Post Vasectomy Pain Forum

Post-vas "optimum" ejaculation frequency

Here’s a question I have for quite some time now wanted to ask. I’m 18 months past vasectomy with constant blue ball pain, no obvious signs of neuropathic pain, and I wonder if anyone has experienced something similar. If I don’t ejaculate for a few days, I get this feeling of “filling up” (maybe classical congestion?), but perhaps not so much in my testes but more in the prostate. If I ejaculate, I get some relief. If I ejaculate too often, it gets painful. The “optimum” frequency seems to be every other day. Any thoughts?

I imagine it varies for each individual, but if you are experiencing pain when you ejaculate too often and congestive type issue when you don’t do it enough, then it looks like you may have found your sweet spot somewhere in between.

Personally, I can do it as often or as little as I want without the direct pain many here suffer from, however, the mild, congestive “blue ball” type feeling persists and I don’t feel as though any ejaculations result in relief from that (perhaps mental relief, but not actual physical relief of resolving the blue balls).

I think the same.


Ejaculating is my biggest pain trigger. It’s generally more so if I ejaculate to frequently. Sometimes I can get away with things and other times I can’t. Sometimes no rhyme no reason. In my case, I don’t think it’s all about congestion of sperm. I think it’s a combination of things.

Regarding the full prostate feeling or even the semenal gland, I’m not sure what to say about that. That could be indictive of a lot of things, including full. Perhaps ejaculating has some sort of PT effect on your nerves. IDK.

If ejaculating seems to help if you pace yourself, I don’t see how that is a bad thing.

i thought the same.
maybe there’s not a “optumum” ejaculation frequency as it may have something to do with what you’re eating? i mean, depending on what you eat, it could be every other day, but it could be once every 5 days, per example? just a thought to share…

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I’m not sure, but I do know that what you eat, drink, ingest, what you supplement with, how active you are, among other things, can or will affect fluid production, sperm production, etc. I’d guess everyone is a bit different in that aspect too.

For instance, I am a smoker, and like to drink a 12oz can or two of mt dew when I get up in the morning. I fit the stereotypical profile for someone that should have a low sperm count, rotten teeth, among other stereotypical things, yet I didn’t have a low sperm count, nor rotten teeth, etc.

I don’t think there is an optimum ejaculating frequency. I feel confident saying there isn’t a one size fits all answer anyway.

I have always had a high ejaculating frequency. Every day, occasionally twice a day, to every other day has been pretty normal for me through my adult life. It was even more so when I was younger.

I personally think that my pre vas ejaculating frequency was one of several things that made me a bad candidate for vasectomy.

I think so too, in my case.

I was just wondering, whether there is any known connection between fluid production / release in the prostate, and pain.

I think sperm production and ejaculate fluid production are two separate things. I for one have always been moderate in terms of ejaculation frequency: in my thirties it was every day or every other day and in my late forties it’s been like once a week, or sometimes twice.

I think my problem was too much sperm combined with other vasectomy issues. Probably my sperm production is in the top 2% while my prostate is probably moderate in creating the fluid. Only 2% of the ejaculate is sperm. So likely when I got vasectomized my prostate stopped receiving the ample amount of sperm it was used to and got inflamed, while my vas area got bombarded with pressure from sperm production. It all works out in my head …

Why would the prostate get inflamed once it stops receiving sperm?
I am trying to understand anatomy to figure out what’s going on.

Good question, beyond my understanding and area of expertise. This is either related to the (1) fluid pressure balance in that area, or (2) to some chemistry within the prostate that we don’t understand.

(1) I think if this is the case then rather than inflammation we should say “bloated” or “non bloated” prostate; I believe urination issues that I had during vasectomy time was due to the prostate - now that I am reversed I feel somewhat a relief and I can control the piss pressure much easier. In fact after I urinate not much is left in the tube meaning the pressure balance is working correctly. So, again, I have to go do my homework and calculate all the capillary fluid pressure balance in that area, but most likely the lack of flow from the vas is causing some hydraulic balance failure maybe.

