Post Vasectomy Pain Forum

grease · March 3, 2020, 4:51pm

First post, new member, looking for success stories with epididymectomy.

After 2 years of pain and seeing a number of urologists, doing many things without success, have found someone that will surgically help with pain via epididymectomy. Dr ensures that procedure has high success rate, but as surgery date is closer, and find more bad experiences then good, now having second thoughts!!

Have not had a vasectomy, but have epi cyst and varioceles that is sources of pain and discomfort.

SomeGreyBIoke · March 3, 2020, 5:50pm

I got totally screwed by epidydymectomy in my left testicle so much so that I had it removed a year later

Francis · March 3, 2020, 6:32pm

Me two my testicle on the right side has shrunk to pea size be careful man

raising4girls · March 3, 2020, 8:38pm

PLEASE double-check me and do your own homework on this as this is strictly opinion.

I’d look strongly at spermatic cord denervation before epi removal. Neither is without risk, and some guys here have been made worse by SCD.

To me, epi removal seems illogical. The testicle keeps producing sperm, but the uros don’t answer the “where does it go” question. SCD seems a lot less invasive, too, and I’m a fan of going for the less invasive option when presented with multiple options.

Seems like many men here, granted their journey started with vasectomy, ended up with orchiectomy after epididectomy. That’s just my read on the stories posted here.

RingoStar · March 4, 2020, 2:40am

Welcome to the forum @grease

For nearly a decade, epididymectomy has seemingly always had a bad reputation in pain forums like this one. There’s always more bad/horror stories than good ones, including from men that never had a vasectomy. But, we do have a few success stories on this site.

I’m not a fan of the procedure myself. The supposed success rates are to wonky for me. I’ve been hearing a success rate of approximately ~30-50% for nearly a decade. I’m pretty certain there are some published studies that suggest the same.

But, then we have studies like this one, which sites a 90% success rate

ncbi.nlm.nih.gov

Epididymectomy is an effective treatment for scrotal pain after vasectomy.

AF West, HY Leung and PH Powell, BJU international, Jun 2000

To investigate the efficacy of epididymectomy in patients with significant scrotal pain after vasectomy.Sixteen patients were identified retrospectively to have undergone epididymectomy for pain after vasectomy; 19 epididymectomies were performed (three bilateral and 13 unilateral). Details from the preoperative investigations, histological examination and follow-up of symptoms were analysed and correlated. Outcomes were initially assessed at the routine outpatient clinic review 3 months after surgery and the long-term outcomes were assessed by a telephone interview 3-8 years after epididymectomy (mean 5.5 years).Of the 16 patients, 14 had excellent initial symptomatic benefit from epididymectomy. At 3-8 years afterward, nine of 10 patients interviewed had a sustained improvement of their scrotal pain. The following were indicators of a poor outcome: atypical symptoms including testicular or groin pain; erectile dysfunction and normal appearance of the epididymis on ultrasonography. Patients with bilateral scrotal pain can have a good outcome after epididymectomy.Epididymectomy in well-selected patients is a reliable and effective treatment for pain after vasectomy.

Denervation of the spermatic cord (SCD) doesn’t have a great reputation in pain forums like this one either, but we have studies like this one

ncbi.nlm.nih.gov

Management of chronic testalgia by microsurgical testicular denervation.

A Heidenreich, P Olbert and UH Engelmann, European urology, Apr 2002

Chronic testicular pain (CTP) is defined as uni- or bilateral, intermittent or continuous testicular discomfort of at least 3 months duration that interferes with the patient's daily activities and prompts him to seek medical advice is a rather common urological manifestation of chronic pain syndrome. Diagnosis and treatment of CTP has been a difficult and often unrewarding clinical situation. Success rates of conservative and surgical measures including epididymectomy and orchiectomy rarely exceed 55-73% and 10-40%, respectively. We report our experience on microsurgical testicular denervation as therapeutic option in CTP.Following an extensive preoperative work-up (urine/semen cultures, transrectal ultrasound, testicular sonography, pain and orthopedic consultation) not revealing any pathologic abnormalities and a positive response to spermatic cord block, 35 patients underwent microsurgical testicular denervation. In brief, spermatic cord was dissected, vas deferens, cremasteric muscle and testicular vessels were separated. After identification of the testicular artery by application of vasodilatating agents using magnifying loops or the operating microscope, all structures besides the testicular artery, vas deferens and 1-2 lymphatic vessels were coagulated and transsected using bipolar diathermy.After a mean follow-up of 31.5 months 34/35 (96%) patients are completely pain-free; no intra- or postoperative complications were encountered. No case of testicular atrophy or hydrocele formation was observed during postoperative follow-up.Microsurgical testicular denervation results in reliable and reproducible excellent therapeutic success rates of 96% and should be integrated in the management of CTP at an early stage. High success rates require adequate and meticulous diagnostic work-up of the patients by spermatic cord block using saline as placebo and different local anaesthetics as an initial therapeutic armentarium predicting postoperative outcome.

Keep in mind that I certainly have not seen the linked statistics play out in real time in pain forums like this one. IDK what’s going on.

grease · March 4, 2020, 3:15pm

Thank you everyone and @RingoStar ! Yeah, I have read all the medical journal articles too and feel the same way about all of this. Have never had a vasectomy for fear of being one the few with chronic pain and not allowing the sperm to escape naturally.

Would also like to see more real time feedback on epididectomies. Have maybe found 5 people online, but of course they had poor outcomes.

Some of the medical articles seem to be a couple drs self promoting their own success rates. There are very few drs that will even do the procedure.

Just want to pain free and be more physically active.

RingoStar · March 4, 2020, 8:45pm

Yeah, unfortunately that seems to be pretty common

Seems there’s at least that many on this site alone.

I’m not sure where to direct you regarding finding numerous individual epididymectomy stories. You’d think they’d be out there tho (shrug).

1986raz · March 5, 2020, 2:13pm

Epididymectomy made my pain ten times worse, lost my job and currently on disability, worst decision i have made ever made to have it removed and will regret for the rest of my life unless my pain is resolved. Have since had testicle removed and still suffering from nerve pain cause by epididymectomy. Run from any uro who tells you it has good sucess rate.

1986raz · March 5, 2020, 2:17pm

I would go as far as saying saying if the pain is life ruining a Inguinal orchiectomy is far safer than an epididymectomy, i wish i went this route instead.

Reversalpain · March 11, 2020, 3:30pm

Epididymectomy solved my pain for me. I’ll post an update in my thread, but I am almost 6 weeks out from surgery and I barely think about the pain that consumed every single second of my life for the past 21 months. I know it’s still early, but so far I’m pleased with my decision to proceed with the surgery given my specific condition.

grease · March 11, 2020, 3:46pm

WOW! Think you are the first person I have talked to with a success story!

What was recovery like?
What was your pain level before and after?

RingoStar · March 11, 2020, 4:25pm

@grease, below is a link to an epididymectomy success story on this site.

Below is a link to @Reversalpain dedicated thread. It doesn’t sound like he’s out of the woods yet, but seems to be trending in the right direction.

I’m certainly not endorsing epididymectomy as anything. Just trying to be helpful.

Reversalpain · March 11, 2020, 5:19pm

I replied privately to you but please read my entire thread. It is a decent journal of everything that I went through.

Epididymectomy success stories?