Darrel’s vasectomy experience

The following is my vasectomy story. Please note that it is long and detailed. There is a quick timeline near the bottom for a short version, but it doesn’t go into detail as to how much pain I’ve been in. I hope people read this before having one of their own.

I had a vasectomy on 12/18/03. I was pretty excited about having this done. My girlfriend of 5+ years talked to her doctor about getting a tubal ligation. We looked into a vasectomy and realized that there were fewer risks, local vs general anesthesia, no hospital stay, etc. so we decided for the vasectomy. I found out that there was a No-Scalpel Vasectomy with fewer risks than a regular vasectomy, so I went with that.

The day arrived and I took a Valium one hour before my appointment (as instructed by the urologist’s office). Right after I took the Valium, the doctor’s office called and asked if I could come in earlier because the doctor had an emergency to go to. I went in, and the doctor handed me the release to sign, I looked at it and held onto it expecting him to start talking about the risks involved (since the release says something like “I’ve been informed of the risks”). He started reaching for the release as if I had signed it. I went ahead and signed it.

My girlfriend asked if I was going to need to put ice on my scrotum after the procedure. He said probably not, but he’ll tell more after he’s done with the procedure. My girlfriend asked of risks, and he mentioned the only risks were hematoma and infection due to the surgery, but those are easily treated.

He sent me to another room where the vasectomy was to be performed. He started by cleaning the area, then injecting a local into the scrotum (a little groin pain that lasted 5-10 seconds or so). He then cut me to start the actual procedure. He told me that he uses titanium clips instead of cauterization (burning of the vas deferens). He pulled out a vas deferens. Note that on each vas deferens, after he pulled them out, it felt as though he let the tool dangle from the vas deferens (it felt like a pendulum hanging from my scrotum that would sway back and forth). When he finished the first vas, he had to shoot me with another local (same pain as the first local). When he was almost done with the vasectomy, he said “I might set a personal record”. That would have been bad if before the operation I said “I’m going to try to set a personal record, huh?”

He finished and I stood up. He was going to show me what he did and noticed I was bleeding, so I laid back down and he stitched me up (maybe 3-4 stitches?). I went out to meet my girlfriend. She had already paid so we left. When I walked out the door, I saw the urologist leaving in his truck. I had a few pains from the surgery during the next couple of weeks (some pinching in the groin and of the testicles). A day after the vasectomy, I had a bruise running the entire length of my scrotum on the right side. I showed my girlfriend this, and she asked if that was normal. I said that I read where some bruising is normal. The bruise was gone within a few days. I ejaculated 3 times over that period of time (2 weeks).

On 01/03/04, I had a lingering discomfort in the scrotum throughout the day like a dull ache, but definitely bothersome. That evening, I noticed a small soft lump above my left testicle in the scrotum that hurt to touch. On the morning of 01/04/04 (9:30 am), my girlfriend and I had intercourse (still experiencing discomfort). I looked up stuff on the internet as to what the problem might be and found Post-Vasectomy Syndrome (PVS), which can be anything: inflammation, sperm granuloma, epididymitis, depression, etc., etc. After reading more and more on PVS, my first thought was sperm buildup that’s causing pressure and pain like epididymal congestion. That same day around 12:15 pm, I started feeling light-headed. I laid down for a few minutes and then got up to go to the bathroom. Right as soon as I stood up, I experienced substantial pain in the scrotum/groin area (mostly on the right side). This pain was the worst pain I’ve ever felt in my entire life – screaming and bent over. It seemed to hit hard every 15 seconds or so. Throughout the following 30 minutes or more, the pain diminished every few minutes.

