Post Vasectomy Pain Forum

Reversal Scheduled

25 months post vasectomy. Reversal Scheduled for March 1st. I can’t go another year like this. I’ll post updates in this thread.

3 Likes

Good luck! Adding characters because min is 20.

1 Like

Best of luck and hope for your best

1 Like

@raising4girls @Juno. Thanks guys.

Couple questions for anyone that has had a reversal that comes across this.

  1. How many incisions did you have and where were the locations? 1 cut down the middle? 2 cuts off center? Is there a consensus as to what would be better?

  2. How many layers was the reversal? 11/2 layer? 2 layer? Does it matter?

  3. What did recovery look like for you? A couple days and back to work? 1 week and back to work? 2 weeks? etc?

  4. Any recommendations on vitamins, supplements etc. to aid in lowering systemic inflammation I can start taking now? I saw a post that recommended Tart Cherry juice that could possibly help with peripheral nerve pain. I picked some up and started drinking it because what the hell.

  5. Any advice you can give that you wish you knew at the time?

Thanks in advance.

Haven’t had a reversal. I’ve written about this in another thread, so if I’m spamming what could be seen as quasi-medicine I apologize.

But personally I would not get a reversal without having an MRI of my testicles first. Reason for this is: If there is a blockade in the epididymus - if sperm has “solidified” inside the epididymus, it won’t do any good trying to connect the cut ends of the vas together again, because nothing will flow though anyway. As far as I understand, some surgeons check this during the surgery - they will cut open, and test the contents of the distal part of the vas, and if it contains living sperm cells it’s okay to do a vasovasostomy. If not, the other option is the more complicated vasoepididymostomy. Many surgeons don’t bother checking this at all, and just connect the two ends of the vas together and I guess pray that at least one side works.

It is possible however to predict if the epididymus is blocked or not with MRI. Not with ultrasound. I’m a radiologist, and I work in a big institution. I’ve always just done ultrasound of scrotum because that’s the standard method. Since last spring though, because of covid, we decided that we should have as little contact with patients as possible, so we’ve done MRI on just about everything instead - including scrotums. So MRI of scrotum is kinda new to me, and it’s a very uncommon thing to do since ultrasound is so prevalent. But during this time, I’ve seen more and more of vasectomied nuts, and signs of blocked epididymus seems to be pretty common. It’s quite easy to see on MRI if you know what to look for. Reference

So - a preoperative MRI could possible say what the chances of success are, at least in terms of getting an open flow. Meaning: If one or both your epididymuses are “bright white” on a special MRI sequence, you’d know that a simple reversal wouldn’t work, with more than 90% probability according to the study. That is something you’d want to know before getting cut, instead of waking up afterwards and having the surgeon tell you that there wasn’t viable sperm in the ends he cut off, and you have just gotten extra scars with no gain.

My interpretation is that the only reason for reversal is to reestablish flow of sperm through the vas. If I knew in advance that there was a 90%+ chance of that not being possible, I would avoid the reversal surgery and do something else instead. That’s the reason for MRI, to possibly give an argument against reversal.

I don’t think many surgeons do MRI first. Chances are some might scoff MRI, because they might not have experience with it. I’ve found no literature that suggest MRI can predict the outcome of pain after reversal. But it is a possibility you could be aware of.

One incision per side. Looked like about 2 cm cuts.

I worked from home for 2-3 weeks and did VERY little else. Coached a couple of my daughter’s softball games but had to sit most of the time. Standing was really rough. I had that problem pre-reversal, too, so I think the surgery just made it worse for a time. That went away eventually.

I found a natural anti-inflammatory called Zyflamend in 2008 and have been taking it most of the time since then. It’s a blend of natural herbs that many other sources call for.

My doc told me that recovery from reversal can take up to a year, so be patient and don’t panic. I was still in a lot of pain at my 3-month post-reversal check-up. My doc told me all the reversal did was put me in a better position for the body to heal itself; the reversal wasn’t healing in and of itself. Good perspective. For example, by 2.5 years post-reversal, my T-level and gone up 35%…by 10 years, it had gone up 200%

I’ve had 2 setbacks post-reversal, one 2.5 years later, one 10 years later (that’s why I had T tests). While I have ZERO regrets on the reversal, I pretty much confirmed during the 2nd relapse that I had GF nerve damage. My point is that I look at my scrotum now like others look at other injured body parts…it may not hurt today, but it’s fragile, delicate, and susceptible to re-injury. Good news is that after the initial bout and 2 relapses, I’ve been pain-free since late 2018, so some of us can conquer this horrible ailment, but man oh man, it takes patience and persistence.

I also take Nerve Shield which is alpha lipoic acid and some other ingredients. That and Zyflamend have been my best friends.

1 Like

I really like the idea of doing an MRI to see what’s in the vas, but just wanted to point out that there is no settled theory about why or how reversal helps some men.

It could be partly or mostly due to pressure relief, but there could be other things going on, such as scar tissue removal, or removing noisy nerve ends and giving them a more normal situation in which to try healing. So just because you don’t get sperm flowing doesn’t necessarily mean there won’t be pain relief. There just hasn’t been enough investigation in to this yet.

3 Likes

Thanks for that clarification. You’re absolutely right, and my thoughts on MRI is strictly speaking speculation since it’s - afaik - not an established procedure most places. I also think you would struggle to find anyone else recommending an MRI, and when there is something just one guy says could help, it’s reason to be sceptic.

1 Like

I’ve been thinking a lot about nerves recently and posted this:

Playing the Nerve Lottery

TLDR: Urologists have no way to know which nerves in the spermatic cord are going to get damaged by vasectomy. What if some people are getting an unplanned GF neurectomy when the surgeon cuts into thier spermatic cord? What sort of variation in SC neuroanatomy exists?

