Post Vasectomy Pain Forum

Post Reversal Closure

Dr. PK somewhat avoided my question on “when should I expect to get closed again post-reversal?” And mentioned that no solid scientific research is available on this. Among you guys who did reversals how many of you are still open? I understand you may not know but if you do can you post your numbers here? Reversal date, closure date, any pain post closure? If yes why and if not why.

Thanks !!

Wow! I appreciate your VR surgeons honestly. I feel the same way about it.

Assuming you read many of my posts, you are already aware that my first reversal was considered failure by month ~7 when I had my first SA. My second (redo) lasted ~24-26 months, and I have multiple SA results from that timeframe.

I can’t help but saying, if people chime in with the good ole “I have a microscope and see swimmers still”, that doesn’t mean a whole lot more than just that. Their count could be ~1 million, 10 million, 80 million, 150 million… who knows. They have no idea what their motility is either.

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@RingoStar thanks for the details.

I think as long as there is sperm in the mix the vas is considered open, right? And as long as it is open, be it partially, the chances for pain and complications come down significantly. All I’m seeking here is to understand what “getting closed” really means. The reversals that close up say after 3 years like yours, do you guys still feel pain and complications as pre-reversal? I have seen some rare graphs online showing fertility rates dropping after two to five years but that does that mean more complications as well or most of the guys remains partially open with minor sperm count, leaving them infertile but at minimal pain and complications. That’s what I’m trying to understand … thanks!

I’m currently going through bit of a set back in my recovery after reversal. @RingoStar is right that watching under the microscope only gives you half of the story when compared to proper lab results, but at £300 a go, it’s not cheap, so microscope is second best thing.

Anyway, my point is that what I have noticed that my counts under the microscope have dropped a lot when I were in worst pain, but there always was a lot of dead ones, tails, heads all sort of debris, so IMHO even when you close up, you fully won’t, and there always will be stuff coming through, releasing worst of the pressure, but that’s just my 2 cents.

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I guess at least one of them would be considered open, but if someone’s count is ~1-5 million, is that really enough to help matters? Purely assumptions from that point forward. Try convincing an expert, let alone yourself, that ~1-5 million motile is doing the trick :roll_eyes:

~A lot of men continue to do well after their reversals fail. I don’t have any detailed information, published studies, etc, about individual accounts other than my own, but that’s what many top tier pvps surgeons, docs, etc, insist is the truth. In all honesty, I tend to believe them up to a certain point. IDK all about it. Don’t forget that we have some guys on this site that are shooting blanks post reversal, and their pain didn’t come back. Don’t forget about reversals for pain that do not include being fertile again either. There’s certainly more to this reversal for pain stuff than just fertility.

I had someone ask me the same question in PM not to long ago. I copied and pasted my response below.

"I still had issues from my third procedure that also caused pain afterwards. I have said on the open forum one time that I wouldn’t have noticed that I was failure when it happened, but that not quite accurate. I should’ve known what was happening as I had more pain going on than normal. I also felt abnormally in need of ejaculating at times when I should not have been, such as while at work. Bad blue balls like feeling, accompanied by other pains. I should’ve known.

I was on a long run just coping with my outcomes, my back pain, life… I guess I just didn’t want to know, but I should’ve. I’d just had it with all this and that back then (fall 2013). I had already given up and resorted to tramadol to get through the work week back then. I was a fabricator / welder in an industrial fab shop back then. I did what I had to do."


I am not the typical pvps pain guy @Vasvictim. I feel confident saying that I have more than one issue going on. If I go with my gut, I’d tell you that the majority of my issues stem from a pre-existing varicocele pain condition. It’s hard to explain, but I feel that I was made worse by vasectomy complications, and perhaps by my first reversal. My third procedure made matters worse to.

I tend to believe that I suffer from (1) blood congestion, (2) nerve damage, and (3) sperm congestion. My gut tells me that I suffer the most from 1 and 2. I have lived with this since ~2013, no intervention since, and this is what I tend to believe.

Granted, I have made some good progress over the years since ~2013. I’m certainly not as bad off as I was pre reversal (in many aspects). I feel that I am in much better shape physically and mentally than many here, but some of that is likely because I’m not getting beat up by this shit regularly anymore, and/or have gotten used to living with residual pvp/s. I can go on lengthy sprees of nearly pain free, to generally ~short lived episodes that leave me feeling about as crappy as many others on this site. On average, I’m doing quite well considering everything.

Overall, I consider myself a success story.

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@RingoStar thanks for the long answer and copy paste of your PM.

So last week I challenged PK on my case; I told him that Shaw (the asshole who f&cked me up) probably did something incorrectly in my vasectomy ( apart from making fun of me and my weenie during the procedure!!:disappointed::unamused:) by placing clips such that they constantly leak sperm which cause granulomas and complications. PKs response was “totally the opposite actually”. His point was good designs result in some “leeway” during ejaculation while in my case congestion happened because it is fully and completely closed up. Why is this related to this topic? I think with reversal that leeway of some sperm pushing itself out is there regardless of fertility condition. This mean when sperm is pushing out in the channels from epi to vas, while some of it will get congested some will flow through, and likely will be less painful, or minimally noticeable as compared to the fully closed up scenario.