I called the urologist who performed my vasectomy. He said he couldn’t get to his office until 2:00 pm. I said, “I hope I can make it that long.” I called my girlfriend and told her she had to come home and take me to the doctor. This pain still came and went (although not as excruciating as it once was) for several more hours (even after he saw me). We arrived at the doctor’s office at 2:00 pm. He evaluated me as I was trying to hold back the screams. He thought it might be an infection. He put me on an antibiotic (Ciprofloxacin) for infection for 7 days. He mentioned that it seemed odd for infection to appear 2 weeks after the procedure. He also gave me Hydrocodone for pain if I needed it. I wasn’t there for more than 5 minutes. I was skeptical that infection was the problem. I took the Hydrocodone occasionally when I was having more pain than “normal”. The Hydrocodone didn’t seem to do the trick unless I took 2 of them and even then, the pain would only diminish for about an hour. I had (and still have) a constant pain that fluctuated in severity throughout every day.

The next day, I got light-headed again and had to lie down for a few minutes. These two times are the only times I’ve been light-headed. I have gotten sick to my stomach a few more times, but nothing major. Upon completion of the Ciprofloxacin, I called him again (01/12/04). He evaluated me again and wasn’t sure what the problem was; he seemed baffled by the whole thing. At this point, the bulk of the pain and swelling was coming from my right side. He gave me some Vicodin for the pain and said to give it time. The Vicodin helped the pain for longer periods of time than the smaller dose of Hydrocodone he originally gave me. I haven’t taken it much (only once every few days) since he said it can be addicting. At this time, I noticed that I’ve had problems going to the bathroom. For example, it would take about 15-20 seconds to start urinating. Plus, I’ve had to get up in the middle of the night to go. I’ve never had this problem before.

On Saturday (01/17/04), I had sex again for the first time since my immense pain (light and quick). I had a little pain in the scrotum and testicles, but not much worse than the constant ache (not even close to what I initially experienced on 01/04/04). The following Monday (01/19/04), I called a urology center to see if they would see me for a second opinion. I explained my situation and they said they’d call me back. They didn’t call back so I went to see my urologist. I explained more of my bathroom problems such as start/stop problems as well as the length of time it takes for me to start urinating. He did a urine test in a centrifuge and found nothing (I’m not sure what all he checked for). I also mentioned that it seems like one of the vas deferens (from the right side of the scrotum) seems to go up to the op site and seems stuck there. He could tell what I was talking about but didn’t seem too concerned about it. He said that it might be a vas that hasn’t “fallen” yet. Basically, it’s immovable. He suggested trying hot baths to see if it helps. He also said that I might have a sperm granuloma. I’ve read that a granuloma is hard, so I didn’t think that was my problem, but I guess it’s a possibility.

He gave me a prescription for a 2-week supply of Bactrim (for a possible urinary tract infection). I took this for the full 2 weeks. My bathroom problem seemed to diminish a little. I seem to not have to go as frequently as I once did, plus I only have to get up every 2 nights or so to go. The start/stop problem only happens rarely and the initial length it takes to start is down to about 5 seconds. The urology center I called did call back the following day and said that I needed to go back to the urologist that performed my vasectomy (a little upsetting).

I called my urologist again on Monday, 02/02/04, and asked if there was anything else he could do. He said there were no more tests that he could run on me. He said the only other option was to go back in there and investigate, but he didn’t want to do that until I gave it more time. That’s fine because I don’t want to go under the knife again just to find out what this thing is. He mentioned that my problem still might be a sperm granuloma, which will eventually go away on its own or could later be surgically removed. He also mentioned that it could be pressure from sperm build-up that hasn’t reabsorbed yet. Lastly, he mentioned that he hasn’t done this, but he’s heard of men converting to an open-ended vasectomy.

I started wearing an athletic supporter 24/7 and that has helped with the pain; especially when I walk. I also started taking 15-minute hot baths when I can (probably 4-5 times a week). I started taking 600mg Ibuprofen 3 times a day. I can’t tell if this is making any difference as of yet, but I’m hoping it helps the swelling. I’ve kept my boss informed of my dilemma. She had been going to the same urology center I had called and that wouldn’t see me. She called someone she knew there and explained my doctor was done with me, but they still didn’t want to see me. As of 02/11/04, I’ve ejaculated (no intercourse) several (maybe 6-8) more times since my initial pain, and after each time it feels like my testicles are bruised all over; they get extremely tender to touch or move. A few hours after ejaculating, they seem to be back to the “normal” pain that I constantly feel.