Would there be some way to use imaging to inspect the GF nerve and take note of whether it was harmed by the vasectomy?

1 Like

Yep. I’ve wondered the same. No doctor has specifically stated why I had the symptoms I had pre-reversal, but the confirmation of GF damage in 2018 (13-1/2 years post-vasectomy!!) tells me the GF damage MIGHT have had something to do with core weakness that led to my lumbar problem and/or the ED problems that have vexxed me since the vasectomy.

@raising4girls Thanks for answering my questions, and the great advice. I took Nerve shield after my hydrocelectomy, and I think it helped some. I will get some more and start taking it now and I will look into Zyflamend.

@stk Thanks for the suggestion for the MRI. I’m sorry you are here, but I think you bring some interesting information due to your background as a radiologist. If my situation were different, I would request an MRI to see what things looked like in my epis before I went through with a reversal, but I have a granuloma on the left side that is causing me some big issues and that thing has got to go. So, instead of just removing the granuloma, I figure I will just get cleaned up, and reversed at the same time.

Maybe I should get an MRI for informational purposes, but I would rather not wait around anymore.

I know I have to look like the dumbest son of a bitch to have more genital surgery, but I feel like I recovered well from my hydrocelectomy, and I am still left with the same shit that started after my vasectomy. I am ready to try and put my body in the best position to start to really heal.

1 Like

I’d be very surprised if this were not happening occasionally. How could it not?

That nerve looks like it about the same diameter as fishing line at that point and typically travels down embedded in the cremaster.

Lots of anatomical variation from man to man – even variation in the same man on the right and left side. So it definitely looks like it is purely a matter of luck whether or not the surgeon cuts that nerve in half on their way to access the vas. It might explain a lot.

1 Like

@Lee1985 Yeah, if I had the choice I’d rather not have any knowledge about PVPS at all, but here we are.

@Ethan_Scruples I’ve looked a bit at what you’ve written about the nerves, and it’s really interesting. It sounds bad that half the nerves get cut during vasectomy, but what if it’s really the opposite - what if you actually “want” as many nerves as possible to get cut?

It sounds counterintuitive at first, but I believe there’s reasonable arguments. Post vasectomy, bad things happen to the epididymus. It swells up, sperm sludges, etc. One thing MRI has shown me, is that even guys who don’t have pain (reason for exam is they’ve just felt a “lump”) can have really shitty looking epididymuses. So why would we want the nerves intact to send the pain signals from the ruined epididymus? Maybe it’s really the crudest vasectomists who gets the best results, those who hack and slash everything. While those who try to injure as little as possible except the vas itself, leaves enough nerves to transfer pain signals from the epididymus. Maybe we who get pain are the ones with an accessory nerve, that lies away from the vas. Food for thought, especially since one treatment is complete denervation.

Unfortunately, these nerves are far too thin to be images by… almost anything. MRI has a lower limit on spatial resolution.

2 Likes

What if it’s really the opposite - what if you actually “want” as many nerves as possible to get cut?

Wow, I hadn’t thought of that but it does make sense.

One thing MRI has shown me, is that even guys who don’t have pain can have really shitty looking epididymuses. So why would we want the nerves intact to send the pain signals from the ruined epididymus?

Ugh, what the hell are we doing to ourselves? Honestly it is shocking to me that I just said “sure, go ahead and cut out pieces of my body” without any meaningful hesitation or red flags going up. I guess it never entered my mind that so many medical people would fail to mention these topics.

I read about the way increased pressure makes hamburger out of the walls of the epididymis, and I just think how much pressure does it take to reshape flesh like that?


As far as the GF nerve goes in particular, it seems like most of the time it is going to be spared, since most of the places where you could cut through the cremaster are not going to result in the GF nerve getting damage. Since most men do not have long term pain from vasectomy, that would suggest that cutting the GF nerve is not a prerequisite to escape long term pain.

Contraction of the muscles of epididymus is powerful enough to shoot sperm out at a high velocity. It should surely create enough pressure to squeeze holes in the epididymus when the vas is closed. So… if your vasectomist cut the nerves that causes the epididymus to contract at ejaculation, it could maybe prevent formation of sperm granuloma. Sounds morbid.

2 Likes

Well, I don’t know for sure if the epididymis the muscle responsible for shooting sperm/semen/cum out at a high velocity or the bulbospongiosus or some other pelvic floor muscle.

I would think the epididymis and vas deferens contract just enough to help facilitate the movement of sperm from its current location to the prostate and then from there Somehow out.

What I would say is regardless of how strong of a contraction the epididymis does, if you are clogged/backed/stopped up it’s going to not feel pleasant…which is 180 degrees from what an orgasm should feel like.

An orgasm is a complicated thing that has lots of different facets. Muscle contractions at different levels, and chemical releases at different levels and somehow the medical community has done a great job at marketing that “NOThInG ChANGeS”.

1 Like

Its total bull shit that nothing changes. Cause it does your sperm antibody tell you that as well as your orgasom and feelings in the testicle. I always felt my balls were separated from my body

1 Like

Good luck to you as well @Lee1985

1 Like

Thanks Ringo, thanks for all your contributions to this site, and thanks for talking with me on the phone last spring.

This place is truly a light in the darkness that is PVPS.

To think last March I almost got back injections because some Doctors thought the pain in my scrotum was coming from my back instead of the opposite. I’m glad I didn’t go through with that.

I’ve done my due diligence on this and reached my conclusion. I’m hoping I can share some good news about a good outcome.

2 Likes

Good luck bro! Let us know how it goes!

1 Like