Actually in my case it seems like Shaw messed up two things:

1- He placed one of the clips too close to the epi, leaving no room for sperm accumulation. Once I feel better I plan to do some basic analysis of this: I’m mechanical engineer, majoring in fluid mechanics and heat transfer and have done research extensively in capillary micro-circulation (=my PhD) Isn’t this interesting? I think I understand what’s going on mechanically speaking. Will describe later - will probably be a simple .pdf with some formulas and explanations. Vas is 0.5mm in diameter, closer to epi the diameter shrinks by 2/5 a lot less volume and length, the push out function of sperm when the balls raise hence hit a wall too close to the source. It will be painful, and it was in my case.

2- I believe while #1 was the major problem in my case, I think the clips he used somehow tightened up the area too much and likely they were causing some damage to the nerves - them being too close epi means that they may have caused a lot of tension and hence “congestive epidydimitis” which was my issue.

All in all, staying positive for now, I think reversal will likely fix the issue. Will wait and see. And thanks again for your generosity and time in typing very important info that helps guys like me understand what’s going on.

Yes apparently sperm gets clogged due to congestion and dies, then leaves later due to the partial blockage. And some gets destroyed by antibodies, which is apparently normal and happens in every male body.

What you should also consider is that inflammation can cause a lot of pain as well when you have a lot of sensitive nerves in proximity. Around 4 months before reversal I started taking papaya seeds powder, which minimised my pain by ~90% in 3 months, and although I had all sorts of nerve issues with shooting pains all the way down to my foot, but gut feeling led me to believe that congestion is my main culprit.

@Vasvictim, by saying what I said in the quote above, I am not suggesting that it’s impossible to benefit from a low sperm count like ~1-5 million motile. But, it sure seems unlikely in regard to pain relief. I suppose we would need to know, or estimate how many mature sperm an individual man is producing daily, and calculate from there. This sounds good hypothetically, but… We are missing some important information that we generally cannot produce. If a man is producing ~50-225 million motile sperm daily, and his SA results show ~1-5 million motile, the math, and my additional thoughts that follow don’t work out for me.

Thanks for your detailed response. I’m still absorbing all that, and looking forward to your calculations :slightly_smiling_face:

Good luck brother.

I did discuss this question of the vas closing post reversal and if symptoms reappear with Dr. P. in Orlando. He said based on research he believes it’s a matter of time before all of them close. He said he did have one patient who was 10+ years out and still going strong. However, he also said that many men improve by being reconnected even if it does close up later.

I asked about blowouts and other problems in those situations, but he said the sperm seems to just get reabsorbed (perhaps it has more leeway than with the initial vas?). Anyway, I don’t have any personal experience to share on this, but the doc has worked with an awful lot of patients so I believe there is something to the benefits of reconnecting with or without flow. I do suppose it would vary by individual depending on what the original concern was.

Same type of pain shot from my right side to the abdomen. When we say inflammation we should talk about the reasons - why does it happen? And why does it happen in a certain percentage of a sectioned and not all. I can almost certainly say that inflammation in my case was caused by the clip being too close to the epi. This was why right after ejaculation I felt pain and complications for days.

When I visited PK for the first time and filled his detailed questionnaire, he came into the room and after talking, the first place he touched during the examination was the clip position, he said it was placed too low and that I had congestive epidydimitis. As though he already knew the reason even before examining me. Paraphrasing his statements he said “during ejaculation the balls raise and because of this congestion that does not happen effectively”.

In the past before shifting attention to high-tech and microprocessors I was involved with biomedical research and have done a post doc in a large research institute in Dallas. I know the difference between medical doctors and engineers. I understand the weakness in medical science. Doctors are empirical, engineers are analytical. When he says “this does not effectively happen” I think by experience of fixing many guys like me (to his own testimony) his empirical experience tells him that “low clips are problems”. As en engineer this does not satisfy me at all. My thinking is, during Ejaculation there is a shock effect balls immediately raise and if something is in vicinity of them (like a low clip) there will be a collision. Then sperm hits that junction which causes pain.

Narco effect :tired_face: … to be continued.

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7 years and still open. I think the right side has closed off. Don’t ask me how I know. Just a hunch.

I think if you alter your lifestyle and diet after reversal your odds of staying open are better. Being healthy in general I’m sure helps. I am due to check again here soon.

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Any pain or complication in the right side?
Do you know if there was any difference between the clip locations between your right and left?

I THINK I’m still open based on a 78MM SA result in September, 2018. Can’t prove that’s from both sides, but uros believe that’d be too high for one side given my age (53 at the time) and being post-reversal which was in June, 2006.

