Post Vasectomy Pain Forum

Dr. Werthman, in LA, California for denervation?

I haven’t heard this doc’s name yet in the pool of good docs who deal with PVPS. Does anyone know anything about him and/or his clinic?

My poor husband - things aren’t getting better. The expensive, experimental treatment that we thought would be covered by insurance is not, and it’s too costly and not effective enough to continue. He tried going back on hydrocodone but it make him so sick he couldn’t sleep. So, we’re back to this weird schedule where the pain keeps him awake all hours of the night and he sleeps as much during the day as he can. Thankfully his job situation has been able to work around his pain.

Anyway, he is very leery about denervation, and we both suspect he’d be one of the ones it didn’t work for, probably would aggravate things, given his poor reaction to any kind of procedure - dental, medicinal, surgical - he just doesn’t respond well to anything, even the “normal” stuff. Is there a compelling reason we SHOULD look into the denervation? It seems to be a little bit of a crap shoot as far as success rates go - some say yes, some say no.

Thanks a bunch!

I wouldn’t do denervation to many horror stories. I am getting a few answers maybe from my pain specialist and he says it all related to GF nerve damage and IL nerve damage. I have said it before on here Brad Bowins book says exactly same thing. I will go in a few weeks for blocks of these nerves to determine where my pain is coming from. If you google these nerves they are positioned exactly in area we get cut very easy to damage.

I know of lots of men that had a reversal for pain with Werthman. You are right, it’s odd his name doesn’t come up here often, if at all.

I know of one guy that had de-nervation with him, and it wasn’t considered a success. Luckily, it wasn’t a horror story either.

The thing that strikes me wrong about de-nervation is, I know of very few success story’s posted independently online. From guys that had the traditional, or the Dr P version of de-nervation, I haven’t seen very many story’s of complete resolution. I find that very odd. You can bet that if I was cured of a curse such as pvp/s, I would let the entire world know about it.

One of the last pvps doctors I worked with described my body as “intolerant” of more work down there. I was advised to give it much time, and that’s just what I did. I am a lot like your husband far as a finiky system as well.

I’m not telling anyone what they should, or should not do. I say, to each their own best judgement far as pulling the trigger again, and again. Personally, I’m against traditional de-nervation given all the horror stories I have read.

Had a reversal with this guy after 3 years of Vasectomy Pain. I had many complications afterward, and was amazingly worse off than before. My stories are on here if you search. He basically cut me off. No phone calls, no follow up, no nothing after 2 conversations with the staff. Do not go with this guy! Talk to Dr. P in Florida. Everybody on here seems to think he is the best, and when it comes to surgery down there, you don’t want to settle with anything less. I did and still paying the price. Also, it WILL be more expensive with Werthman.I have been through these forums and denervation seems to not be the way to go. It gives people more issues. Less Surgery is always better if possible. It’s also trying to find out if its congestion pain or nerve pain. Nerve pain is the worse and just takes time to heal, but congestion pain can be relieved with Testosterone or another natural supplement somebody mentioned on the site. Can’t remember what it was, but it naturally lowers sperm production. Do Tons of research and pick THE BEST doctor before jumping into Surgery.

Thanks for your input on Werthman…I also was wondering why noone on this board was saying anything about Dr. W. That was the impression i received after calling twice after spending for the phone consultations about 4 years ago (back when I think it cost $500 …i could be wrong about the $ …he acted like i was bugging him) . I’m also glad that people speak highly of Dr. P here. I got the best gut feeling after talking to him.
A little about myself. Vasectomy 20+ years ago. Pain and medications most of those 20 years …income and energy sufferd greatly. When it started to precipitate a divorce about 4 years ago, I got a reversal from a dr at the University of Davis California (considered their best at their University and highly recomended by the the best Prostate surgeon in the city. (I was to tired and had a bad experience going far from home for a back surgery many years ago…and he seemed like he cared). After a small improvement in orgasm that was canceled out by more continuous pain I have decided I will give it about 4 to 8 months more healing and I am going to go with my pick ( after this search starting here) I plan to try one more time to see If i can find someone to fix this walking nightmare! Both the connections were into the epididimus! He turned out to be the nice guy that I hoped he was…he called me too sensitive. I am not a fan of Urologist’s after this odesy. If i knew then that he was going to go that route…I would have never done it! Considering talking to Dr. P soon to see if he thinks he can fix me. Would have never had a vas had i known what i know know. Thanks for all this great info to all on this board …so I Decided to join. Don’t know if this is the appropriate place to say hello…but hello all ! my fellow pain mates who have been swindled buy the folks who “swore to first do no harm”!
Lastly … Specific to the question above. I would make sure that Gabapentin or Lyrica helps your pain before getting anything done to your nerves. And here is my reasoning…they are considered the best pain killers specific to nerves. If they dont help your pain at any amount I wouldn’t think that any surgical work on my nerves (200 mg of gabapentin makes me dizzy and prone to falls but does help my pain some, especially sleep…and i can’t even function on Lyrica because it causes headaches and dizziness). My pain doc said that they were going to come out with a new nerve pain med in a month or so (which I’m sure they will rip us off on the price for). But it may be worth it for people who can’t tolerate Gabapentin or Lyrica. Good luck on your decision.
Have you considered this test first?

