Giraud’s experience: Childfree vasectomy with a history of prior testicular pains

Hi! Thanks for putting up a great site. Here’s my story:

First of all, I am childfree, and perhaps it seems as odd to others as it does to me that most vasectomy literature uses words like “when your family is complete,” etc. I suppose we are a minority! This is one reason I wanted to post my thoughts.

I am almost 38 years old, I had my (conventional, two cuts, closed) vasectomy about 5 weeks ago, and I am married to a wonderfully supportive woman. I have never felt the paternal urge that so many men strongly feel. I knew one guy who married a woman with several kids already, but he wanted one of his own with her – this is an alien thought to me, and although pro-children folks sometimes say the childfree are “selfish,” I somehow think this guy was acting more selfishly!

I have always been very concerned about accidental pregnancy. I was somehow afraid to bring up the idea of vasectomy, given that it’s so final, even though we had decided not to have kids. I seem to be again in the minority for really wanting it (it seems many men get coaxed by their wives, which is perhaps why they have regrets).

One day, while we were watching “Everybody Loves Raymond” (in which the topic was Ray’s potentially thinking about getting the snip), my wife said, “Have you ever thought about it?” I was surprised, but my response was that I had thought about it before (but we did not continue to discuss it at that time).

It got me thinking though, and now I knew it might be OK with her for me to do it! So I did some research, and then I asked her how she felt about me doing it. She said she was all for it if I was comfortable with it. She said she could always go on the pill though (we had been using condoms for years, along with condomless sex during small portions of her cycle when it was “safe”). But I have long been against the hormonal methods. I think it does bad things to a woman’s body and mind (the side effects are scary!). She had mentioned the pill several times in our relationship, and I always pleaded with her not to go that route.

What a wild idea this was! Was I actually going to go for it? Wow. It was a little scary, and as I read some of the horror stories on the Net, I wondered if it could be a mistake. Still, I was more than willing to take the chance.

One thing that made me wonder was my history of testicle pain almost 20 years ago. The doctors never knew what it was but said it could come and go over the years, which it has a little from time to time. Over time, it has been very mild, but a week or so before my vasectomy, it returned a little stronger – it must be a mind-body connection. Thinking about it must have made it either more noticeable or somehow triggered it a little. My right testicle was always the one that ached a little. I always suspected perhaps some kind of pressure down there or blockage. Who knows, maybe I was not getting any sperm through that tube anyway! Maybe I was never fertile, who knows. I didn’t have a sperm count done before, so I guess I’ll never know, which is fine. I wondered if a vasectomy could make this worse, or maybe if it was a blockage, maybe it would have little or no effect. Still, it was worth the risk: the idea of freedom from worry about pregnancy and contraception (for which there is no other great method, in my opinion) was exciting!

Anyway, back to what happened next. I called one urologist, but I could not get a consultation for a few weeks. The next one I called could see me in a week or so, so I went with that one. I spoke to the doctor for a mere 10 or 15 minutes, in which he asked what made me consider this. I told him that we did not want to have kids, and it seemed like a good option. He asked how old my wife is (she’s 35). This seemed to satisfy him. I guess our ages and my sure answer were what he was looking for – who knows. He told me how the procedure would go, and he examined me (felt my balls, etc.). The guy seemed like he was pretty experienced at doing vasectomies, but my only complaint was that he seemed to blow off a technical question I had from my Net research (I’ve noticed lots of doctors are like that – not wanting you to know too much of their expertise). I decided to go with him in the end. My appointment was in a couple of weeks.

