Adam’s experience: Adam’s PVP Diary

I’m 37 and have been suffering from low-grade chronic testicle pain since I was a teenager. At 21 I was diagnosed with a cyst (left testicle) and was told that surgery may or may not solve the problem long term. The operation was done under a general and recovery went fine, in fact, I was pain-free almost immediately and stayed that way for nearly 6 months. Alas, the pain eventually came back and I just learned to live with it. Mostly minor, sometimes better, sometimes not – usually worse after heavy exercise. Fortunately, it never seemed to have an adverse effect on my sex life, in fact, both of my wife’s pregnancies happened the first month we tried.

Ok, so that’s the background. After a few recent pregnancy scares and ruling out female birth control (for medical reasons I won’t go into) a vasectomy seemed the best route. The doctor was picked for his experience (over 9000 performed to date) and I chose “no-scalpel” surgery. I discussed my past history and was told there shouldn’t be any higher risks to the procedure from the cysts. I even “sperm-banked” so no reversal needed on the remote chance we decided to have more biological offspring. Before the operation, I was told that some men will have swelling after the procedure which should go away with ibuprofen in a few days. I figured “how bad could it be?”.

Answer – bad, really bad. Everything started fine, with a local anesthetic applied and the first few minutes uneventful. All of sudden I felt mind-blowing pain and intense nausea and sweat started pouring out of my every pore. 20 minutes of hell (and a few hurls) later I was limping out of the office with scrotal support and hope that the worst was behind me.

The next 48 hours was actually bearable, just minor pain and discomfort but on the 3rd day the lower part of my right testicle began turning purple and swelled to about twice the normal size. The pain of standing up with no support was indescribable, and I was forced to take cold showers while “holding the boys” or risk passing out. Interestingly enough the left testicle (the ‘bad” one) seemed OK.

By day 7 the pain lessened a little to where I was able to hobble around the house slowly but anything more still hurt like hell. Luckily I’m in an occupation where I work from home often or I’d be screwed. Talk with the Dr. confirmed scrotal hematoma which by the third week abated.

Today is day 23 and I’ve only been outside the house a few times since the operation. Both testicles are still equally swollen (about twice normal size) and about a week ago I developed a jelly-bean-sized granuloma on the left side. The pain varies between annoying and downright show-stopping, some days worse than others. Cold packs and Advil help a little and at this point, I’m able to sleep on my side again by folding a pillow in half and wedging it between my legs. I’m a very active person and it’s taking all my energy not to slip into depression right now. This is definitely the worse thing I’ve been through.

At this point, I’m guessing that since the hematoma is all but gone my body is just having a really hard time reabsorbing sperm, and I’m hoping with every digit crossed it doesn’t turn into a long term Epididymus problem. I Will post an update in a few weeks.

Update April 2, 2004

Day 25

Worst day yet. I pushed things and drove to work for a couple of hours (15 minutes each way, desk job) and am paying the piper for it. The pain is so intense I’ve been throwing up every few hours. After one of the nastier episodes my 3-year-old daughter told me that it’s OK Daddy, adults are allowed to cry too. Despite everything else, the swelling has continued to abate. The best position is standing with my feet akimbo or lying down on my back.

Day 26

Back to the Doctors office and he’s really concerned about the pain. He confirms the left granuloma at 1.5cm and the right one at 1cm, but the physical exam thus far hasn’t hurt much, even while sizing the granulomas. But when he got to the bottom/backside of both testicles I almost passed out. Afterward, he pointed out that inflammation is minimal and definitely not proportional to the pain I’m feeling.

We discuss the possibility of infection and although he didn’t see any visible signs mentioned he wouldn’t rule out Chlamydia or some other opportunistic bacteria. Since I’ve had STDs in the past (Condyloma) and was going to insist on antibiotics anyway (after reading the posts on this site) he wrote me a prescription for Doxycycline. Also got prescriptions for Vicodin (hydrocodone) for nigh time, Tylox (oxycodone) for when it’s really bad, and Darvocet (propoxyphene) to make it through the days at work (we were both thinking positive).

Overall I’m pleased with his concern and frankness and we both agreed to give it some more time. It really helped to have my wife there to drive home the point of how bad it’s been. She’s been totally amazing through all of this. I’m very lucky in that regard.

