Post Vasectomy Pain Forum

Decision about reversal, 12 months post-op

Surgical Therapies
#1

It’s becoming increasingly clear that i’ll have to make a decision about whether to pull the trigger on the vasectomy reversal. Just some rough background: I’ve never been in that much pain—nausea has been my primary symptom–and i’ve seen some improvement over the past few months with drugs (first nortriptyline, now lyrica). I didnt have much improvement with pelvic floor therapy, acupuncture, or GI interventions (i.e., GI ruled out GI issues causing the nausea).
I’m now enduring mild nausea pretty much all day, everyday, usually just irritating/uncomfortable but sometimes worse. I’ve got some testes pain (down low, epididymus area), mostly nagging but some sharper pain, at times. I think i’ve finally nailed down that congestion is the root of the pain/nausea. 3 of the 5 urologists i’ve talked to have seen nausea as part of PVPS. Dr. P (formally of PUR clinic) strongly recommended the reversal. My current urologist (Dr. Dean at GWU) is more reserved—he thinks i have about the same likelihood of it helping (i.e. ~70%) as everyone. He also describes the risk of other complications at 1 - 2%—about the same as vasectomies in general—and I was curious what others think. Is it dumb to get a reversal given that i’m not in tons of pain? Or is it worth the relatively small risk of making things worse given that it is likely to make things better? Is there anyway to know whether i’ll still make progress without surgical intervention? Any thoughts?

Dr. Dean also describes a reversal recovery as not much worse than a vasectomy—does that sound right?

Any nausea folks out there? I can live with this mild nausea for a while…if I knew it would eventually get better i could live with it for a long time. But I can live with it forever, and i really just want to get my old life and my old self back.

Looking for opinions.
Thanks

#2

You and I are in a very similar situation, except that I am about 37 months post vasectomy.

Things have improved over that time, but I still have times frequently – like right now – where I’m feeling that mild nausea, burning epididymis etc.

I don’t think there is any way out of the dilemma. Getting a reversal sounds completely rational in your situation. I may try to get one this year.

On the other hand, you take the chance that something will go wrong. That’s just a risk you have to accept if you do the reversal.

You just have to decide. You could wait another year and see how it goes. That’s what I did. And then I waited another year, partly because of COVID.

As far as comparing the reversal recovery to the vasectomy recovery, I think it’s silly to say reversal is similar to getting a vasectomy. There is maybe some overlap in that some men with a vasectomy have a worse experience than some men with a reversal. Generally though, men with a reversal say that during the acute recovery phase it was significantly more painful. It can also take a long time to recover from a revers soal – like 3 to 12 months. So it is important not to get discouraged if you feel worse for a while.

#3

You could consider getting an MRI of your scrotum. Based on what I wrote in this thread. It may help you with your decision. If the epididymus has a certain appearance on MRI it can to some degree determine if a vasovasostomy would be possible or not. The reasoning is that if there is high T1 signal intensity in the epididymus, the sperm isn’t free flowing fluid anymore and maybe won’t flow easily through the reconnected vas. If you have that, it would be an argument against reversal.

#4

Based on personal experience, not medical science, I think reversal is the right prescription for symptoms like nausea, low-T, high PSA, etc. My hunch, and it’s just a hunch, is that some of us end up with sperm (excess protein) running around our bloodstream. Much as my GP and family and friends were/are pro-vasectomy, my dentist was not, and he pointed out to me that no one really knows what happens to all that protein.

On reversal recovery, yes, it’s longer and tougher than the original vas. First off, if you’re a pain patient, you’re operating on already aggravated nerves. Second, it’s a longer and more invasive surgery. That said, many of us get through it.

Best wishes.

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#5

The reversal was more painful than the vasectomy, but it wasn’t awful. With my vasectomy, there were two tiny little incisions about a centimeter long or so and only a little bruising and swelling, where as with my reversal it looked like my hacky sack had been unzipped down the middle and sown back up, was black and blue, and swelled to about the size of a grape fruit. I was only in a little discomfit after the vasectomy, until about a week and a half in, after which it started to hurt more and more each day until it topped off after about a months then slowly got a bit better with time. With the reversal, I was in quite a bit of pain, but it wasn’t unbearable by any standard. I think that had I not developed PVPS, I would have been more or less recovered from my vasectomy after a week or two, but my reversal took a few weeks for the swelling to go away, and the pain gradually subsided over the course of months, but the worst of it was over within the first month. Overall, I’d say that my post surgery reversal pain was about equal to or less than my worst PVPS pain, but it didn’t bother me as much because I was optimistic.

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#6

Mine was the other way around my vasectomy was more painful than the vasectomy reversal. One hour after the vasectomy I knew I had made the biggest mistake of my life. Pressure to have the bloody opp.then pressure inmy balls from then on.

#7

Hey guys,
Thanks for the response. Hearing that EthanScruples is considering the reversal certainly reaffirms my decision (Ethan I appreciate that you have given me lots of advice over the past year). I am going to move forward with it and roll the dice. I just dont have a sense that my current situation is going to improve—even if it stays mild I think it is here to stay unless i change the anatomy. I’ll keep everyone posted. Thanks

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#8

Good luck man. I would never have considered a reversal if I had not read so many stories where guys see improvement.

