three months, seemed like I made the right move, then one side got worse, then both sides got worse, now it seems like its going back to how it was pre-reversal. And I went to one of the best - Dr. P. What a crock of shit!!! Some days I think about using zip ties, and a sharpened garden tool. Bottom line: the doctors have no good treatment option for you.


@alex, I have no idea what he’s talking about either.


@crotalus97, how did you come to the conclusion that Dr P is one of the best far as his reversals go?



That was mobile app weirdness/paste buffer garbage. Please disregard.


This is really (REALLY) a tough call. My vas was 13 years ago this coming Monday with pain onset 8 months later. Back then, there were no forums, just a website that had a few dudes’ stories and their emails and Kevin Hauber’s book. All discussions were done via email and phone, ya know, the old ways.

There were just a handful of uros in the US treating PVP patients plus a couple in CN, and they were hard to find. Drs. Marks, Werthman, and Thomas were the primary guys doing reversals as treatment and Dr. Levine just starting up the denervation approach. Many of today’s newer practitioners like Dr. P., Dr. Sabanegh, and Dr. Nangia learned under Dr. Thomas. Like so many, I was in so much pain, and one of the gurus (Thomas) was in my backyard, so my “research” was “tell me what to do, Dr. Thomas.” Tried a GF block, did nothing, so we went for reversal.

I never believed I had congestive pain. I just wanted to be restored. He found during my reversal in 2006 that I was leaking actively at both vas tips.I attained pain-free status for 9 years (except for one six-month relapse) from late 2006 through mid 2016. My PSA dropped back to normal and my T-level doubled post-reversal.

So, based on my personal experience and the handful of guys I got to know in the 2005-10, I became pro-reversal for PVPS.

More recently, due to this forum, it’s become clear that reversal isn’t a magic bullet. Heck, the new leading theory is that the main benefit from reversal is that damaged, painful tissues are removed during the reversal and that restoring flow doesn’t contribute to pain relief. That may be the case.

I feel somewhat guilty for my past pro-reversal posts. At the same time, what else can a guy attempt? It SEEMS like a logical approach (to restore the original state) but if there’s nerve damage in there (and I’m starting to believe that’s a component in many of us than we know), reversal could be a huge risk.

Long winded way of saying “I don’t know.” For that reason, I can respect physicians who can’t tell us whether any surgical intervention would work. It’s a crap shoot, not even a calculated risk.

Clearly, the best approach is not to get a vasectomy in the first place. That’s where I’ve lost total respect for the medical community, the feminist movement, and other outlets. Men are being butchered with no regard.

Very, very tough call on what to do next.


Perhaps Dr. P is more of an expert with the nerves. Did I make a mistake going to Dr. P? I wonder sometimes. After two months post-reversal Dr. P was ready to perform SCD on me. This Dr. Marks is mentioned a lot on this site, but then @jsh came out worse after getting a reversal by him. I wonder maybe all these doctors are more or less wolves trying to prey on us, but then some people get better. The only solid recommendation I could get from the several urologists I saw in NJ was to go to Marc Goldstein in NYC, but he is a fertility expert. This is a very difficult subject to discuss and learn about.


@crotalus97, That’s pretty scary brother ^^^, and it’s not surprising at all.

Dr P did my first reversal 4~ months post vas in 2010, and it was a blunder all the way around. Lots of complications, and a failure far as return of sperm. It did help me with some pains, but my recovery was up and down, very bumpy, and there were a lot of issues (to many).

Honestly, I don’t think Dr P is very concerned about fertility when it comes to his pain guys. He has his own views on pvps, and like many other doc’s, he thinks he’s right about so much. He might be fellowship trained, but he does way to many surgery’s in one day for me. I’m not into the running behind, and the cramming thing. I’m not into profit vs perfection either.

Another thing he does is teach during his procedures, or at least sometimes, or etc. He was doing this back in 2010, and still does it. There’s a story on here that’s about a year old that confirms just that. I’m definitely not down with anyone but the surgeon I hired, and trusted to do my surgery, or do anything to me while I’m under anesthesia (under the knife).

I had a redo reversal with Dr Marks a year after my first reversal (2011), and it was a completely different experience all the way around. I’m not sure on why far as some stuff goes either. Perhaps more of the irritated nerves were removed, perhaps Dr Marks was a bit more gentle with me, I really don’t have a concrete answer.