(2) All I can say here is sperm = life , and prostate was receiving that for say 30 or so years after puberty. Did it adopt to the chemistry and build a layer or some mixture (notice Marks half and half comment) that it’s unable to build anymore?? Maybe the tissue itself is now different and transformed. Who knows. This is beyond me and pure speculation!!

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when calculating it, maybe is a good idea to share it with your doctor? it does sounds like it could be true, but i always think that a doctor may help more. come back with updates

Doctors generally are not very good at such things. I’m an engineer and more interested on the mechanics than they are. Specifically they believe NOTHING changes post vasectomy. This by itself, if done correctly, and backing the testimonials of many like people on this forum will be something that they won’t be able to brush under the carpet. I’m saying this and I’m a busy guy - I’ll have to spare some time and read some papers, and do some analysis. Expect this to take a while … will see.

@Vasvictim, be sure to get some SA results before you release your anticipated paper. I don’t want you to be feeling silly if you come up short on your analysis :roll_eyes:

The focus of the so called paper(s) is not really going to be on SA results per se. if I get the time to do it I will just try to focus on what happens when:

(1) One cuts off sperm to the prostate: why do we think prostate behavior changes, mechanically speaking is there a fluid capillary pressure balance that breaks when sperm is cut off to the prostate?

(2) A stupid surgeon placed a clip too low: what’s the difference between a low clip and high clip situation? Does the vas absorb and retain sperm in (normal) vasectomized men versus (abnormal) cases where the clip is positioned really close to the epi and causes pain and complications?

At least two separate application notes which can be related. Both can be done without the SA :smiley:

The high clip, low clip stuff is already out there to be read. I do support the ideology, the proper methodology, and so on.

Regarding the prostate, based in what I have seen in real time, experienced myself, etc, I could write an essay on my thoughts myself. Don’t forget that we have some guys that had a reversal for pain than are shooting blanks, that no longer have the prostate issues (many symptoms).

Still looking forward to your write up :slightly_smiling_face:

That makes the problem more interesting. Shooting blanks probably mean not enough sperm for fertility but the line is partially open or fully closed? Of course we can never know. My write up will take a WHILE to come out.

Where? in this forum or in the academic literature? Please forward links if you have them handy.

You will have to do some homework, but here’s a thread where some of what we are talking about gets discussed in some detail.

Seems some of what we are looking for was in the thread below, but has since been removed. IDK what was where for absolute certain, it’s been a while. I have some ideas as to why some stuff was removed, but will it at that.

Another relevant thread below.

Again, best I can tell, some text and/or posts have been edited or completely deleted (by several pvps doc’s). I have been reading this forum since the day it came online, and know what was posted in the past. Don’t ask me to summarize and/or repost the deleted stuff onto the open forum, etc. I’m certain the posts were deleted for a reason.

Hope that helps.

I will respond later today when all consults and commitments over if that’s okay.

Sheldon

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My thoughts below

As with all care, doctor’s posts are purely opinion, thoughts, speculation and theories based on our own experiences. As the only doctors that can really offer an intelligent opinion are your doctors that have seen you, examined and cared for you in person. My thoughts should be used for shared discussion and decision-making with your personal doctors. And lastly, PVPS is a complex, multifactorial process with many unknowns so what works for one may not work for another. Much care is trial and error. I am a fan of trying conservative measures before moving to any surgical options.

Hope this helps.

Sheldon Marks, M.D.

On Mar 9, 2020, at 12:07 PM, RingoStar via Post Vasectomy Pain Forum <notification@postvasectomypain.org> wrote:

\ 45x45 RingoStar
March 9

Vasvictim:

Where? in this forum or in the academic literature? Please forward links if you have them handy.

You will have to do some homework, but here’s a thread where some of what we are talking about gets discussed in some detail.

