Vasectomy

[INTJ]

Before your friend goes any further, I would recommend a web search for "Post Vasectomy Pain Syndrome". Its made me seriously reconsider.

 

"There is a well-recognized condition that occurs among a small number of men after vasectomy, known as a post vasectomy pain syndrome. This syndrome can begin immediately after the vasectomy or many months or even years after the vasectomy has been completed. The frequency of post vasectomy syndrome varies amongst given practitioners. Some studies report as high as one third of men after vasectomy have some type of lingering discomfort. Other studies report that the frequency of post vasectomy pain is one case in thousands."

 

 

A non-meticulous ?rough? surgery where significant amounts of tissue and nerves have been disrupted and/ or tied that have caused lingering irritation of the nerves. While this may be one of the more frequent causes of post vasectomy pain syndrome of post vasectomy pain syndrome one can imagine that it would be less common in the patients of experienced vasectomists.

 

 

A sperm granuloma could develop post vasectomy that becomes inflamed and aggravates the surrounding nerve endings. The sperm granuloma is a build up of extravisated sperm at the end of the cut vas tube end. The reason why a sperm granuloma may develop is not well understood.

 

 

Inflammation and swelling of the surrounding nerves called neuroma could develop. This could cause intermittent or constant pain.

 

 

A congestive state in the epididymis from back pressure to the epididymis and testes from performing a closed-ended vasectomy. Some authors believe that by blocking both the upper and lower cut ends of the vas tube the normal passage of sperm from the penis and away from the epididymis and testes causes a build up of pressure and ensuing pain. Studies have shown that this situation can be prevented to a large degree by performing an open-ended vasectomy. This is one in which the lower end or testicular end of the cut vas is left open thereby allowing the sperm to drain out of the tube preventing a build up of pressure.

 

 

A vasectomy carried out too close to the epididymis can cause chronic pain and inflammation at the epididymis.

 

 

Some speculate that post vasectomy pain could be mediated by an immune reaction. It is known that antibodies to sperm are produce by the body after vasectomy. It is possible that these antibodies can react with testicular epididymal and or scrotal tissue to cause an inflammatory reaction.

 

 

An undiagnosed depression that is totally unrelated to the vasectomy. In these cases the vasectomy and the perceptions of continued pain become a somatization reaction i.e a physical expression of psychological pain. Depression can also be caused by post vasectomy pain syndrome. The depression can keep the pain perceptions ongoing even once the original cause of the pain is long gone.

 

 

Shorter term causes of post vasectomy pain include infection and post operative inflammation which should resolve easily with the appropriate medications and not linger long enough to fall into the category of becoming a syndrome.

 

 

While there is no evidence that vasectomy causes prostatitis, new cases of prostatitis have been infrequently described post vasectomy. So prostatitis should be ruled out by digital exam and possibly scope.

 

 

Potential Treatments for Post Vasectomy Pain

 

 

 

In regards to a rough surgery, this would likely be the most difficult to treat and to identify as a cause of pain. Possible treatments could include exploration of the area to remove scarred or inflamed tissue, manual manipulation or stimulation of the painful area, or just allowing time to heal.

 

 

In the case of a sperm granuloma, injecting it with steroids or actually cutting out the inflamed granuloma has been found effective in the past. Surgery should always be viewed as a last resort in this case.

 

 

Nerve blocks i.e. injection of various anesthetic solutions have been tried. So have injections of steroids, or excision of the neuroma.

 

 

In regards to pain resulting from a congestive state from a closed ended vasectomy, converting that vasectomy to an open ended vasectomy or considering a vasectomy reversal have been identified as being effective in the past.

 

 

Surgery carried out too close to the epididymis causing chronic epididymitis may respond to medications or require an epididymectomy.

 

 

Some advocate the use of a steroidal anti-inflammatory like Prednizone for 1-2 weeks. This treatment may be particularly helpful in treating an antibody/immune mediated cause of the pain.

 

 

Regarding treatment of shorter post vasectomy pain like post operative inflammation or infection, the use of anti-inflammatories for inflammation and appropriate antibiotics for infection have been shown to be effective in dealing with this type of pain.

 

 

In case of depression and somatization, counseling and anti-depressant medications can be very effective.

 

 

Prostatitis can be treated with antibiotics like Cipro, sometimes requiring many weeks of therapy.

 

 

Getting a second or third opinion from different practitioners with an expertise in treating post vasectomy pain is always advisable.