My current symptoms are the following:

1. Left side of scrotum – very small lump (hardly noticeable) above the testicle that is a little tender to touch. I only occasionally feel the pain coming from my left side. Currently, I rarely feel pain from the left side – maybe once a week.
2. Most of the pain I’m having is in the right half of my scrotum. There is a bigger soft lump (feels like a firm squishy ball – if that makes sense). This lump (or the area surrounding it) seems to swell at times during the day. It is at the top of my testicle and can be moved around. It causes pain when I mess with it. It is not attached to the scrotum, and it doesn’t seem to be directly attached to the testicle. It could be attached to the epididymis/testicle by some tissue. The right testicle is a little tender to touch. The constant ache I have is mostly on the right side. I have since found out what this problem is (read on).
3. Also on the right side, there is a small (maybe 1/8” in diameter) round tube that seems to go up to the base of the penis at the op site and seems stuck there. I can’t seem to follow it after that. Following that tube in the other direction, it feels hard and rough (prickly) and seems to go behind my testicle towards the bottom end of the testicle. I lose it about 2 inches down. It seems to cause pain as well when I mess with it. This could also be contributing to my constant ache. It could be something that is normal and supposed to be there, but it’s just inflamed or something? This “tube” is now only hard in one small spot.
4. At the base of the penis where the op site is, I get a prickly feeling at times during the day (not often, but it bothers me). Also, that prickly, discomforting feeling appears when I have an erection. It seems like I’m stretching part of my skin that shouldn’t be stretched (if that makes any sense). This prickly feeling has since greatly disappeared.
5. Sometimes (not often) during the day, the pain on my right side becomes more and more discomforting and I tend to constantly adjust my genitalia hoping that it’ll feel better. After ejaculation, there is a little more pain than “normal” and both testicles feel bruised all over and are very tender to the touch and movement. This bruised feeling in the testicles still exists after ejaculations – however, the bruised pain has diminished.
6. After urination, there is a little more pain in the scrotum than normal, but I believe that’s just be caused because I’m having to move my genitalia in and out of my underwear (so it aggravates it).
7. The simplest little accidental hit on my testicles causes pain. I have to be very careful.
8. At some point during the day, I get a pinch above my pelvic bone (higher in the groin). This usually doesn’t last long (a minute or so). It’s like somebody pinching something in there, then letting go, then doing it all over again (at 2-3 second intervals or so). It usually happens once or twice during the day, but there has been one day so far (02/14/04) where this happened several times throughout the day. It happens on either side. As of now, this pinching feeling only happens once a week.

02/12/04 – My thinking of the situation:

Surely it’s not a tumor or anything like that, right? Could it be the titanium clips that are causing something?

Rupture of the epididymis due to congestion? I have had no health problems until this happened. I rarely ever go to the doctor. I rarely get sick (even a cold). I definitely have not had pain in the scrotum area before my vasectomy. Unfortunately, I have no idea what the initial excruciating pain I had is contributed to, but a sudden onset of the pain could mean epididymitis, testicular tumor, or testicular torsion. Plus, I have no idea what that “stuck tube” is.

On Friday, 02/20/04, I called my primary care physician. I explained my situation and he saw me that same day. He evaluated me, looked at, and felt my testicles. He did a urine test which came back negative, and he ordered an ultrasound. He also put me back on Cipro (10-day prescription). He mentioned that Bactrim isn’t for all of the internal organs down there. His office called the hospital to arrange for me to have an ultrasound. I went in the following day (02/21/04) to have it done. The lady that did it started the ultrasound on my right (the most problematic) side. A couple of minutes into it, she said, “You’ll hear a noise, but that’s just blood flow going to your testicle.” I heard nothing, but I didn’t think anything of it. She later went to the left side. A few seconds later, I heard a noise denoting blood flow. She spent maybe 2 minutes on the left side and then went back to the right. I again heard nothing, so I was scared. After she was done, I cleaned up and she showed me the way out.