The vasectomy

So along came Friday the 13th (11/13/2002), the big day! I was more nervous than I had thought I would be. I went ahead and took the tranquilizer he had prescribed (I had considered not doing this, but when the time came, I welcomed it!). My wife picked me up at work at about 4:15 PM and drove me to the doctors. She kept telling me that I did not have to do this, that there were other options she was willing to entertain if I didn’t want to go with it. She seemed really concerned for me, which I really appreciate. I think if I had seemed unsure myself, she would have wanted me to not do it. But I was sure. I went into the room, where the lounger/table was. The nurse, who was very nice, asked me to undress and lie on the table. They had not wanted me to shave beforehand, and she did this as we chatted. She did ask how many kids I had, and I responded “zero!” She only looked a little surprised. I asked if there were many like me, and she said a fair number, actually.

The doctor came in next, and although he was not talkative, I was comfortable enough. I regret not watching the procedure. At the time, I was afraid if I watched, I might see something that would worry me later, given that I was nervous. The injection hurt only a little. And I felt no pain after that, and I did not even get the “tugging” sensation that so many people speak of. I did hear and feel the cauterization though – I could hear the sizzling, and I felt something – maybe it was an electrical impulse (I hear that some such devices work on electric current rather than heat). It was strange knowing that he was burning an internal part of my body right there and then! I remember him discussing things with the nurse, like asking how she thought something looked or something – again, made me wonder, but I also had a distinct feeling that the cauterization was thorough (that was the only thing I felt or heard). I did not feel the second side needle that I remember, and it went quickly too. When they were done (the actual operation must have taken 15 or 20 minutes), I sat up, saw my gauze/stitches, etc., put my underwear and pants on, and I was out of there!

After the procedure

My wife drove me home, and I sat with ice for the rest of the evening. I took the hydrocodone (I’m not a fan of that variety – causes a bit of nausea sometimes) that night, and I slept fine I was tender the next day as well. There was some blood spotting (not much), and I tried a pain killer again, which did not agree with me. We were going to go on a driving trip, but we did not go far, since I did not feel great (due to the drugs).

Going to work on Monday was fine, but I was still tender (it hurt a little while I walked). Overall, it was fine though. And with each day, the tenderness became less. I could feel lumps around where the tubes were cut, but I think they were the metal clips and some swelling. I can still feel them, but they are smaller now. There was slight bruising on the sides of the scrotum after a few days, but that went away quickly. I masturbated on the 5th day, and that felt fine. We had sex at a week or so, but we maybe could have a bit sooner. I was still tender, but not bad.

Last week (at about a month), I took in the first semen sample, and it showed zero sperm! They told me to bring in the next one in a couple of weeks (2 to 2.5 weeks later). At 5 weeks now, I have noticed a bit of aching in that right testicle, and only a slight bit of tenderness in the left. Yes, I worry a bit about potential pain, but then again, this feels a lot like what I experienced over the last 20 years. We’ll see if the vasectomy makes it better or worse (essentially the aching has been almost non-existent most of the last 20 years, and it does not alter my life at all).

I have read postings from men who regretted the decision and had a reversal, mostly because they could not deal with being infertile. This makes me worry only a little: is the evolutionary thing so strong that mentally this is too big a change? I don’t think so, and I sure hope that we, as humans, can get past this. I do not think of manhood as being defined by having offspring, so I doubt I will have these feelings. Sex is not meaningless if it is an intimate sharing between you and someone you love.

I am especially aghast at the guy who does not want more kids but had a reversal. You are not less of a man because you do not have sperm cells in your ejaculate. Come on! What about being a great lover, making your partner happy, etc.? For me, fear that pregnancy could result was more of a joy killer than a source of excitement. Yeah, “risk” adds excitement, danger, etc., but sex is exciting too, especially raw and spontaneous sex with no barrier between the two of you!

I suspect they were pressured into it, and maybe they are the types of men who feel so strongly that fathering lots of children is what satisfies them. For me, I have never wanted kids, and I am happier as an uncle. I don’t dislike kids, but I just don’t want that lifestyle. I could not be happier that I am not fertile.

Assuming I do not suffer future pain, this was a great decision. The sex seems as powerful as ever, and I’m sure once I am given the all-clear, the freedom will be great!