Day 27

Started off the morning feeling much better until our English Mastiff puppy’s massive tail found its mark. Of course, he didn’t mean it but in classic puppy jubilance swung it around and I just wasn’t on the ball (both figuratively and literally). An English Mastiff’s tail btw if you haven’t seen it is about as long and wide as a string of sausages and attacks everything in its path with deadly speed when the rest of the animal gets excited. Now I know this is a bit of a tangent but I believe others with chronic pain know about living in a constant quasi-Ninja state of mind. No matter what’s going around me or where I am, over the years I’ve trained myself to block all threats within a foot of the family jewels with almost super-human reaction time and strength. That instinct failed me big time this round.

4 Weeks

Today is a good day, with a noticeable reduction in pain and tenderness. It may sound strange but it just feels like my body has a better handle on things instead of it being a runaway train. Despite the examination, travel, and tail whipping of the past few days I’m back underneath the “I want to kill myself” threshold that was broached a few days back. Not sure if the antibiotics are helping or things are just taking their course. Even took it out for a “solo test drive” and happy to report no problems there – didn’t seem to affect anything either way.

5 Weeks

The last week has been a roller coaster ride, with some days bearable and some not. The granulomas are healing nicely but the testicle pain is as bad as ever.

I’ve forced myself back into half days at work but productivity continues to suffer. Believe it not to add to the stress I’m in the middle of a merger between my company and another through all of this and am eager for it to be complete so I can focus on the options for getting better. Next week I go back to the doctor when the antibiotics are done. If he has no further advice I’ll insist on a referral for a PVP specialist. If he doesn’t give me one I’ll call my old Uro back in NY who I’m sure will point me in the right direction, although based on all the Internet research I’ve done the last few weeks I’m not optimistic that there’s much more that can be done except take more antibiotics or start to consider a reversal or some other type of surgery.

As a sidebar, my wife is convinced I produce more sperm than the average guy and that may be contributing to the problem. When I sent in my samples to the sperm bank a few months ago the counts were way above average so maybe she has a point. I wonder if anyone has ever done a study on pre-vasectomy sperm counts to see if there’s a correlation with pain afterward?

Driving seems to make things much worse, although being a passenger isn’t much different than laying on the couch so I’ve been trying to get out at least once a day and not fall further into depression. Could really use a time machine right about now. I feel like I’m in a movie part that I never tried out for.

6 Weeks

Woo hoo! I can finally say there has been a measurable improvement from the previous week. My body is FINALLY starting to get a handle on the healing, both visibly and in the way I’m feeling pain. Up until this past week, the pain was always there and often extreme, now it’s sorer overall with occasional shooting pains like before, but less frequently and at a lower intensity. As bad as it still is I can now function enough to get things done enough of the time. There are also times (when I’m not moving) that I feel little to no pain. Sleep is one of these times and therefore the quantity and quality of sleep have improved which I think is helping everything else. What about swelling at this point? The left side seems approx 10-20% larger than before the op, right side approx 30-50% depending on the time of day. What’s kind of weird is that the left side stays the same size but the right side will grow or shrink depending on day and time.

I’m rarely using pain pills anymore and instead have cranked up the vitamins now that I’m off antibiotics. I take strong multiple vitamins, saw palmetto, and a GNC cleansing formula (psyllium husks, acidophilus, etc) each day to keep everything else happy. I’m going to give things some more time and then make a judgment call on whether to have Humpty Dumpty put back together again. Aside from what appears to be a logical scenario of “fixing the fix”, all the other surgeries I’ve researched seem barbaric, risky and often do not help. My hope is that the healing and pain abatement continues to the point where it’s acceptable again and I don’t even have to consider surgical options, hopefully in a few more weeks.

At my wife’s request, I’ve put together a numeric pain scale so she knows where I’m at on any given day and how best to deal with me.

Adam’s Pain Scale

1-3. Mild to mild + discomfort, annoying but not debilitating except for sports and other exertion. I’ve lived with this type of pain most of my life.
4. Medium discomfort with some pain part or much of the time
5. Medium + discomfort, enough pain to force me to start paring down the day’s schedule. Can still focus on work for half days, full days usually turn into a 6 if I keep pushing it. Advil will hold it at bay or bring back down to a 4 sometimes.
6. High discomfort, medium pain most or all of the time. Walking is done selectively, most of the time is spent lying down or standing still. Bring on the Vicodins. Hard to stay focused on work (from the pain and/or Vicodin), even from the home office
7. Medium to medium + pain all the time. Plan on moving as little as possible, with television the primary activity.
8. Medium-high pain all the time and some vomiting. Like 7 but too much pain to stay focused on TV. Tylox is usually taken at this level but at level 8 and up pain killers just displace some of the pain but it’s definitely still there.
9. Constantly high pain and vomiting, regardless of movement or lack thereof. Just shoot me, please.
10. Soul-crushing pain and discomfort. This was experienced only once, during the Vasectomy procedure itself.