In all honesty, during this period of time, I tend to believe that my left repair failed directly or shortly after my 3rd corrective procedure (~6-7 months post redo reversal). My left side is my bad side. If it did fail in that period of time, I used to speculate that it was due to inflammation caused by my 3rd procedure which was done on my left side. I used to speculate that I may have taken some damage early in my vasectomy, and thus had some blockage on that side as well.

As I recall, this seemed to be more related to my better right side. I used to feel pretty confident that all or the majority of my SA results were the product of my better right side.

I can’t prove any of what I speculate, but this was always my gut feeling.

The reversal surgeon had to take more tissue on that side to get viable ends if I recall correctly. My nut hangs higher on that side and it’s always been more sensitive. I did bump myself and got a hematoma on that on day 9 after my surgery. Stupid. I’m still pissed I let that happen.

I’m basing that on just how it feels. I still have sperm in my ejaculate but at about month 3 after my surgery until month 11 the amount of ejaculate and force behind it was much greater. The ejaculate was whiter and thicker too. Anyone who says there is no difference is full of shit. There are some men who say it’s not different but here are many more that I’ve read here and other places that say there ejacualte get’s thinner and more watery and there is less force behind orgasm.

I shoot half n half now, lol.

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Hi Mike.

PKs other important message to me has been that he always places the clips high so that it is a lot easier to reverse. Lower ones are a lot more difficult. I assume your right side hanging higher might have made it more difficult to place clips higher and also makes it more difficult to reverse. That’s my assumption based on what I heard from PK saying “some surgeons select the easy path and place clips too low, or in easily reachable locations”. I definitely know the issue on my right side was this; clip was way too low. So, the lower side of the vas closer to epi has a diameter of 0.2mm, while the upper side (like where he reversed me on the left) is 0.5mm diameter. This is a HUGE difference and honestly I don’t even know how a micro surgeon can operate on such thin lines.

So in your case I think one side is closed (likely your right side) and that’s the one giving you pain. Still, if there is no granuloma or leaks (which I doubt there will be) tour pain is solely mechanical, meaning due to push force of sperm. And again I promise that soon I’ll write something about this, The lower side very close to epi is most likely the problem many have here. Really comes to surgeons who are not specialists or best in what they do.

This is just my opinion. I remember going to a Male Fertility Clinic years ago and was told I had a very low sperm count and would most likely have trouble conceiving children. This all after I’d already had twins! I felt as if something was not right about the information the Dr was giving me. Move on a couple of years later and my Wife ends up pregnant with a little girl. Move on another year and a half later and my Wife ends up pregnant with another little girl.

I’m saying all this to say that many of us on here have realized that these doctors are obviously not out for our best interest. If so they wouldn’t be performing these barbaric surgeries on men. These Doctors are all connected with one another. Like a brotherhood. Meaning the Urologist is connected to the fertility Doctor, the fertility is connected with the pharmaceutical companies who are then trying to market testosterone drugs.

I don’t believe your sperm count determines fertility. I believe it’s an unknown God given ability that happens from the bond and connection a man has with the woman he’s intimate with. Because after the convo I had with this Doctor you would have thought I needed a miracle to have kids. I no longer listen or respect anything they have to say.

My personal opinion is to just get the reversal from a good surgeon using the latest technology. Once you are restored back to your natural state, take it easy, relax, let your body heal, and God will do the rest. Honestly, all this site does it provide emotional support. It doesn’t heal. Only time and God can do that.

Godspeed my friends


I appreciate your input, but we should try to stick to the facts, evidence, science, etc, rather than bring religious beliefs into why reversals fail, close up, how men get better, the recovery process, if ones sperm count is relevant to fertility, and so on.

Well said bro.

Excuse me if I may, but last time I checked, “Science” was a “religion”, in its full glory. They call it Scientology, and it is indeed a religion.

“A “Religion” is an organized collection of beliefs, cultural systems, and world views that relate humanity to an order of existence. Many “religions” have narratives, symbols, and sacred histories that are intended to explain the meaning of life and/or to explain the origin of life or the Universe”.

Mr RingoStar no disrespect, but it’s extremely biased to push away ones perspective right to a belief simply because you as a person don’t agree with it. This is how schools are fooling our children and families. By pushing out God, and covertly pushing in their own religion. The one called “Science”. I don’t agree with a whole lot on this website, but each one of us has our choice to accept what advice we choose to accept. By limiting what one can say here, you are then swaying everyone in one particular direction. That’s what dictators do, and that my brother is wrong…

I’m sorry but there no getting around it. Science is without a doubt a religion. And it’s unfair of you to shun another simply because one has a different view point than your own. If you don’t like me now, and no longer want me apart your site because of what I’ve expressed here today, so be it. But that won’t change the fact that you are being selfish and insensitive to your fellow mans point of view.

I hope you truly understand what it is I’m getting at. I don’t follow religion, I follow “The Holy Bible”. And there is a huge difference between the two.

Thank you