18th February update

Just an update on how things are going for me! Things are going well! I’m getting really used to the freedom of the vasectomy – it’s funny, it’s quite normal now to not have to worry about condoms, etc. I guess it’s not surprising that it would be easy to get used to it!

Over the first two months, I had a dull ache on the right side and rare pulsing sensation on the left. At 3 months, it was much better – usually no pain at all, but sometimes a feeling of pressure or slight ache.

Now on some days I feel a little bit of ache, but the usual case is none, and the pressure seems to be subsiding.

Also, I have had that same shower experience that others have reported: when I manipulate my balls, they feel tender. I still feel that, but to a lower and lower degree.

I mentioned this before, but it is important: about 20 years ago, I experienced aching (sometimes rather annoyingly severe) in my right testicle and epididymis. The doc (at my college clinic) tried everything, including antibiotics – they always assume STD in college! Nothing helped but time. Finally, months later, one doctor told me that I may experience aching from time to time for years, and the cause is relatively unknown (maybe pressure?). So I wonder if I had a blockage on my right side many years pre-vas.

Anyway, the ache, over the years before my vas, subsided to pretty much nothing probably 15 or more years ago, but it came back to a small degree the week before my vas! Was this my mind starting to focus on that part of my body? Who knows – interesting though.

So I can’t definitively relate my ache to my vas completely – it certainly makes the “blockage” more definite, but again, this ache has come and gone with me for 20 years (mostly in the first few of those years). I can say from experience that mine did subside over time, and now that I am 5 months post-vas, the ache has slowly but surely gotten better.

So to those of you who are experiencing some aching after the vas, hang in there. It can and does (as evidenced by myself and others here) take time sometimes – not the couple of weeks that some people report! Also, my data point shows that there can be other causes of this kind of ache not related to vasectomy at all. In my case, I’ll probably never know the reason for the non-vas ache: maybe the cause was physiologically similar to a vasectomy’s effect, but maybe not.

I’ve seen some ask, “how’s the sex life.” Well, no complaints! 😉 Things are feeling back to normal (it felt a little strange at the beginning, but as time goes by…).

I will say that there is one difference: unprotected sex used to be more “forbidden,” and there were these “special” times (that we considered safer – not sure they really were!). Now that there is no worry of an unexpected pregnancy, it has less of that feeling that “Oh boy, it’s the special time of the month.” So having the worry gone is great (relaxed, etc.), but with that is gone the “forbidden fruit” aspect, not that I enjoyed the worry or “risky” feeling – those were unpleasant. Along with the worry sometimes came a heightened awareness or sensitivity physically with sex or something – a sort of focus on the physical bareness. It wasn’t necessarily a good feeling – more like an “I can’t believe we are doing this” feeling like we were getting away with something. I guess that’s true now even more so, but it’s now “normal” to not need protection. Hard to explain!

This is something I did not expect! But I don’t know as I’d call it a “drawback” of vasectomy – just an interesting effect. I think more than anything it takes getting used to a different mental model of sex: one in which sex does not equate to a potential pregnancy. It really makes you think about it – what weird physical act sex is (there were times, years ago, when I’d think this too, and too much thinking about it makes it kinda strange)! Even though for so many years I went to great effort to prevent pregnancy, it’s different when it’s entirely disconnected from it. I think that this is the core of what makes some men have trouble being sterile.

April 10 update

As I’ve said in some previous posts, I feel slight aching sometimes in (especially) my right testicle, but sometimes the left one too. It has varied over the months since my vas (even day to day or hour to hour), and my feelings on it have been to wait and watch the trend to see if it becomes less and less over time. Much of the time, the ache is not there at all.