To put things in perspective, here are the pain ranges for the last 6 weeks. Keep in mind these are based on actual highs and lows and not averages.

Week 1: 8-9
Week 2: 8-9
Week 3: 7-8
Week 4: 6-9
Week 5: 5-8
Week 6: 3-8

Update 8 Weeks

I went to a highly recommended acupuncturist twice during Week 7 and the first visit took about an hour, with 16 or so needles inserted in various parts of the ear lobes, wrist, forehead, stomach, and feet. I felt just the slightest pain on a few of the insertions but that quickly faded. The Dr. also gave me a bottle of Traumeel, an herbal anti-inflammatory.

Now here’s the strange part. As soon as the needles were in I felt some weirdness down below. Tried ignoring it, thinking it might have been in my head but it became quite distinct and persistent. The level of pain and discomfort I usually feel fluctuates throughout the day very slowly. In this case, subtle waves of alternating types and volume of discomfort passed over the testes for about 10 minutes and then slowly subsided. It was not an enjoyable sensation by any means, yet not intense or unbearable either.

For the next few hours, I didn’t notice a difference (if anything I felt worse), but the following two days were on the lower end of the pain scale. Unfortunately by the third day, I was almost as bad as ever. Interestingly the pain was composed 100% of “ache and tender” compared to “sharp, stabbing” pain.

The day after that I was scheduled for more acupuncture but this time the treatment was far more aggressive. The Dr. apparently took me as a personal challenge. She said outright I was one of the more “intense” cases she had seen and asked my permission to put needles in sensitive places (not where you’re thinking – that was spared). Some did hurt quite a bit, especially on the fleshy part of the inside of my thumb but I didn’t care as long as it had even a small chance of helping. Altogether I counted 30 needles and the ones in my stomach appeared to go the deepest. After an average evening, I awoke the next day feeling the best I had thus far and have had 3 similarly good days since. Not sure whether the acupuncture really has had an impact or it’s just a coincidence but there are also some physical improvements including a reduction in swelling, less “hang” on the right side, and closer to normal skin tone.

Theory: I’ve had plenty of time to think about the root cause of this and currently believe it’s comprised of two components.

1) My body is having a major problem adjusting to the new plumbing configuration and resulting backpressure. This could be the cause of the ongoing epididymal pain but doesn’t explain the horrible experience I had during the procedure or the resulting hematoma. After 9000 vasectomies I’ll give the doctor who did it the benefit of the doubt (for now) that nothing went awry with the procedure itself.

2) I, therefore, hypothesize that my vas deferens (especially the right one) may be shorter than the average guy’s. That would explain the intense “piano wire pull” I felt during the operation despite a local anesthetic. It would also explain the ongoing pain not specifically in the epididymis, but closer to the other section of each vas and especially on the right side because the ends of the vas may have torn when pulled out of the scrotum (he used the NSV technique). By the time both vas were cut, cauterized, clipped, and released there would have been considerable rupturing on all ends due to the lack of vas “slack”. I ran this past my urologist who said it was unlikely but also wouldn’t rule it out. I’ll keep looking for alternative explanations in the meantime because I’ve been told a level 1 ultrasound won’t pick it up and at this point, I don’t want to go through the pain and expense of a level 2 unless I stop making progress.

Pain scale:
Week 7 3-7
Week 8 2-7

9 Weeks

Since the last update, I’ve gone through two complete swelling/abatement cycles. As usual, the swelling was mostly on the right side while the left was more black and blue and painful. I’m becoming more convinced that the initial hematoma was a sign of substantial epididymal rupturing and would explain why the right side of the scrotum fills with fluid (and nearly fills both sides sometimes!). Also, since the vasectomy, I’d estimate there’s a 30-40% reduction in the average ejaculate volume (which most doctors will tell you is impossible) but it must be going somewhere. Also for the record, there’s also a distinct difference in odor as well. Not bad – just different. This time at peak swelling I purposefully manipulated the epididymis on both sides and confirmed that the right side, while twice as swollen as the left, was far less sensitive to the touch. I can also say that there was no difference in pain after the manipulation. This seems to contrast heavily with some people, who’s pain goes through the roof after anything touches them. I even pushed myself to throw on a supporter and mow the lawn which while uncomfortable didn’t affect the pain either way afterward. It’s almost as if the increased scrotal fluid forms a temporary layer of shock absorption. Weird.

