Post Vasectomy Pain Forum

Why is there such a huge divide with urologists about orchiectomy?

Why is there such a huge divide with urologists about orchiectomy?

Some urologists say losing one testicles isn’t an issue, and then others don’t recommend it?

Hi there, Does anyone have any input regarding this subject?

Any input we can provide here is pure conjecture from a bunch of non-physicians. Couple of thoughts come to mind:

  1. I think there’s an aspect of “do no harm.” Removing testicles, on the surface, probably sounds like harm.

  2. Phantom pain. If the pain is neuropathic and especially if centralized in the spinal cord, removing the testicles could leave the patient with one less ball and the pain still there like diabetics whose feet still hurt after they’ve been removed.

  3. Trust in time. A lot of docs believe that “time heals all wounds.” Many of us have gotten better, more or less, simply through the passage of time.

It’s hard to speculate. I think the best insight here would come from a urologist who performs a multitude of interventions for PVPS such as Dr. Parekatill. He has performed orchiectomy on at least one forum member, but he lists it as last resort. Must be for a reason.

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I personally think it’s guilt, greed and ignorance. If they admit they fucked you up bad enough to make getting your balls removed to make the pain go away is something you would consider, they have to face the fact that a “cash cow” operation for them is not safe… and therefore they shouldn’t do it anymore. I think there is so much denial in urology over that possibility they can’t do anything to acknowledge something that would mean they can’t do it anymore. No more easy money + facing the fact they’ve maybe screwed up a lot of guys.

It’s not complicated. They have women’s magazines, left wing man magazines, every mainstream publication that is afraid to incur the wrath of the “right thinkers” all shilling for them. They are being enabled by a cabal of people that do not give two shits about men’s health. But like a lot of things today you will hear vasectomy called a “men’s health” issue. Ha ha ha ha ha… Yeah right.

Only the most motivated of men, that want the operation for THEMSELVES and not doing it for any other reason… not their wife, not their partner… not their parents… Not some fucking left wing feminist environmentalist douche bag entreating them to get one… or anyone guilting and shaming them… Only motivated men that have researched it and understand the risks and are highly motivated to get a vasectomy should get one.

It should be for completely selfish reasons-> wanting to bone women/any and all women and not your wife or girlfriend…and have ZERO responsibility or fear of pregnancy happening. That’s the only reason a man should get one.

Getting a vasectomy for your wife or girlfriend is stupid. If you are doing it for that or because of any particular woman… DON"T DO IT.

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I personally think it’s guilt, greed and ignorance. If they admit they fucked you up bad enough to make getting your balls removed to make the pain go away is something you would consider, they have to face the fact that a “cash cow” operation for them is not safe… and therefore they shouldn’t do it anymore.

I think the same thing is going on with reversals. A lot of uros will suggest an epididymectomy or SCD but not a reversal. Why? I think it may be more palatable to them to think about this as a “bad nerve” that needs to be excised rather than face the fact that the vasectomy is the cause of the problem and needs to be reversed. And that’s part of why my insurance will cover SCD but a reversal is an “experimental treatment” that they will not cover. My impression is that reversal has as much or more evidence as an effective treatment as SCD, but uros don’t want to acknowledge that.

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Mike and Ethan are more right than me. I was thinking in terms of a urologist treating a PVP patient (victim) after SOME OTHER uro had done the vasectomy.

In the instance where the patient (victim) goes back to the vasectomist (negligent perpetator?) for help, there’s 0% chance he/she will recommend orchiectomy. That would require them to admit their golden goose vasectomy practice was flawed, and we can’t have that.

The wonderful doctor who treated my PVPS (not a vasectomist) told me a lot of things. One was that he was frequently greeted at AUA conferences like a “skunk at a garden party” because of his anti-vasectomy positions. Of course, much of his practice was dealing with their victims, TWO PER WEEK according to him back in 2006.

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I encountered real resistance to a reversal as a potential solution. It would be just dismissed out of hand and other extreme surgical methods offered. That is until I started talking to specialists.