For the most part, it is hardly noticeable. Sometimes it starts to get “bothersome,” but it never interferes with my life. Last week, however, it started to feel just a bit worse, so I decided to make an appointment to see the urologist who performed the op. I just wanted to make sure he was aware that I still noticed some discomfort at times, and should I be alarmed (or could it be an infection). After hearing all of the stories here about how urologists react (not wanting to deal with it, etc.), I wondered how he’d react.

If you read my story, you’ll see that my urologist insisted on a closed-ended, and although I wondered if that was a good idea, I went with it. Since he did not mention open-ended as an option, I wondered what he’d say regarding helping residual pain. I remember he had mentioned that there were things that could be done in the event of pain, like epididymectomy (he did not mention reversal).

Anyway, I really liked my interaction with him this time – he seemed very frank and realistic, and he spent the time to talk to me about it. He did an exam, feeling the tubes, etc. and asking if anything he did felt tender. Actually, it didn’t. He said everything down there feels fine.

What he suspects is going on is that I have some congestion down there, and it’s taking longer than usual to subside. He said that the sperm I produce has no where to go, and one’s body will usually adapt to break down and absorb the sperm, and even that the sperm production will usually decrease a little over time.

He said that about 5% of men have some pain that lasts longer than others, and maybe 1 in 400 have pain that never goes away due to the pressure. And then he said if that happens, it “sucks.” I appreciated his candor in this – from this message you can’t read his tone, but it was basically backed by a caring but a sincere attitude (i.e. not trying to placate me, but being honest).

Following that was the most interesting thing. He suggested seeing how it goes for a while and if it improves. I stressed that it was fairly mild. He also said there were things he could try if it does not improve. The real shocker was that he said he could go in there again and basically cut off the testicular ends and leave them open! An open-ended conversion!

I guess this shocked me since he seemed so in favor of the closed-ended at first. In some ways, you could wonder why he did not give me that option initially, but I guess what I am pleased about is that he is suggesting a possible fix (if I later need it) that goes along with what people are saying in this group. No suggestions of reversal or more drastic measures, which just basically makes sense (I have found it odd to hear of reversals being the suggestion – makes me suspect that whoever suggests that may see dollar signs, as it is much more expensive).

So I continue to hope that the days I feel aching become fewer and fewer, which has been the slow trend in general, but it’s nice to have a relatively simple option with this same urologist, and it’s nice to hear that not all urologists say, “it’s in your head so go away,” etc.

Even though I like being sterile (it makes me feel very free – I now look at other men and think, wow, they probably, have to worry about this!), I can understand why it might really do numbers on one psychologically, since it’s an unexpected mental and philosophical shift. It has made me do a lot of thinking about what sex is and what we are as sexual beings. I think I am now “growing into” my new vasectomy in some regards, getting used to this new reality. I guess what I am saying is don’t be surprised if vasectomy hits you mentally more than you expected. The carefree nature of sex now is different – and it’s great to be able to be so spontaneous. The end result is great, but it changes the way you think about things a little!

July 8, 2004 update

For those of you who have been following this story, you’ll recall that I have had some mild aches since my vasectomy (done September 13, 2002 – coming up on two years). Even though I experienced some similar symptoms many years before my vasectomy, it is clear that the vasectomy has had an additional effect. My plan was to “wait and see” if things got better over time (i.e. if the trend was in the right direction). Overall, it was, but during recent months I feel it has reached a sort of stasis. The aching/pressure, caused almost certainly by sperm back pressure (my urologists opinion backed up by my intuitive feeling about it), would often be absent for days or weeks, only to return (sometimes very mild, but sometimes slightly more bothersome). This made it tough to know what to do since while it was not there, I always became optimistic that I was on the mend, but when it returned, my mind would start to consider taking some action. As you can imagine, this cycle is also irritating, as it tends to play games with your head (getting your hopes up, then dashing them, etc.)!