 

 

Time, sometimes 1-2 years, without doing anything at all, may heal the problem. ::

Some investigations that may help sort out the cause of post vasectomy pain include:

a) a careful physical examination of the scrotal contents by a qualified physician.

scrotal ultrasound

c) semen culture and sensitivity and gram stain

d) anti-sperm antibodies

 

e) scrotal exploration

 

f) probing of the testicular end of the vas.

 

g) a careful psychological history to rule out depression.

 

h) Cystoscopy ? scoping the urethra with observation of the prostate gland and bladder.

 

 

Although the chances of PVP seem pretty slim, to me its not worth the risk. I'd rather pull it out and give her a "Pearl Necklace"

 

 

Cheers,

 

 

 

INTJ

[gobbledonk]

INTJ,

 

*Any* surgery, whether its a nose job or a heart transplant, carries some risk - not the least of which is infection. Given that most of us are in the prime age group for testicular cancer, the symptoms you've described dont scare me nearly as much as the big C.

 

I'm sure that something as complex and potentially painful as the male reproductive system is prone to all kinds of nasties, but the worst ailment I've seen wasnt the result of surgery. One of the guys I served with in the Army didnt front up to work one morning - a huge drama in the military. It transpired that his wife had been forced to rush him to the hospital that morning after he rolled over in his sleep and twisted the tubes which we all hold so dear. The resulting pain is rumoured to be right up there with childbirth and the like, making the fact that it is potentially fatal almost insignificant to the victim.

 

There are a host of other possibilities post-vasectomy, and I urge anyone who is considering such drastic action to think carefully and examine all the facts at their disposal. Given the chance to make the decision over again, I would still do it, complications or no.

[BelgianBoy]

Hi,

 

Ok, my turn then......

 

I had it done nearly 2 years ago under local aneastetic as well, drove home after that, waited 2 hours, then went to dinner with friends.

No pain at all....... I concur with Artie on all points.

 

Next morning had a morning woodie as usual and the only inconviniance I had was a terrible itch for days on end from shaved balls :hubba: :hubba:

 

Other than that I am very happy I had it done.

 

Cheers !

[Old Hippie]

Hve read of a higher rate of prostate cancer in men who have had this proceedure...

[bangkokbutcher]

Only just spotted this thread.

 

Now I have known quite a few guys that have suffered this minor op, and it really does seem to be down to the individual as to how you react to it.

 

Dont want to bore you all to death with how each of them reacted to their ops, but it certainly aint stopped me from putting my name down on the NHS list for mine (mainly because if I have any more kids I'll be bankrupt)

[Steve]

I do NOT like pain. I am seriously considering it but if the analogy of getting kicked in the balls is any thing close to what its going to be like, I'll pass. I'll just have to risk the world having a 2nd chocolat steve. The world can barely handle one. ::

[gobbledonk]

Thats funny OH, because I believe that the rate of both prostate and testicular cancer among vasectomised men is a bone of contention among researchers, with some claiming that it lessens the likelihood of contracting both, others that it increases said likelihood, and a thrid group claiming that there is no appreciable difference. I'm pinning my current hopes on the recent discovery that drinking six (!) cups of coffee a day can halve mens chances of contracting the dreaded TC. I'll die friendless, agitated and with incredible halitosis, but at least I shant be clutching my scrotum when my rellies come to ID the corpse ::

[Pescator]

Hi BB,

 

Mayby you could perform this procedure yourself, you seem to have the right equipment at hand judging from your avatar ::

 

Cheers

Hua Nguu

[vegasdave49]

I had mine done 5 or 6 years ago. It was done scalpeless. There where no stitches, and it was completely painless, aside from a small pin prick when injecting the novacaine. Ok no comments about a small pin prick. I was a bit sore for a few days and I wore a jock for about 4 days. That seemed to help a lot. But really the discomfort was easiely contoled with tylonal. As it has been pointed out you do have to wait for a bit for the pipes to be cleard of the sperm. Once you get your final test, you are cleared for, "any place, any time". In this age of STD's you might figure whats the point of going through this. Well, we all are suseptable to an occasional lapse, be it alcohol or stupidity driven. Also there is that chance of a condom breaking ect. All of this is nerve racking, but hearing those words, "I have your baby" could be devistating on many levels. For me I am at the point where knocking up some girl would completely screw up the rest of my life. I have to say that is is a huge relief to not have to give that issue any thought.

[Guest]

Mine was done 25 years ago. :: So I just smile when they try the "me have baby" routine. tell them to say hi to the father for me.

 

Seriously if you are young, you might consider having the 'valve' installed rather than the cut or solder job. Supposed to be easier to turn the flow back on if you decide to be papa down the road.