The following Monday, 02/23/04, I called my doctor’s office at 10:00 am and explained that I was scared about the ultrasound results and was hoping they would follow up with me as soon as possible. I called again at 3:00 pm. They said they’d call around 4:00 pm or 4:30 pm. No word from them still. I called again on Tuesday, 02/24/04, at 10:00 am. They called at 2:30 pm and said the “ultrasound came back normal, there is no mass, and it’s probably just an infection so continue taking the Cipro.” I was a little disappointed. I called them back and asked if there was a way someone could explain how my ultrasound came back normal or if they could show me that it’s normal. They are giving me a copy of the ultrasound (they never gave me a copy – read on…).

Tuesday, 03/02/04, I finished the 10 days of Cipro and called my general doctor. He wanted to see me again. I went in and he prescribed another 10 days of Cipro. On Sunday, 02/29/04, I finally thought there might be an end in sight. I really could tell there was a difference. Right now, I’m going to contribute it to this round of Cipro (that’s why I went back and got more). There is still pain, and it seems to be irritated when I move it (ie: going to the bathroom, etc.) I still have not received copies of the ultrasound, but I’m growing less worried about them. As of 03/02/04, I probably feel 60% better than I did when this pain started. I would say I’m 40% better since I went to see my general doctor. Things are looking up!

I finished the 3rd round of Cipro, and there has been no improvement. In fact, a couple of days after I got off of the Cipro, I started having pains on my right side again (like they were when I first went to my general doctor).

03/17/04, I turned in a sperm sample to the hospital lab to see if I was sperm free. Since I was there, I requested a copy of the report from my ultrasound. The report said that everything was normal: No masses, vascular flow was normal, both testicles look normal. I got the results back from the sperm test on 03/19/04. It was a 4 ml sample and it came back “No spermatozoa seen”. Good news I thought until my girlfriend said stuff like “Do you think that it’s ok now, or should we wait longer and get another test”? I was a little perturbed because I’ve gone through all this and so far have paid twice as much more for the pain problem than I did for the vasectomy (vasectomy cost $500.00 – aftercare adds up to just over $1000.00). Needless to say, we’re not having unprotected sex as of yet, and if she doesn’t get over her “worried” state of mind, who knows if we ever will (ok, we did later).

Quick Timeline

12/18/03 – Vasectomy performed (non-scalpel with titanium clips – no cauterization) – stitched up at the operation site (the doctor had an emergency to go to afterward).

01/03/04 – Lingering discomfort (constant ached) throughout day. Noticed lump above left testicle.

01/04/04 – Sex in the morning. Immense sharp pains (mostly on the right side) started 12:15 pm that came and went every 15 seconds – lasted 30 minutes, then pain diminished slowly throughout the rest of the day. Saw a urologist who prescribed Ciprofloxacin (1 week). Pain is mostly on the right side now with a bigger lump on the right side (left side lump is small).

01/12/04 – I’ve realized that the time it takes to start urinating is taking 15-20 seconds. Saw a urologist again. He did not know what my problem was. He prescribed Vicodin for pain. Sometime this week I was having a start/stop problem when urinating, plus the frequency has increased dramatically (3 to 4 times more than normal, plus in the middle of the night). Also this week, I noticed a tube leading up to the op site that seemed stuck there (thought it was a vas deferens, now it might be normal, but inflamed?) – it’s immovable.

01/17/04 – First sex since 01/04/04. No immense pain, just felt bruised and a little more pain than “normal”

01/19/04 – Saw a urologist again – told of my bathroom problems. Performed centrifuge urine test (negative). Prescribed Bactrim (2 weeks).

02/02/04 – Finished Bactrim and called the urologist again. He said there’s nothing else to do besides go back in there and investigate or give it time. The bathroom problem I was having has diminished slowly (still there though).