These observations plus what I read in an excellent report “Testicular Pain Following Vasectomy: A Review of Post vasectomy Pain Syndrome”¹ lead me to believe the left side is in a classic struggle to get its close-ended vasectomy epididymal absorption under control (say that 3 times fast). The right side, however, might be acting more like an open-ended vasectomy due to early and substantial epididymal rupturing that is allowing sperm to leak out. What’s a bit strange is that the initial granulomas are now almost gone and over the tissue in that area seems in pretty good shape. From what I understand granulomas should almost always accompany sperm leakage into the scrotum (?).

Also had 3 more acupuncture sessions this past week and can say there’s been a major reduction in the more intense pain (but not swelling or ache) since I started a few weeks back. While I believe it’s helping there’s absolutely no way to know for sure. Comparison with an identical control group just isn’t possible and at 8-9 weeks out I may very well have been due for some more healing and the two happened to coincide.

In the last two sessions, she hooked up some low-voltage wires to a few of the needles. I could actually feel the electricity traveling across the skin from my thighs to my stomach. While none was felt in the groin (thank goodness!) I did feel a noticeable improvement in the day’s discomfort immediately afterward and then had two decent days, but then the next day both testicles were in so much pain I had to stay home from work and take painkillers. The following day it was back to being manageable again. What a roller coaster ride.

Pain scale:
Week 9 2-7
Week 10 2-6

12 Weeks

Over the last few weeks, the cycle has changed quite a bit. The intense pains are gone and I’m left with varying levels of ache. At this point there no longer seems to be a pattern for when things are better or worse, it can vary every few hours or stay the same for a day or so. Sometimes it’s bad enough to keep me home from work but more often than not I’m able to stick to a normal schedule. Aside from ache I still experience tugging and pinching sensations up my abdomen a good amount of time still. Sex usually makes things a bit worse for a couple of hours but then I go back to the way I was beforehand (pardon the pun), with no apparent mid or long-term effect either way. Intensity is about the same as pre-vas but volume and distance noticeably less. Still wearing scrotal support that helps tremendously when I’m out and about. Sitting is still a challenge but I’m OK at work with a chair that leans way back.

Pain scale:
Week 11 2-5
Week 12 1-4

4 Months

There’s been slight improvement overall this past month, the sharp pains are now completely gone and I’m left with alternating soreness, tenderness, and ache which seems to be pretty random and varies in intensity. Most days are bearable if I’m careful (the slightest touch in the wrong place still hurts) and other days can be annoyingly discomforting, but nothing that has slowed my work schedule down the past few weeks.

I’ve finally been able to start exercising again which is really helping and I’m working on getting a hand-powered bike so I can make use of the great local trails here. Air travel still requires painkillers, especially on long flights but Vicodin seems to keep it under control.

New insurance kicks in July 1st and I definitely haven’t ruled out a reversal later this year if the improvement doesn’t continue. I still remember what it was like to be nearly pain-free and refuse to accept the current level as the status quo going forward.

Pain scale:
Month 4 1-4

6 Months

I just hit the 6-month mark post-vas and went to see a PVP specialist about options. After relating my history he did an exam and pretty much concurred on the remaining options for getting pain-free. I can continue as-is and hope that the pain eventually subsides, OR go for a reversal and hope that I’m in the 60-80% that get relief. I had ruled out converting to an open-ended vas for a number of reasons and basically feel it’s worth being fertile again if there’s a chance I can lead a normal life. We BOTH ruled out removing anything else.

He was the first doctor I talked to who admitted 3-5% of men who get a vas will have some type of pain. He also said he’s seen a correlation between any complexity or difficulties the original Doc ran into during the vas and potential long term complications.

I’m now working on lowering the cost of reversal through insurance but will find a way to cover it either way. Life is just too short. In the meantime, he suggested testosterone therapy to see if I get relief and to rule out nerve damage before going under the knife. I’m especially concerned about side effects, even short term (weight loss, mood swings, etc). He did a blood test for PSA, etc, and gave me a prescription for the patch (Androgel 5mg) but I want to do some more research before going ahead.