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I called Marks office a lot after my reversal. I got to a really good place relative to where I was prior to reversal for about 4-5 months. I did start calling a lot after I had a pain spike 11 months or so out. They always indulged me in some way or another every time I called with more SA scripts or suggestions on other providers. I was always sure to let them know they saved me from catastrophic pain when I called (even when I was freaking out). I don’t know if they would have stopped returning my calls if I had not always qualified my calls with that sort of positive talk but I think I knew it was important to put that out there when I called. There is a reason there are not a lot of PVP providers out there. We are hard to deal with as a community as we are very needy and just not as rewarding as say a couple looking to have another baby etc… Cutting someone off after 2 calls is really bad. Based on that I would give Werthman an F and never recommend him to anyone. You just don’t take 5-10K of someones money and not at least try to help them after you operate on them. That’s not compassionate or even very professional IMO. Shouldn’t be doing reversals for pain at all if you’re going to be that way. I wonder if he omits that outcome when he sells reversals for pain now? Very sad.

Unfortunately I recieved a similar experience with Dr Werthman. First, I was told by the assistant that the consult would be 300$. When I met with Werthman I got the feeling I was bothering him and he kinda rushed me along. I told him I think my pain is coming from two granuloma lumps at the vas site. He gave me a physical and told me I didnt have granulomas. I just remember thinking then what the heck are those two huge lumps doing there?!? Turns out when I got a vas redo not too long after they removed two huge granulomas which signified bilateral epididymal blowout. After a 10 min rushed meeting i went to the assistant to pay and she told me it would cost 500$. I told her you told me over the phone 300$. She said, “well thats a flexible number. Since your case was more complex its 500$.” Really?! A 10 min meeting with no significant insight was more complex?!? Youd also think Werthman would have had a little compassion on the guy whose nuts hurt and give the standard price. Anyway, thats just my experience.

Haha yeah its all show. Fancy beverly hills doctor. Fancy website. Rigged ratings. Makes sense.

Yeah i feel you. Marks is awesome. Im just like if youre not gonna have compassion and if im a burden to you dont have a portion of your website that gives the impression you do lol.

I will definitely call Dr. Marks before I make a decision. I think I remember his web site says that phone consultations are free, which is the way it should be. Am i also right that Dr. Marks does the reversal with just a local also? With all the pain that I have been through I think that may be best at this point so that I could give him feed back … Like “that fees better” or woa “I don’t like that!” Lol I mean heck they work on teeth nerves that way and they’re almost as painfull. Am I right about how he does his surgery? Does anybody know? Thanks in advance.

What are SA scripts? Sorry for not understanding the lingo. But is it Steroid and Antibiotics? The reason I ask is because I cant get anyone to give me a steroid script to try…and I honestly think some prednisone would help my problem…alot! They just keep giving me expensive Testosterone and it does not stop sperm production the way they say it does…at least not in me! All Testosterone does is work for about 10 hours (sometimes none) make me want to have sex and then 14 hours after that …the pain comes back twice as strong. Has anybody here experienced this reaction to Testosterone? All it does is give me some short term relief, make my wife and I temporarily happy and then I’m a grouchy nut in pain again. Excuse the pseudo pun.

You are not completely out with Marks but you are not coherent or altogether there either. I felt nothing and hours blew by like nothing.

SA - Semen Analysis

Eek. They did a vas to epi connection for pain? Apparently that’s a no-no for PVPS guys. I was speaking to Dr. Jarvi, who did my reversal 2 weeks ago, and he told me flat-out that he would never do a vas-epi connection for a PVPS guy, and he’s never seen of, nor heard of ANY PVPS patient benefiting from a vas to epi connection. Basically, it’s vas to vas or bust.

Secondly, fuck that Dr. for saying you’re too sensitive. I wonder how he’d feel with some vise grips on his junk all day? Maybe he’d change his tune.

