You mean there’s an honest urologist out there somewhere? Wow. Hang on to him.
My decision was easy. While I was having something done for the pain, I was also pretty convinced that my low T and high PSA were due to sperm being outside the reproductive tract. I wasn’t sure that reversal would fix those problems, but I was more sure that an open-ended conversion would not.
IIRC, Kevin Hauber’s book on his own experience cited his open-ended conversion as an unnecessary and wasted step.
Yes, it’s old but I think every PVP sufferer should read Kevin’s book. Not the gospel but pretty close.
@NC79, another obvious thing to consider should you choose to have a reversal is just having one side done, assuming your pain is unilateral, which it seems it is.
I know bilateral reversals are very common in the pain world, as are bilateral open ended conversion’s, but there’s at least one guy on this site that a unilateral reversal would’ve likely changed his everything. I’m speaking of @jsh.
I don’t recall anyone I’ve ever read about having a unilateral open ended conversion, but I’m not suggesting it’s never been done.
Just some thoughts.
assuming it didn’t trigger pelvic floor issues, maybe.
Yea, I figured it would be good to get your input here, that’s why I tagged you.
It’s pretty crazy to see guys having reversals on this site, seeing all the different recovery’s, outcomes, etc. Guys that you’d think would have a bad trip don’t, guys you’d suspect wouldn’t do, and everything in-between.
There has to be some sort of balance when we are warning people. Guys like me don’t want to scare the crap out of anyone, but all at the same time, I’m going to be straight up with them.
thanks @RingoStar as for the open ended conversion i will need to confirm if it would bilateral or unilateral… I was under the impression it was just on the left side but this is a huge assumption i would need to confirm. As for reversals i would assume it would be bilateral as well but will get his input on one side reversal and if this is even recommended. @jsh i assume your’s was a full reversal both sides
The One-Side vs. Two-Side debate is interesting.
My reversal uro insisted that bilateral was the way to go primarily because of my PSA and T issues outside the pain. I agreed even though my pain was at least 95% left back in 2005-06.
Fast forward to today, and PM and Uros are only treating my left side.
Hard to know which way to go especially on reversal if self paying. They don’t charge half price for one side vs. two.
I was open ended from start. Its same shit just different name to sugar coat vasectomy, i have suffered extreme pain. Been reversed over 12 months now, still not well. But if you going to get opened up dont bother with open ended crap just get reversal this is my opinion.
Thanks @Loz am under the same gut feeling if am having another surgical procedure it should be a reversal at least i know i put myself back the way i was intended to be and faithfully i can recover fully. But am still in the wait and see phase as am not doing anything until at least 1 yr. My doc thinks if not fully recovered by 9 months post VAS should look at surgical intervention.
Just providing update to the thread and for my own journal. Today am roughly 9 months post VAS,
- my uro diagnosed me with congestion
- daily meds include nortrypline at least for another 3 months, turmeric, and papaya seed powder
- switched to the most part brief underwear
- am definitely better than i was 6 months ago, visited my uro today and he says left side epi feels good along with the vas site all left sided issues. My biggest complaint outside of the random pains and non linear progress is pain during and post intercourse.
- my left leg pains have minimized not as tight, routine massage and osteopath have helped along with strecthes.
- Next steps continue with the nortrypline and reassess in the new yr which will take me to about 1 yr
- discussing next options with my Uro he says if am going to do a reversal he suggests only doing the left side as i have not had any issues with my right side ever. He would clean up the vas site (granuloma’s and scarring) but leave any clips if any as he doesn’t want to touch areas that aren’t in pain. Am hoping i don’t need to make the decision for reversal but has anyone done a one sided reversal. I understand his train of thought of minimizing the risk as much as possible but am on the fence because i feel if am going to do a reversal and be fertile again i should just do both sides vs the one side. Appreciate any thoughts or feedback.
Thanks for the update.
Your inquiries resonate with me, but I don’t have any answers per se, but more questions :-0.
I’m just about 10 months post vas and while I’m overall better than I was 6 months ago, I’m in (hopefully in the middle or the tail end) of a what I’m calling a flare up over the past 4-5 days. My current uro (he did NOT to the original vas!) never really diagnosed me with anything specific, but he fully acknowledges my discomfort and thinks its been too long since the procedure where I’m still experiencing said discomfort. He’s generally saying I prob have some disturbance with the epididymis and the nerves just need to settle down…
Far as meds, never had taken anything more than naproxen, ibuprofen, and acetaminophen (only prior to my nerve block which was very unsuccessful BTW)
Been wearing tighty whities exclusively for 9 moths now!
I was scheduled for a ‘excise’ (what you are referring to as cleaning up any granulomas and scarring) on Oct 11, but really was feeling much better the last few weeks of Sept so I cancelled it on Oct 1st. Now I’m thinking of going back and potentially going back to uro and rescheduling.