I had zero complaints regarding my redo reversal other than it didn’t meet my expectations in the long run, but I knew that was a possibility beforehand. Obviously, reversal results and outcomes will vary man to man, just as many published pvps studies suggest.

If I could’ve done things over, I would’ve went Marks the first time, but who knows what my story would be now if I had. I certainly didn’t enjoy learning all of this the hard way, and that’s why I tell novice readers to get it right the first time. Regretting our choices is not recommended. Don’t buy into all the hype, cheerleading, etc, and go slow.

I know when it comes to Dr P de-nervation procedure (neurolysis), it seems it takes 15 minutes (the actual procedure itself). This is what modern urology wants. They want a quick fix for pvps (the pain), something insurance will cover, and keeps men sterile (my opinion).

True three layer microsurgical reversals take hours to complete. They aren’t very economical far as treating the masses, and will likely be failures on some level at some point as well. Insurance doesn’t like to, or won’t cover them, and like many pvps corrective procedures, the outcomes are unpredictable.

Unlike reversal, there do “seem to be” a lot of pros to de-nervation when it’s actually successful, durable, and doesn’t cause any other issues (hypothetically)(in theory).

Personally, I think a lot of pvps corrective procedures are over rated by a lot of the people that “sell them”. I did read your 10 year follow-up statistics in another thread, and I found it odd that the numbers do not reflect the 86%~ success rate that are in some of his other published literature from 5-8~ years ago. I will note that in the literature, it does mention that some men suffered injury/s. I posted a link to that literature toward the end of a thread titled “please ask questions before de-nervation”.

Another member recently weighed in far as how many of the 10 year study people were actually pvps guys. I think that’s an excellent question to ask myself.

There’s so much we dont know about “all of the hidden data” regarding reversal, and de-nervation, and I have outlined some of that recently. Some of these “pvps doc’s” are doing there reversals night and day different than one another, and claim to be getting the same outcomes. Idk about all that, and I say, prove it.

Personally, I’d tell you that de-nervation is where modern urology is trying to take the surgical treatment of pvps to (the future). Why? It’s fast, it’s cheap, and if it works, and is durable, it’s probably the way to go (hypothetically). Beleive me when I say, there are people in this world trying to figure just that out (better de-nervation procedures, etc).

Far as is Dr P better nerve doctor, or better with nerves regarding pvps? I suppose it depends on whom you ask, and whom you believe. Opinions certainly vary across the board. I live in the same state as Dr P, and don’t see him anymore.

Bottom line, you have to do what you think is best for you. You gotta know where to draw the line. Use common sense, and extreme caution before you submit to another surgery. Wait long enough until you feel confident that conservative treatments, and time alone are not in your best interests anymore. You do remember how you ended up in the boat your in now right?

Far as I’m concerned, bedside manner, compassionate talk, great charisma, etc etc don’t mean much. At the end if the day, it won’t mean a whole lot if surgical decisions take a turn for the worst. Like many, I’ve learned these things the hard way over time. I had 3 corrective procedures myself over a period of 2~ years (2010-2011).

Hopefully I haven’t discouraged you in any way. This post might be TMI, but I’m just sharing my thoughts, and my experience. I see no point for a forum like this one to exist if we cannot speak our minds, and/or the truth, etc.


These comments ring true to my sit as well. Had a reversal with Dr Marks as well with no change in pain BUT my white blood cell count went from 12x1000/ Mcl before reversal to 5x1000/mcl which showed my autoimmune response to millions of foreign toxic sperm entering my blood stream while closed off. Dr Marks even noted a super high concentration of white blood cells in my scrotum. So while I didn’t get any pain relief I was relieved that my body no longer had to deal with toxic sperm in my bloodstream. My blood tests before and after reversal is definitive proof that sperm absorbed in the bloodstream after a vas wreaks havoc on the immune system.


I had one almost a year ago. It’s definitely helped. I still get some aches and pains but most of them stem from where a granuloma developed. I don’t regret and it’s given me peace of mind. I was so distracted by regret, anger and frustration every day whenever aches and pains came around. No it’s a few times per week and not nearly as severe. In fact, since the reversal I’ve only had a handful of experiences where the pain rose to moderate levels. Pre-reversal, it was every other day if not daily for moderate aches. Let’s not get confused though - the reversal doesn’t undo the vasectomy, it just repairs it as best it can.