I am not sure which has bothered me more: the slight ache or the sensation of pressure (which has generally been more common than the ache). This pressure was especially evident after sex, and it took away (only slightly, mind you) from the “release” that sex provides. It was almost as if I kept thinking ejaculation would release the pressure, then realizing, “Oh wait, of course, it can’t!” (Trifold’s story is interesting in that he does experience this relief, theorizing that he is getting some leakage from the testicular vas.)

When I had visited my urologist over a year ago, he said that for some men who have the testicular vas ends closed (my vasectomy was the traditional two-cut closed-ended variety, using cautery and metal clips) it can take more than a year for the body to adjust to absorbing the sperm that can no longer go anywhere and for the resulting back pressure to resolve. And he said some never are fully free of the problem. He had suggested the option of an open-ended conversion as a rather conservative approach to try. Basically, he could open the sealed vas ends on the testicle side. It was a good feeling to have my urologist offer this as an option to think about, but I still waited until now.

I saw my uro again last month, and he said similar things. He suggested several options: open-ended conversion, reversal, or removing the epididymi. A partner at his medical center was the one who does reversals, and he brought it up, I think, to see what my reaction would be. When I clearly indicated that I’d rather not reverse what I set out to accomplish, he smiled and said something like, “Yeah, you wanted to be sterile, or you wouldn’t have had the vasectomy in the first place!” I think, in a way, he wanted to see if I had regrets that would only be rectified by reversal.

He agreed that the right first step if I wanted to go the surgical route, was to try the open-ended conversion. He described it as exactly the same procedure as the original vasectomy, except he would make the cut closer to the testicles and leave the ends open. I went ahead and made an appointment, intending to think about it, but almost sure I would go ahead. I called a week or so before my appointment to ask some questions that came up (pondering his description of the operation caused me to wonder about some details). I asked, through the nurse on the phone, if he intended to remove the original sealed end of the testicular vas, or if he would simply go in and cut again. She got back to me with the message that he had said he would just leave it in there, and that the body should absorb it. This freaked me out a little! I wondered if it would be more likely to recanalize and leave me with the same issue again. I immediately started looking up more info on the Internet, including info on the open-ended page at vasectomy-information.com. I started calling around at this point to see what other doctors might think. I called the doc from Vancouver mentioned on the open-ended page. His office gave me his cell phone number, and I reached him! Unfortunately, since I was in the US, he would not talk to me about it, saying that his insurance recommended not speaking to people from the states because they like to sue everyone (or something to that effect). Damn lawyers in this country! I don’t blame the doc; I blame the litigious society we live in… Anyway, I asked if he could recommend someone in the US with whom I could talk. I guess I just needed to talk about this with a second doctor to give me some peace of mind, especially since it was pretty clear from my uro that this whole thing is in the realm of the unusual! He gave me a name (which I won’t repeat here publicly, since I do not know if he would want this). Anyway, the guy reassured me that my urologist’s plan was sensible and that disturbing the original vasectomy site would probably be less desirable than making a new cut at a different location. These are the kinds of things that we non-doctors would not necessarily think of, I guess. He also called me back later to make it clear that since I am not a patient, I should not construe his words as official advice. I assured him that I understood and I appreciated his talking to me. Read on to find out what actually occurred!

Anyway, I had the procedure on July 6, 2004. It basically was similar to my original vasectomy in many ways (gee guys, how many of us get to do this TWICE! Yippee!) I will say that the pain of the needle was more intense (could be because he was sticking my already pressurized and sore vas). Also, he did use a cautery device, probably electrical, on some of the tissue as he worked (I think in order to get to stuff or cut stuff out – not completely sure). Wow, did this send some weird jolts through me! Not pleasurable, but not too painful – when he noticed my wincing, he applied more numbing I believe. I talked a bit to the doc during the procedure. Since we had talked a lot about this, it was more natural to discuss things as it went on. Now a surprise (to me as well as to him!): on the left (first) side, he pulled out a section of the vas and said, “Hmm, got it!” or something to that effect. He showed me the piece, and I asked him if he got the old end out, and he said yes! I asked him, dryly, if I could keep souvenirs, but he did not quite get my joke (actually, I was only half-joking, and I’m sure my wording was not as clear as it could have been!). Then on to the right side, and guess what: he got that end out too! So, basically, my worry about leaving a segment in there was moot. The old closed ends came free. I thank the urologist for going to the extra effort of removing the tissue. Somehow I feel better about that. I am not sure if the clips came out with the pieces. I think the urologist said he saw clips or “something” – I don’t remember for sure (I think the Avitan/lorazepam made my memory of parts of this a little “funky”). But he also had told me during an earlier discussion that often the clips just fall off the ends of the vas sometime after a vasectomy anyway (and hang out in the scrotum somewhere – nice thought!).