Big question- did you or anyone actually ever have this ‘clean up’??? I want to see of any general success rates. My uro hasn’t specifically mentioned a reversal, but that might be the last resort. Really want to wait the year (vas was non Jan 11th) before I get opened up at all, but this roller coaster is just maddening… like you, my pain and the uro has pretty much confirmed (by feeling around) that my pain is isolated to the left side as well…
I don’t really have any thoughts, suggestions, or feedback for you. You really got to sort this out, and/or decide for yourself as there’s potential risk involved.
@Cannon83 is the only guy on this site that comes to mind in regard to has anyone had a unilateral reversal. Seems he had his around 4~ months ago.
hi @Jdubb64321 seems like were in similar situation and timelines my vas was done end of jan… also in the wait and see period but also wondering if i plateaued… am going to slowly wean off any meds to see how i manage without anything. I was never offered a so call clean up procedure… was offered open end conversion or unilateral reversal. If am not congested then could be the same scenario as you of nerve/scar tissue related. I know i did have enlarged epi on left side because it was confirmed by an ultrasound 6 months ago… so during the epi episode maybe nerves were affected… or i developed scar tissue that’s impeding the nerves. That’s the Russian roulette syndrome were dealing with no one really knows until their opened up again…
thanks @RingoStar i actually reached out to cannon83 and he has been very helpful informing me of his experience of a unilateral reversal…
Hey guys throwing the question out to the forum any ideas what is causing this specific pain? On self examination of left side while holding what used to be the family jewels lol… i place pressure with right index finger behind the left testicle and feel my source of pain am not sure if am hitting the epi or vas tube or something else. I then do the same on the right side and feel some discomfort but no where near the left side pain. I know its my primary source of pain because the pain continues well after the self exam. Now the questions… what is the source of pain epi? Site of vas cut? Granuloma? (I don’t feel a lump) or scar tissue. Out of all these potential pain points is there clear distinction between lets say epi pain vs scar tissue vs granuloma? Appreciate any feedack.
Just curious what area of the left testicle is your pain source? Is it side, bottom, upper, or underneath? Mine pain source on right i would describe as on the side but really hard to tell for sure. @NC79
Hey @Ben hope all is well I would have to behind the testie and more so underneath…
So it’s been officially over 1 yr since the VAS and still dealing with PVPS. It hasn’t been all doom and gloom but still dealing with pains. Apologies for the long winded post…
I have improved significantly since my worst bout of pain last March-August. Typically i have more good days than bad. The good days consist of minimal to almost no pain at all, and the bad days are usually a pain of 2-3. Pain is most profound early in the morning or after ejaculation. I find that when my testies have no support ie taking a shower they seem to hurt but when i put on briefs or a good supportive pair of boxers i get relief. Upon self examination my EPI still feels tender and sensitive compared to the right side but again not excruciating. Uro says EPI is no longer dis-extended… but if it’s still tender what else could it be inflammation? Scar tissue?
I can do everything i need to or want to do in my day to day life but find some discomfort during exercise activities that involve the treadmill. Mentally i haven’t moved on as i still think about next steps and the outcomes of those decisions. I have come to the point of just being pissed, i no longer feel sorry for myself but pissed that am dealing with this BS from a voluntary decision and how it’s affected the last yr of my life.
Currently am not taking any medication or supplements, stopped taking nortrypline back around Christmas time and saw no difference in pain level staying off the drug, which is a good thing since i don’t need to rely on meds to mask the pain. One thing i am taking now is CBD oil from a government provided reseller in Canada to help with overall body pains including vas related pains and the stress and anxiety that comes with PVPS. It seems to help but am still working on finding that right dosage amount. But i won’t take antidepressants so CBD oil is my preferred choice.
Still dealing with left leg issues, my Uro and doc don’t think it’s not vas or nerve related but am pretty adamant it is related. Next visit i will ask my Uro again about experimental nerve blocks to rule it out. He suggested the first time they won’t do nothing for me but i feel i have to try. Does anyone know of any risks related to the nerve blocks?
Here is my biggest challenge next steps…
- Do nothing and give it more time, since time has been my biggest ally and pray that i will just get better with time and i don’t have to make a decision on next steps. I would consider myself 80-85% improved since VAS. But my gut tells me this is probably the best am going to get.
- Perform an open end conversion left side only since its the source of pain. I have read plenty on site of the mixed outcomes and results of a open end conversion
- Perform a left sided only reversal. Again read plenty on the site of this approach vs a full reversal. On the flip side i understand the approach of the Uro of least invasive approach and don’t disturb the side that doesn’t hurt. Mentally though i don’t know if i can accept this approach as i will kinda feel like the bionic man in a broken state…
- the last approach full reversal, which am leaning towards, yes i understand more riskier than the other two approaches but mentally i can accept the risk as i know am put back the way i was and just pray things will improve and i have long term success.
Next steps will be to discuss again these options with my Uro on my next appointment and get a real understanding of how each of the procedures are done so i can make a more informed decisions. I don’t envy any guy in the same boat where pain isn’t constant or debilitating, but still present. This is what makes the decision that much more difficult but ultimately i will have to trust my gut, if this whole ordeal has taught me anything it’s to trust your gut and do your research and ask questions lots of them!