Anyways, sorry you’re here man. 20 years. That just makes me angry to think you’ve suffered this long. I’m 30 years old, I had mine done a year ago now and was reversed two weeks ago. Pain’s back to baseline and I’ve only noticed a slight improvement yet. Probably got another 50-60 years of this ahead of me till my pain goes away ‘naturally’ if you know what I mean.

Maybe reach out to Dr. P or find another PVPS doc. Dr. Marks only does reversals, and since you’ve been reversed via vas to epi, I don’t think there’s much else they can do in that regard to be honest.

Basically at this point it’s:

  1. Re-do reversal (don’t know if possible).

  2. Denervation.

  3. Removal (inguinal only).

  4. Wait/tough it out. (sucks I know)

Good luck man, you’re not alone in this.

Dr Marks does his surgery in what’s often called “twilight sleep” using Versed (an anti anxiety similar to Ativan and Xanax) and Fentanyl (a synthetic opioid much more potent than morphine). You more than likely will have very little idea of what’s going on in the room and will definitely not be having much conversation with the people in the room. They may be able to ask you some simple questions. However, they will not want you moving around because it is micro surgery so you’ll be pretty well out of it.

Thanks for getting back to me vasregret. And its nice to have a chuckle even if it hurts. I knew he had done something wrong when he did a vas to epi incision. He took 5 to 6 hours wotking on me (he did both sides that way!) When i left i was praying that he knew what he was doing and that he had been trying extra hard…but now after a couple of years has gone by i realized he just didn’t plum know what the heck he was doing. You just confirmed it. The epididimus is a very sensitive device. And after his “fix” thats where the majority of the pain is now. Drag. I knew i should have gone to Dr. P! He was really friendly and he had a million dollar robot helping him…but you know these Urologist’s they are in it for the fast money. I had a couple of Urologists tell me that maybe he had that expensive robot because he really wasn’t mthat good! I called Dr Turek in San Francisco who refused to work on anyone who was using narcotics (my pain had become so bad and i can tolerate them) … Then Dr. werthman acted like i was bothering him after my second question …i decided that he was out and Dr. P was on the other side of the country…I’m in Sacramento. So i went with a fertility urologist…and made another mistake. My odesy has been one mistake after another…i dont want to make another! The vas to Epi has caused a whole host of new problems. Where before i was at a constant feeling like my BALLS were going to explode because they always felt full …to intense pain 12 to 24 hours after orgasm because that little extra had been added that the balloons could not take …i think that they were pushing on a nerve at that point!
You see i wasent one of those people who felt great pain right away…it was weird. I just changed overnight after my vasectomy. I stopped playing my guitar and i stopped running and playing tennis because it just didn’t feel right or i just didnt want to. I just didn’t have the drive to do the things i liked but i could still hike and i could still have sex. But little by little my back began to hurt (which was where the main nerves from the scrotum go into the spine ) and i had an operation there…big mistake…because i now believe that that was refered pain that was coming from the testicals…And that did not go well, in fact it went horrible. Then the actual pain in thhe scrotum started gettin worse. And by this time i was looking for pain reduction. So i went to a really nice doctor who “promised me that he was going to get to the bottom of this for me”, and when i called back a 2 months later after finishing the Talwin medication that he had given me …the nurses informed me that he had hung himself because his ne trophy wife had put him in so much debt he saw no way out! " WHAT! Lucky me …that was another year set back…find a new doctor. Poor guy!
Anyways back to about 15+ years ago it started to feel like my epididimus was going to explode after i had sex. It was starting to be in terrible pain. Especially in the morning and the evening …when a man and his wife usually want to do it. It was then i started to learn or suspect circadian rythms being involved. Sorry about the spelling…but sound it out…it will come to you…but the reason
Im telling you this is that all the other Urologist’s that i went to see over the next few years were so unfriendly and rude i just let it get worse and worse. One threw me out of his office because i said the cipro and the sulfa drugs hurt my stomich. Another bared me from his practice because i missed an appointment (he refused to listen to the story that i had been in so much pain the night before that i had to take so many sleeping pills that i just couldn’t wake up AND the pain was draining the life and strength out of me (he was just plain unsympathetic of that answer) . Then another Urologist gave me about 5 minutes, and he said, “well i’ve seen this before…you’re just going to have to live with it and take antidepressants the rest of your life”! But i can’t tolerate antidepressants because I’m not drpressed…I’m in PAIN. And i was wisked out of his office …after paying the $90! And Dr. werthman asked for an ultrasound to which he could see nothing wrong and if i wanted to talk to him any further on the subject i would have to drive or fly down to los angeles and dr Turek in SF and Dr. Werthman dont take insurance…great! So this is why I went with the pleasant Dr. Who did the vas to Epi proceedure. He later said that i was soo filled up with “old dead sperm that he had to do this because there was no place to connect to on the Vas!” Oh i said…I thought i was told that my body would reclaim that? To which he didnt say much. But the jerk did call me about a month later and say that he did another reversal on another guy who was filled up with “old dead sperm …and his reversal went fine” i think that was your basic cover your ass phone call…what do you think? And when i asked him if he cleaned our most of that “old dead sperm” (delightful isnt it!) he said, NO! And I said why not…I dont really remember what he said after that.
So now I joind this board. Hopefully this can help. Between the pain, trying to work, keeping 2 kids out of trouble and all the other things I’ve had to do in my life I just havent had the energy to do anything like join some groups such as this. I hope Dr P is the answer…because the guys on this bord have me leaning that way. Now how to find 3 weeks to fly down to Orlando get the proceedure done and stay thereba couple of weeks …long enough to make sure I’m not totally crippled with pain. Thanks for listening and validating why the last guy failed to make me better. Hopefully with all the minds on this bords i migh be able to solve this “simple proceedure” and have the last 5 to 15 years of my life pain free and undrugged up. Lesson learned …dont let anybody evr cut on you unless you are dying or in terrible straights (like cancer) …and the only if you have done all your homework to (a) make sure it it absolutely necessary and (b) you get the very best Dr. that there is! P.S. Do you know i can get more statistics on your average baseball player…than i can on a surgeon who is about to cut on me! Weird isnt it? Tired of typing …i have to save some energy to do do battle with my wifes employer because he doesnt want to pay her and he thinks he can do it because she’s just a woman…ist life grand!