02/07/04 – Started wearing athletic supporter just about 24/7

02/09/04 – Started 600mg Ibuprofen 3 times a day. Haven’t noticed if it’s helping or not. It seems like I’m getting better by a minuscule amount every week (hard to tell though). Some days are, of course, worse than others and some times during the day are worse than others.

02/19/04 – Ejaculated several more times since 01/17/04 (no intercourse since then). Pain afterward is a feeling of testicles bruised all over and very tender to touch. The bathroom problem seems to happen only once a day (start/stop plus the time it takes to start). The frequency has dropped to maybe 1.5 times more than normal. I still have to get up in the middle of the night 3 times a week.

02/20/04 – Saw Primary Care Physician. Performed urine test (negative). Ordered ultrasound and prescribed Cipro (10 days).

02/21/04 – Had ultrasound performed at hospital. Feared there was no blood flow on right side.

02/23/04 – Called general doctor at 10:00 am for the results of the ultrasound. Called again at 3:00 pm. They said they’d call around 4:00 pm or 4:30 pm. No call back from them.

02/24/04 – Called the general doctor again at 10:00. They called at 2:30 pm. Said the ultrasound came back normal, no mass, and probably just an infection. They told me to continue taking the Cipro. I asked how this was possible; they are giving me a copy of the ultrasound.

03/01/04 – Took the last Cipro pill. Could tell there was a difference (hopefully due to the Cipro). I just noticed that I feel quite a bit better than 1 week ago, but I just noticed it (at the end of the Cipro).

03/02/04 – Went back to my general doctor and he prescribed another 10 days of Cipro. Today’s the first day that I’ve had a smile on my face since my pain started. My doctor did mention the term “epididymitis”. I was a little relieved he mentioned that word since he still feels like it’s an infection. I’m starting to believe that’s what it is. I still have not received copies of the ultrasound, but I’m not too worried about that anymore since my pain is diminishing.

03/13/04 – Took last Cipro pill (3rd round). Could not tell any difference.

03/15/04 – Noticed an increase of pain where I feel discomfort all day on the right side. I had to take a Vicodin (no help this time). The left side seems to not have any significant pain. I also feel pain above the pubic bone (more toward the abdomen on the right side). Plus, right along, the pubic bone it seems like blood vessels going across or something; if I rub my fingers lengthwise along the bone, it seems like there’s some pain associated with that (like that makes any sense).

03/23/04 – Went back to my regular “family” doctor. He referred me to a urologist.

04/02/04 – Went to the referred urologist and right off the bat he said I have a spermatocele due to back pressure of sperm that made my epididymus burst. The sperm leaked and that’s what’s causing pain. Basically, there is no cure for this besides going in and cutting it out. Since that might cause other problems and is not guaranteed to fix this problem, I’m going to live with it for now. He also mentioned I have tethering, which is basically one of the vas deferens is stuck to some tissue. That’s what the stuck tube is that I mentioned earlier.

My latest:

On 03/23/04, I went back to my regular doctor and he referred me to another urologist. I saw him on 04/02/04, and he immediately said that I have a spermatocele, which was caused by the backpressure of sperm. This caused my epididymis to burst and leak out sperm. The body doesn’t know what sperm is so it attacks it. Basically, there’s no cure for this besides going in there and cutting it out. Since more surgery could cause other problems and might not fix this problem, I’m opting to live with the pain for now. I at least now can do a few sporting activities (not long lengths of time though).

The urologist also said I have tethering, which is basically one of the vas deferens that is stuck to some tissue. That’s what the stuck tube is that I mentioned earlier. This stuck tube is not prickly anymore, plus, it’s only hard in 1 small spot (which could be the clip). He mentioned the pain might go away within 6-12 months, but of course, the pain may never go away. He said if it becomes extremely bothersome, he could go in and cut it out.

By the way, I’m getting to have unprotected sex now since we know it’s not an infection. We’re just not doing it during her “ovulating” time of the month. I’d say I’m about 70% “healed”.

Submitted by Darrel