Last week I went online and bought a $100 fold up guest bed and mattress. In the middle of the mattress, I cut open a circle about 8″ in diameter and then cut out the springs directly underneath. The final step was taping up any sharp edges and lining with a cloth.

How did it work? Well, I tried it last night (lying on my stomach of course) and while it took a little bit of getting used to, I slept more soundly than I had in months.

I know the whole thing probably sounds a bit extreme, but I really couldn’t take it anymore. Tonight I’m thinking of lining the bottom with a cold pack and am giddy with anticipation at the thought of it. I think I’ve FINALLY lost my mind!

A few days later

The new mattress is working but unfortunately since it costs only $99 (including the frame) it’s not exactly comfortable for many of the other parts. Specifically, my back and neck got really angry after the second night so now I just grab an hour nap on my stomach each evening when I get home from work and then use the regular bed at night. The other logistical issue I didn’t count on was how much I’d grown used to sleeping next to my wife, so the napping plan takes care of that problem as well. After a few days, I’ve found I have more energy at the office so while not a perfect solution I consider it a win.

The mattress has also had an interesting effect on friends and family. It’s been stored near the front door the past week and a lot of people have asked about it. After hearing the reason most say “You’re STILL in that much pain?”. I don’t complain very often so I guess the mattress drives the point home on its own.

September 26, 2004

After 2 weeks on Testosterone therapy, I’ve decided to stop because of some side effects. The really good news though is that for the last few days I’ve seen a huge improvement in ache and discomfort, and can honestly say yesterday was the first day I didn’t think about pain at all the last 6 months! There is also some slight but noticeable (good) shrinking that has taken place which I’m guessing is taking pressure off the parts that were hurting the most. The tenderness when touched is still there but significantly reduced.

The reason I’m stopping is because in the past week I’ve become increasingly anxious, especially at the office. I’ve spent the past 10 years working stressful jobs with no problem but even minor things (like calling a satisfied client) will now trigger intense feelings of anxiety and dread. I didn’t sleep at all last night and it took all my willpower to make it into the office today. With some big presentations coming up over the next few weeks I just can’t take a chance on being in this mode any longer.

Other, more minor side effects include acne and aggressiveness (like road rage), and I also noticed a bizarre effect it’s had on my wife. Apparently, some of the T can either rub off or be transferred via body fluids because she’s been so horny the past week it’s amazing. This is obviously a good side effect from my perspective (nearly pain-free sex every night the past few days!) but I’m sure it’s not good long term and is another reason I believe it’s prudent to stop the T. This is of course all speculation but the T package insert did say partners can be affected and I’m assuming this is what they meant.

So, I’ll see how things progress over the next couple of weeks. If the pain comes back slowly I feel confident that a reversal is a right way to go, even though I didn’t make it to the full 4-8 weeks.

One other important point to mention: I spoke to the original urologist a few weeks back who did the vas and told him about the T therapy. He hadn’t heard about it before but was intrigued and said he would be interested to see how my open-ended vasectomy would be affected. What?!?!?!?! Open-ended?!?!?! I had assumed all along he did the standard NSV closed procedure (I know – I really should have asked before and/or afterward and he should have made it clear at some point when I was having pain) and was totally blown away by this info. Thank goodness I didn’t go to another doctor to get an open-ended conversion, imagine his surprise and my disappointment when we found them already open! I went back through my notes and some things are making more sense now. It probably explains why I’m not suffering the intense, stabbing epididymal pains that many with a closed-ended vas have described. Why my body can’t get the absorption under control is still a mystery. I know the immunological response isn’t supposed to kick in right away but maybe I had already developed that response from the original op for cyst removal 15 years ago?

With all that said I would still recommend T therapy as a diagnostic tool for people who have tried everything else, just beware of possible side effects.

Just a quick update: within a week of stopping the T therapy the ache and soreness slowly came back and is now as bad as ever. I went ahead and scheduled a reversal with Dr. Witt for November 12th which will be close to 9 months from the original vas. I should have a final answer on the insurance appeals by then, but even if they don’t cover it I’m going ahead with the op.

November 13th, 2004

It’s been 24 hours since I went in for my reversal and I’m just chillin’ (every 20 minutes on/off cycles) at a hotel in northern Atlanta. The operation was done under general anesthesia and took 2 hours. The staff and facilities were exceptional and my concerns and questions addressed promptly and taken seriously. I’m still battling United Healthcare to cover it but had decided not to delay the op and will get a refund if/when the insurance eventually comes through. Total cost – $10K for everything. I knew I’d eventually find a use for all those credit cards I had paid off.