Thanks MikeO …I never got a SA. Maybe because the Dr. who did my reversal knew that he messed up. I had an option to do it but all i cared about is that the pain was gone. It wasent. And because that Dr. was very condescending towards me and downright not very nice to me I really didnt want to see him again. Do you think that getting an SA now would be useful after the fact or should i wait until i settle on a new Dr and he can make suggestions…lastly do you or anyone know of a GREAT doctor on the west coast of the US that has solved other peoples pain? I had herd of one in Vancover BC. But i just started looking again because Jeff Sessions has arbitrarily decided to cut peoples pain medications here in the USA. What a genious he must be to know what everybody needs! Thanks for getting back to me on SA definition.

I see your first post now @IamHurtin. This guy might be great at something, but it isn’t reversals for pvps. Vas to epi repairs? That’s a big no no.

I’m sorry this has happened to you, I wish you had found this forum before you ever heard of the surgeon at Davis.

Sounds like you’ve had a rough go of it. I actually read your story/posts while on my vacation, but I’m catching up still.

Your experience with werthman sounds awful. If I was to comment on that, I would just be echoing others here. Dr werthman, your fired, lol.

@IamHurtin, Here’s what the AUA currently sites far as a % of men that end up with pvps.

Here’s what they say, “Chronic scrotal pain associated with negative impact on quality of life occurs after vasectomy in about 1-2% of men. Few of these men require additional surgery.”

Just FYI, I do not agree with what the AUA is indoctrinating the public with here in the states, and elsewhere. I find it disturbing how they state pvps is effecting the quality of life in these men, but few of them will require an additional surgery. What a joke.

Many studies flat out contradict the 1-2% statistics, they appear to be much higher. The Canadian health care system, and the NHS clearly state a higher risk of pvps. Do your homework.

Here’s a link to the AUA’s official website.

It’s almost 2018. The AUA needs to get with the program far as up to date.

@Ringostar beat me to it. Here’s the Canadian Guidelines: - first page, paragraph 1, 1-14% chronic scrotal pain

NHS: Some men get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent, and vary from a constant dull ache to episodes of sharp, intense pain. For most men, however, any pain is quite mild and they do not need further help for it.
Long-term testicular pain affects around one in 10 men after vasectomy. The pain is usually the result of a pinched nerve or scarring that occurred during the operation. You may be advised to undergo further surgery to repair the damage and to help minimise further pain.