I still haven’t found a better summary than what @Mainman said:

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#9

@MeerSwan You’re not alone man. I’ve made it as far as I’m going to go without taking some aggressive action.

My reversal is scheduled for March 1st. I’m at peace with the decision and ready to get on the road to real recovery.

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#10

THanks guys. I forgot to mention that he wants to do a spermatic cord block before, just as a last-ditched effort. Any reason not to give it a shot? (no pun intended)

#11

Cord blocks are generally not a problem. I’ve had several, hurt worse for a day or two after, then back to baseline, and better once the steroid (and botox twice) kicked in. Some guys here have, however, reported being made worse, so they’re not without risk.

Benefit of a cord block is a diagnostic tool…theory is that if the nerve is numbed, the nerve itself could be the root cause. Good to know before going for reversal. In your case, though, with nausea, I’m convinced you’re one like me with an autoimmune response to the “chemistry” change of vasectomy. That’s a total non-medical opinion, but since the medical community can’t provide a better explanation for T-levels dropping, PSA going up, nausea, brain fogginess, etc. I believe there’s more here for some of us than just congestion or nerve pain.

Again, big caveat that this is just my opinion, but for guys with more symptoms than pain like I described, I like reversal’s restoration of sperm back in the reproductive tract. Worked for me.

#12

I’m getting my cord block on Monday and planning on scheduling the reversal for mid-March. I know this is basically the same question as before, but i have to keep asking it/asking myself it: am i dumb for taking these more aggressive steps given that my pain is a 0-1 and my nausea is a 1-2? Should i be riding out the pregabalin a bit longer (on it for about 2.5months)? Thanks all!

#13

These are questions and thoughts that countless men have dealt with in the past. Many men are dealing with them currently, and there will be men that will be dealing with the same questions and thoughts in the future. Every man has to draw a line for themselves somewhere.

I don’t think you are dumb for considering all of your options. If you are just panicking and willing to roll the dice on anything with anyone without properly researching everything beforehand, I might agree with you then. If you have been making slow but steady progress, you might want to hold off a while longer. It’s totally your call.

There are countless men in this world that have had a positive experience with reversal. There are guys on this site and elsewhere in the world that had a positive experience with waiting things out for as many as ~3 years. Does that mean that you will have the same experience that they did if you have a reversal or wait this out for ~3 years? Anything is possible.

I will be curious to know what you end up deciding for yourself and how things work out.

Hope that helps.

Good luck and keep us posted.

#14

No one here is dumb. I think we all, to some degree, are victims of false advertising. Set aside the big one, pain. You’ve got chronic nausea. In 2006, my prostate swelled up so badly I felt like I was sitting a tennis ball. Turned out my PSA was 4.2. Also felt lethargic. Turned out my testosterone registered in at 285 and 325 on two different test. Post-reversal and 15 years later, my PSA is under <1 and my T is 600-750. Being vasectomized did something to me that doctors deny or, at best, can’t explain. You’ve got the same situation. Many here feel “off.”

I commend your doc for suggesting a cord block. Do you know if he’s using a steroid and not just a short-acting anesthetic? If he’s going to use a steroid, I was told that the steroid takes 3-7 days to kick in. I’d suggest perhaps waiting 6-8 weeks before you declare the cord block a failure and have the reversal surgery. So, while I suggest giving it a bit more time than the 3-4 weeks you’re giving it, I do agree with scheduling it now if you can and not too far in the future, just give the cord block (if steroid included) to work.

Best wishes!

#15

Well, i did the spermatic cord block two days ago and no change whatsoever (steroid plus numbing agent). I see raising4girls suggesting waiting 7 weeks before calling it a failure—but the urologist suggested i’d see changes right away. i’m kind of inclined to get the reversal on the schedule while i wait. just an update, happy to hear others’ thoughts

#16

@MeerSwan

Hey man, I wasn’t sure if I should even post this, because I don’t want to influence your decision, but for what it’s worth, I kept a low grade nausea feeling the past two years.

On the ride home, this past Monday, from my reversal I told my wife this was the first time in two years I didn’t feel nauseous.

I can’t say if I would have gone through the reversal if that was all I had, because I had a lot of other things going on that caused me to pull the trigger.

I’ve got a ways to go, but I’m very encouraged right now.

So far on day two, the reversal has been the easiest compared to my vasectomy and hydrocelectomy.

I’ve currently got no pain in my testicles or epis.

#17

Thanks for the reassuring info, Lee. I had already scheduled my reversal for 3/22, so your input wont sway me one way or another—I’m already committed. I’m excited and hopeful, but i’m trying not to have any expectations (i.e., like expecting that i will wake up not nauseous, which is my biggest dream). i’m trying to remember that i may feel like shit for a few weeks, months, years…
wishing you luck, m

#18

I think I’m having similar experience to what you described (raising4girls). Mild pain/discomfort, but messed up hormones and other autoimmune issues. I debate daily about getting a reversal. More and more I think I’m going to

#19

It’s very hard to offer suggestions or recommendations. All I can do is state what I’ve tried, what’s worked, and what hasn’t. As the old standing caveat goes, Your Mileage May Vary.