Wrt to oriectomy w/o a prior vas, it’s a tough risk reward to estimate and your just going to see Drs and people on different sides of it. All you can do is weigh their advice.

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So what is the general rule about the body and it’s recovery when it comes to a vasectomy, epididymectomy or a orchiectomy?

All three procedures have side effects, but not everyone will suffer the same, and the specialists all have their views on the subject which we never get told the truth; not until it’s too late.

I once read that orchiectomy can prolong a man’s life.

Hi @raising4girls, I think I’ve asked you this before but I don’t remember, who was the doctor who treated your PVP?

Will send you a PM. More characters since I must have 20.

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Think about a lot of the members here. Very few have a vasectomy and end up with pain localized to only the surgical area. Leg pain, back pain etc. So if you remove the testicle will your leg pain get better? Maybe, but if the pain is centralizing or sympathetically mediated it probably won’t help. It was offered to me (removal). I was ready to go forward but covid hit. I hooked up with a great pain management and am 90% better by blocking the sympathetic nerves. Imagine if I had found this person two years ago? Why don’t more doctors understand pain pathways? Why do many urologists hear pain and want to cut? Yes, sometimes it is appropriate. It boggles my mind how compartmentalized medicine is and how you have to quarterback your treatment. I’ve read more journal articles than I did while in school (I’m in a healthcare field-odontology :wink:). I’ll post more later but I think we have an opportunity as a group to bridge this knowledge gap.

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I’m afraid that rule doesn’t exists. Most men recover just fine from vasectomy. Clearly the subset here did not. It sounds like you should be looking up medical studies on oriectomy. Statistics are the closest thing you’ll find to a rule. I found drawing out decision trees is helpful. I was arguing myself in circles when considering a reversal.

Made me think about comparing with Covid19. In the case of vasectomy where most (pick your number, at least 80%, perhaps as many as 99.99%) do well, the procedure is seemed safe by the AMA and AUA and guys like us are viewed as acceptable collateral damage.

Flip to Covid19. Granted, if you draw the short straw there, you die, but many of us came close or hoped to die because the pain is/was so bad. With Covid, the stats show that 95% of the confirmed cases are recovering. Further, the CDC indicates that there are at least 10 asymptomatic cases for each confirmed case and, since they’re asymptomatic, we can presume they’re also recovered, so move the decimal one place to the right, and you’ve got a 99.5% rate for recovery if infected.

Again, I don’t want to be interpreted as minimizing Covid. The US has 5MM confirmed cases and likely 50MM actual cases. Both are far greater than the 500,000 vasectomies.

But, on a percentage basis, the poor outcome numbers are comparable. In one case, most in the medical community call for shutting down the country; in the other case, most in the community denies there’s even a problem.

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Made me think about comparing with Covid19

I’ve had the same thought.

Sample advertisement for COVID19 if doctors reacted to it like they do to vasectomy:

Busting Five Commonly Heard Myths about COVID19

Myth 1: "If you get COVID19, you will die."

This myth just keeps coming back no matter how many times it gets busted. Sure, everyone has heard the horror stories about a friend of a friend’s grandmother who died alone in a hospital bed, surrounded by people dressed in hazmat suits and unable to say her final goodbyes over the phone to her loved ones because of her tracheostomy. While it is true that any viral respiratory infection involves risk, COVID19 is a relatively safe virus that millions of people have gotten and recovered from. In fact, most people who get COVID19 do not have any symptoms at all!

Myth 2: "COVID19 will do lasting damage to your lungs."

The reality is that there are no long term studies that show that COVID19 has any negative impact whatsoever on lung health. There are many factors that can cause shortness of breath, most of which have nothing to do with a COVID19 infection. Smoking tobacco, brisk cardiovascular exercise, even eating too much fatty food can cause many of the same symptoms that people naively attribute to their recent COVID19 infection. Lung capacity also tends to diminish naturally as we age.

etcetera…

It’s an interesting comparison. The difference would seem to be in the scale of COVID-19 and the voluntary nature of a vasectomy. Maybe we need some epidemiologist to review PVPS and raise the alarm. We deserve real and accurate stats on vasectomy outcomes at consultation.

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