Also because of me, (lol) Uptodate updated their vasectomy complications page:

“Post-vasectomy pain syndrome – This condition is thought to result from buildup of fluid in the epididymis leading to a chronic dull ache in the testes. There is some controversy as to how commonly this condition occurs. Historically, rates for post-vasectomy pain syndrome have been reported as very low (<1 percent). However, surveys have found that the incidence of “troublesome” post-vasectomy pain is reported by approximately 15 percent of men, with pain severe enough to affect quality of life in 2 percent. However, survey respondents may not have been representative of all men who have had a vasectomy. The preferred therapy for post-vasectomy pain syndrome is nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand name: Aleve), and warm baths. If these measures are not enough to relieve pain, local nerve blocks or steroid injections may be performed by a pain specialist. Cases that do not respond to therapy may require surgery, including possibly a vasectomy reversal.”

Another thing I hate about the AUA guidelines is the “few of these men require additional surgery” well, I would argue that NONE of us ‘require’ surgery, it’s not like we’re going to die because of PVPS, and a lot of the 1-2%'ers are told ‘there’s nothing we can do’ or ‘a reversal will make you worse’ or ‘give it time, give it time’ or even worse ‘man up/it’s in your head.’

So much for informed consent. Print those guidelines out and show them to your uro, see what they say. They’ll probably hand you some BS line about, ‘Ive never seen it’

Thanks for getting back to me @vasregret , @RingoStar, @thissucks and somthing whitman who is the equal of my favorie writer H D Thoreau. I have read these data in my research and now it will be nice to have all the web url’s in one place. The numbers of the Canadian and the UK are so far different that the USAs’ numbers I have got to believe that SOMEONE is Lying! And I’m pretty sure who. Living in a country that sells Machine gun conversion kits on the web and has mass shootings monthly gives me a hint!
This data is all well and good and I do appreciate it but I really gotta find the best of the best of the best …sir! (Men in black…who may also be the people who are covering up these statistics…ha). I can’t believe what an odesy this stupid little snip has done to me. I used to love life, I traveled did sports, loved making love and its all been stolen by a lie and a bunch of bad politicians who are too afraid to admit that we are headding into a global population crisis and are too afraid that they may offend some religious constituants or they may slow down the sales of viagra (one of the few things that are keeping this economy afloat) that they can’t be honest or can’t spend a few dollars that they blow on defense or “a WALL” or whatever stupid project, in order to find a safe effective way to stop spem production.
But I digress. I believe that it is congestion of the sperm that has nowhere else to go. And That once your body gets used to not reclaiming it … It doesn’t restart magically… Especially since you are fooling it on a regular basis when you have sex! Or some of us are just sperm factories first, and workers second! Lol. I think I will start my own thread or discussion because i dont want to look like I’m beating on Dr. Werthman because he may be the best for all I know. I will start a discussion called “who have people had the best success with” or something like that and I will list all of the doctors that I have herd that “believe in PVPS” and are trying hard to do something about it and I may end up talking to the top two or so. I beleieve my reversal worked for a short time and just got clogged up again. I can feal my Vasdeferens getting thicker and thicker…(even though the Urologist’s that I have gone to see can not!). And it has also become obvious to me that our body’s switch back and forth between testacles which switch back and forth manufacturing sperm and they empty out at alternatives also. “What a great way to learn”! And circadian and time of night and sleep cycles are also involved. The sad thing is that I can’t seem to find a single Urologist who is interested enough in his or her chosen profession enough to know more than Me or anybody on this board seems to know. And that’s both SAD and SCARRY! I’m going to eventually pick a urologist and then i will tell him/her that i’ll send them a 1 or $2,000 bonus if I’m better after a year and a half. I don’t know. I am seriously thinking about having them removed. I would do just about anything to be rid of this pain. I’ve just about had it! i was seriously thinking about running out and having it done until I saw that the guy on this board who had it done was so recent he hasn’t had time to know if the long term plusses were worth the operation or not. I really don’t care if i have the stupid nads or not anymore. Actually I’m kind of interested to see if (a) what life would feel like without them or (b) if that does fix the problem! I used to be a sprinter and play tennis. I have very thick upper legs. Sometimes I wonder if I just dont have any room up there and thats the problem. Who knows? But again I can’t seem to find a Dr. That seems to be interested in their profession enough to discuss it. Its really sad that we either have too many people and not enough doctors, or they only care about how fast that they can make more money, or they hate their profession so much that they won’t discuss it intelligently or theoretically! I’d do just about anthing to find a doctor that was “interested” in solving this problem. But I’ve yapped long enough. i’m going to find or start a discussion to find out who is the best and maybe I’ll see you guys there. Thanks for any help that you can give and i hope that you can find someone that can solve this curse for you too. Please let me know if you do!