Minimizing risk of Post Vasectomy Pain Post Vasectomy Pain

According to this article, there are elements to the surgery which could reduce the incidence of PVPS. Open-ended technique Infiltration of the vas deferens with a local anaesthetic such as bupivacaine before its division/ligation @DrMarks Do have any thoughts on this? Does it mesh with your experience? I am not a fan of the open ended vasectomy as this encourages sperm to leak at this open vasectomy site into the surrounding tissues. the body does like sperm, sees it as a foreign protein and so attacks by creating a dense inflammatory response to all it off, which is sperm granuloma which can be very tender. I also don’t like metal clips or silk or permanent or even absorbable ties. If the vasectomy is done high up enough. well away from the testicle then their should be plenty of vasal length to allow for the added build up of pressure and so not have pain. I also think it is best if a small 1/2 to 1 cm segment is excised, and the ends of the abdominal and testicular vas are separated by interposition of peri-vasal tissues.

Seems some of what we are looking for was in the thread below, but has since been removed. IDK what was where for absolute certain, it’s been a while. I have some ideas as to why some stuff was removed, but will it at that.

PVPS - everything you ever wanted to know and then some Post Vasectomy Pain

First of all, I have been a big fan of this continuation of the prior support site. I think those few that have worked so hard to educate so many deserve a real thanks. Why I am here now after all these years. I have always kept a distance from being involved as I felt that this site was best served by those men with PVPS and those that had PVPS to be able to talk and share honest thoughts. It concerned me that if doctors had a presence, you might not want to be honest or that it might motivate… it is why we tend to stay away and allow you all to share your thoughts and feelings, as well as ideas.

Another relevant thread below.

PVPS- who screwed up and what did they do wrong? Post Vasectomy Pain

Vasectomy – what exactly did they do and what was done wrong? Most often I don’t think that for most it is not that there is anything that is done wrong. Since PVPS is extremely rare in most urologist practices, I think it is not what we do but rather how that’s each person’s unique DNA responds to the cautery or ties or trauma of the vasectomy. There are some doctors that are too aggressive with cautery or ties or damage to the adjacent tissues or excise lengthy segments. Though in general I think that vasectomies performed by family practice doctors and general surgeons tend to be far more aggressive that urologist vasectomies, I don’t recall thinking that PVPS is anymore common by doctors in any specialty. As the author of these posts I have taken the liberty with my very first article to change the agenda of what I offered. This first piece is on the vasectomy itself and questions I am frequently asked. Again these are my opinions, based on experience and my own thoughts. Take everything I say and what everyone says, yes even the experts, with a grain of salt. Agree 100%. I may be wrong and am always open to being corrected or learning other’s th…

Again, best I can tell, some text and/or posts have been edited or completely deleted (by several pvps doc’s). I have been reading this forum since the day it came online, and know what was posted in the past. Don’t ask me to summarize and/or repost the deleted stuff onto the open forum, etc. I’m certain the posts were deleted for a reason.

Hope that helps.

Visit Topic or reply to this email to respond

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@DrMarks nice to see you here.

So in normal vasectomized men (90x+% that live happily ever after) the major volume of the sperm produced remains in the vas am I correct? My assumption is the vas can hold a lot of sperm and likely is a lot more flexible than the epidydimis? I am almost certain that my problem was congestive epidydimitis which was most likely due to low positioned clips, specifically one on the right side was extremely close - my understanding is the epi itself despite being a very long tube due to its diameter size is unable to hold a lot of sperm and hence bloats if the vas cannot share and contain the larger volume of sperm produced by the testicles, am I correct? Is there any use of someone doing research and showing that the vas is the savior of the men who luckily have their clips placed very high versus men like me whose urologist was dumb (or purposeful) by placing the clip very low close to the epi? How come such a simple problem is ignored by some urologists?

Does science know what happens to prostate after vasectomy? Would it be useful if someone does the research and show that the sperm mixture could have a major positive contribution to the prostate’s well being? Does urology look for such studies? Are you guys interested in these studies that would go against the theory that NOTHING changes post-vasectomy?

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