So far the pain is manageable, especially compared to what I went through with the vasectomy which was at least twice as bad for a long time! The type of pain is also different than before, more swelling and soreness and so far none of the dreaded aches. The gauze needs to stay on for 48 hours but I took a peek and it looks pretty scary down there with lots of stitches. Without going into too much detail picture Frankenstein as a baseball AFTER the big game.

I’m seeing the doctor one more time before heading home on Monday but he called last night and reiterated that everything went well on his end. He also mentioned there was a lot of scar tissue removed on both sides that may have been contributing to the problem, and my plumbing is now successfully restored to its original pre-vas state. Now I just have to wait and see where the pain winds up in a few weeks. I’m prepared to live with the results whether good or bad.

I DEFINITELY don’t recommend reversal unless someone has exhausted every other possibility. As bad as it is what blows my mind is that I’m currently in less pain than after the original vas and expected to heal faster!

There’s one and a half weeks to go before I can take it out for a test drive and I’m not looking forward to a life of condoms again. Our resolve to not have more children hasn’t changed but my wife and I joke that if after all of this she has an accidental pregnancy down the road we’re naming the child “Lucky” 😉

Oh, and one final comment regarding the pre-vas pain. Dr. Witt was unable to find any cysts near the incision sites so I’m expecting that pain (which is lower down and closer to the testicle) to still remain when all is done. Interestingly I have noticed that the left side hurts a bit more than the right and in the same spot and way as my “old pain”. Perhaps the repressurization is affecting it now that the plumbing is hooked back up.

I really think that one day a set of pre-vas diagnostics will go a long way in preventing these situations and is sorely lacking now because of a lack of technology or maybe by most doctor’s lack of motivation to use them (hey this stuff is pretty rare, right?). To put it bluntly, an NSV is for lack of better terms a “blind” procedure that doesn’t take into account each individual’s particular anatomy and variances thereof. Imagine that before each vas an Uro could look at the scrotum through some type of 3d imaging device and make sure there were no problems beforehand. Also, imagine if they could see the effects of their work on internal parts DURING the operation. I really think that would prevent untold suffering in just making sure doctors don’t have to fish around for the vas anymore. I’d also like to see more attention given to sperm count and sperm antibodies and their effect on problems afterward.

December 3rd, 2004

3 weeks post reversal and doing great. Still quite sore but the previous “evil” pain and ache from the original vas hasn’t returned and I’m back at work this week in full force. The original cyst pain is noticeable once again but no worse than before.

Most of the soreness is limited to where the stitches are and continues just below the surface but doesn’t seem to extend very deep. Sitting and walking is uncomfortable but if I stand still or lie down just right there is no pain whatsoever! The scar tissue removal and fixing of the torsion previously mentioned must have been pretty intense, as some internal parts are still hard and/or swollen and I guess I have a long way to go to loosen up to where both sides hang down normally again. Hot showers and baths are no longer a form of torture and actually feel good again which I take as an excellent sign. Still wearing a suspensory which helps a lot – especially when sitting.

What’s amazing is how scary it still looks down there – plenty of fading black and blue, yellow, and other colors – but I consider that a sign of more healing (and an accompanying reduction in soreness) to come over the next few weeks and months. Even if it stays at this level it was definitely worth the time, money, pain, and effort to get it fixed. My wife and everyone else has noticed a huge change in my demeanor and it no longer feels like I’m dragging a boat anchor throughout the day. Finally starting to sleep through the night again which is making a huge difference.

Also took it out for a test drive and no problems to report there. Not happy to be right back where I started regarding birth control but that’s OK in light of everything else. I’ll miss doing it au natural but apparently it just wasn’t meant to be.

I heartily agree with one of Trifold’s other posts that a good check of the tubes before getting a vas is critical. I think however it should also become a standard procedure that some type of imaging device is used before and/or during a vasectomy to completely map out the area. The NSV technique is wonderful in reducing the chances of infection but in my case suspect much suffering (or perhaps all?) could have been prevented with the older but less “blind” method. I’ll always wonder if my body’s response to the resulting sperm leakage of the open-ended procedure would have been tolerated OK if not for the damage inflicted when the vas was yanked out.

Submitted by Adam

1 Testicular Pain Following Vasectomy: A Review of Post vasectomy Pain Syndrome by Cory G. Christiansen and Jay I. Sandlow, The University of Iowa Department