Post Vasectomy Pain Forum

Urologist wants to remove my entire Epididymis

Last ultrasound showed a 3mm granuloma, Urologist first attempted Antibiotic treatment but that did nothing to correct it. Now he is now suggesting the next step is to just remove the Epididymis all together. He warned me that it should correct it but I may still have pain if it’s a nerve issue?

Now I am a little freaked out because even researching on here I am not finding many people had the epididymis fully removed, most people are being offered reversals. If he jumps straight to this and it doesn’t work I am assuming that reversal is now off the table.

If I have a granuloma now because of it being tied off who is to say that I won’t get another where it’s tied off again at the Testes?

Exactly that. I’m staying away from the epididymectomy right now too. What is your pain level on a scale of 0-10?

Don’t do it there is no come back from an epididymectomy being there still had pain

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Epididymectomy seems to me as the most counter-intuitive surgery of all. Post vasectomy the testicles still produce sperm. It’s supposedly to be absorbed by the epididimus, according to the shitty info I got before the surgery. But if you remove the epididimus, what happens to the sperm then? It either leaks out through a mess of sperm granulomas that will form on the scar surface of the testicle, or it will cause continuous pressure (and probably pain) inside the testicle. I would rather have the whole testicle removed, than risk epididymectomy,

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I am also worried because the Urologist hasn’t even examined me, we had 2 phone appointments where I described my pain. Can he really be that certain from one Ultrasound report and talking to me over the phone to just start slashing away again? Due to Covid no operation will happen until at least October anyway.

So what now? Should try for a second opinion with Dr. Jarvi in Toronto.

Again, what is your pain level at? I was about 2-5 and then I had the sperm granuloma removed. That just made it worse, and it bounces now between a 3-9.

That was my question to my urologist as well regarding epididymectomy. He said that the testicle re-absorbs the sperm and he’s seen alot of luck with it, but was oddly so quick to offer it. He had also told me there’s a slight chance I could lose my testicle if they accidently knick a blood vessel. I dont want to even have the slightest chance of losing my nut.

He also said some guys do well after a few cortisone shots. So I am currently going that route.

Using the Comparative Pain Scale I would say I am at 3 daily, If I think about it it hurts as much as getting a needle but I am able to get used to it and it doesn’t rule my day to day life.

During sex it goes up to 5 and after ejaculation it jumps to 6. Then for 1-3 days after ejaculation it stays at a 5 before lowering back down again.

And yes part of me managing to keep my pain at 3 is not masturbating at all and as much as I hate it avoiding sex.

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Do you know of any resources that I could read up from. I would rather go to my Doc with here are some articles on why I think this is a bad idea rather than a bunch of really great guys on the internet warned me against it.

I am at a 3 on average but it goes up for a few days after ejaculation.

Cortisone sounds like a better route than cutting out a chunk of flesh.

Yeah if it’s a 3 I would probably try your best to avoid any kind of surgery. I wish I had waited longer before I considered anything. Using that pain scale you posted, my top end is probably down 1-2 points. I was maybe a 4 before I had the granuloma removed. I wish I waited longer, it was still manageable then. I didn’t even really use pain killers then, I should have. Its a big regret I have had and if I can prevent guys from doing it, so be it.

Any time they operate you are putting yourself more and more at risk. I had to take a month off work after my granuloma removed, I think I’ve heard it’s about 6 weeks off for an epididymectomy.

Personal, non-medical opinion…epi removal is the worst solution to scrotal pain. First, it truly makes no sense other than, perhaps, caveman sense of “if it hurts, remove it.” We can do better. Ask the uro what happens to the sperm that the testicle still produces when the epi is gone. He’ll probably get indignant. If he’s honest, he’ll say he doesn’t know.

I’d run for the hills from any uro who suggests epi removal before reversal, cord denervation, or even simply nerve blocks before epi removal. Candidly, based on the anecdotal evidence on this forum, radical orchiectomy seems like a better alternative than epi removal.

Even my urologist digressed after offering epididymectomy lol. He didn’t seem too certain in his decision. Yeah i would definitely get more opinions

While consulting several Uro’s for my PVP, at least two of them said “whatever you end up doing, I strongly recommend against Epi removal, as it usually causes more pain.”

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I am reading up on it and from one older study they say 50% chance at reducing pain, an updated study now says 70%. So there is a 30-50% chance it will be worse. Ugh

I don’t think there’s a single man on this forum or the prior Yahoo forum that got better from epi removal. That option is batting 0.000. Not to say the other options are foolproof. The only sure way out of PVPS is not to get a vasectomy in the first place, much like the WOPR computer states in the old movie War Games when it says the best way to win at nuclear war is not to play in the first place.

But, once you’re a victim of PVPS like us, the “do no harm” oath should be even more important. Nerve injections, pulsed RF ablation, cord blocks, reversal, and cord denervation all have risks and some men here have had neutral or worse results, but each has its wins. In 15 years, I still haven’t read one single man say he was cured by epi removal.

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I always appreciate reading your advice on this forum Raising4girls.

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I had epidydymectomy after advice from a surgeon on my left testicle, and had to have it removed because of the pain. In hindsight, I should have had a reversal first.

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In hindsight I would never have had the vasectomy. I should never agreed to it

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You and me, both It’d be interesting to know how many men would opt for vasectomy if they simply found this forum before having it done. My bet is that at least half the men who see this site before a vas would not have it done.

Thanks, but there are many more here who contribute more frequently and more value. Several do a much better job of publishing real research which is a HUGE service to all of us.