@crotalus97, Rather than edit my previous post, I’m going to clarify what I said above in regard to neurolysis being fast, and cheap, etc.

I already mentioned the procedure itself takes about 15~ minutes to perform. That’s definitely fast.

When I say it’s cheap, I mean it’s cheap for hospitals, providers, etc to perform, providing they have a davinci robot on hand. The davinci robot is capable of doing all kinds of stuff, and becoming more and more popular in a lot of high end institutions. Many of them already have these robots in place in their OR’s.

The procedure itself bills out for approximately 15K~ and up for something that takes them 15~ minutes to complete in the OR. Thats 1K per minute far as billing it out, and/or profit margins go.

Unlike reversal, I’ve never heard of a case in the states where insurance denied a neurolysis claim either. There is big money to be made with neurolysis, make no mistake about it.

@alex, sorry I took your thread beyond “waffling over reversal”. It’s all good info for people to be aware of.


No worries, I’m really happy to get everyone’s stories and thoughts.

One thing I wonder about sometimes is if the stories on this forum are likely to worse than what happens to the average person. My thought is that people who have better outcomes are less likely to stick around the forum.


I think there’s definitely some truth to that ^^^, but honestly, I know of many people that aren’t doing so well that don’t post online anymore, or online period.

I feel confident saying anyone that assumes the size of this group, or its active members means a whole lot is assuming way to much.

I too feel bad in regard to @jsh outcome post reversal, but he definitely got a proper warning from me beforehand on the open forum. I recommend several conservative treatments first, and pointed out so many things for everyone to consider regarding reversal in numerous reversal threads over the past year.

I do agree with some of @jsh thoughts regarding “I wonder if Dr so n so even tells people about my outcome”. Believe me, I’ve been there in my own mind before, and still can relate when I see pvps docs quoted words, and statistics by members regarding reversal consultations, outcomes, long term patency, etc, etc.

I certainly know of guys that dropped off this forum, and other forums that are doing very well, and we shouldn’t assume to much about anything. I’m not doing that bad considering all, and the only reason I stick around is to help others, and/or help them sort through some of this stuff, etc.

I’m going to stick with what I’ve always said, and believe to be more the truth than not. The majority of guys I know about don’t regret their reversals, but I’ve definitely seen some that do, and for various reasons.

On a final note, and in my opinion, papaya seed powder has got to be the best new thing in pvps discussion’s since the invention of bubblegum. The forum I belonged to prior to this one didn’t know about it. The only thing we knew about was TRT, which certainly seems to carry a significant level of risk in comparison to papaya seed powder. Papaya seed powder doesn’t require a prescription, it’s all natural providing you get a non GMO and organic product, and it’s cheap to. I’ve seen a lot of men report success with it in the short time I’ve known about it.


for the record, I do believe the jury is still out on me. I think people heal at different speeds, and perhaps I’m just a very slow healer. I think that part of the body is beyond incredibly complex, more than even modern medicine realizes. Then you throw in things like medicine, the muscles in the pelvic floor, etc. For example, my PFPT believes that much of my left side cord pain over the last 5 months is related to the positioning of my legs and groin during my reversal surgery. Who freakin knows. Also for the record, relative to many others here, my pain these days isn’t THAT bad, i mean its 1-3 usually. Usually on the weekends with proper stretching, rest then activity, ice, the position that I sit, what I wear, I can get it to a regular 1 with brief periods where its not so much “pain” as it is just sort of discomfort that i’m aware of.

I’m curious where I’ll be in a year, or even 2. @orange how did you feel your healing progressed? Do you feel that it was linear, etc? For example, my scar, the area where Marks did the incision, still has not “inverted”. I mean you can barely tell there is anything there from the outside, which is a testament to his skill i think. Now underneath it is still thick and very tender, in fact it contributes its own pain from time to time depending on how the skin lays or is touched.

So when i’m in a positive hopeful mood, sometimes I attribute some of my pain to healing pain, the kind of pain you’d expect after a major surgery. I think we are all just jaded and ready to accept any aches and pains as detrimental instead of potentially a sign of healing to come.

We just got a treadmill, so i’m hoping to at least walk/jog regularly which hasn’t seemed to hurt my progress and can only benefit me from a pelvic floor standpoint i think.