After I got up and got dressed, I walked over to where the surgical tools and stuff were, and there they were: my two 1/2 inch vas ends, sitting on the paper on the metal tray, looking like white maggots with a bit of blood on them. I didn’t see clips (that I could tell), but they could have been buried within the scar tissue, and I didn’t linger long and stare at them. Funny to look at those vas pieces though! The urologist told me he wants to hear, in 2 or three months, if this procedure helped. He definitely showed concern for my well-being as well as (I’m sure) curiosity. I get the impression from him that there is a lot about vasectomy that is in the realm of mystery for the medical community (the same thing we have come to know through this newsgroup). He used the word “murky” at one point in our discussions.

I spent the next couple of days at home relaxing and using frozen peas. The soreness wasn’t too bad (perhaps less bad than after my original vasectomy), and today is day three. I am back at work, and I do still feel soreness. Also, some of the soreness on my left side over the last few days has been deeper up in the groin. I wonder if it’s from extra tugging, as this operation was less straightforward and more “special.” The doc definitely was fishing around more (partly to dig out the old ends, etc.). A bit of bruising is starting to show on the scrotum today as well.

I feel like an old hand at this now: twice as experienced as most men! I am sore from the operation, so it’s too soon to tell what the result will be. I’ll update this again after 2 or 3 months have gone by, but I’m sure I’ll banter about it here in the interim too. I hope this will be helpful to others considering this option, which I would bet is rarely done, although my urologist said he has done it for other men in my situation.

August 4, 2004 update

I still consider myself in the “too soon to tell” category, so I don’t want to try to draw conclusions, but what I have observed so far is that my left side seems in better shape (no real pain, and no pressure). Along with that, I have noticed what could very well be a granuloma on that side, which would be expected from opening the testicular end.

On the right, however, I still have soreness and tenderness in the testicle (in fact, it’s been a little worse, and of a different nature, lately). It does not seem like there is a feeling of pressure, and the pain is perhaps more general to the testicle and vas tube site near the operation rather than the epi. Still, even though there are some enlarged vas areas on the right (near the site), I don’t feel anything like on the left (i.e. perhaps no granuloma has formed on the right). Also, the epi seems as large and firm as it has always been (even for many years before the vas). When I squeeze the testicular vas tube, it is sore, either indicating pressure still there or simply inflammation from the healing process. It’s all very hard to tell at this point.

In conclusion (even though I don’t want to draw any right now), the right side could very well have not changed, whereas I do seem to notice a change on the left. The “nature” of the pain on the right is different, which could be a good sign, I suppose. It could be that the right side was hosed from the beginning. Almost 20 years ago (long before my original vasectomy) I went through mild pain for a couple of years on the right side. They never knew what it was, but perhaps that side has always been blocked. The other thing that worries me is that if it is partially blocked, the outflow might not be enough to keep the opened vas tube open. This is just my own theorizing, but the doc did say the tubes could re-seal in time, but “hopefully the body will have resolved things by then” (a nebulous statement which didn’t seem to be based on actual sureness, but rather it further illustrates how little the medical community understands all of this).

A reversal was mentioned as one potential solution, but my urologist wanted to read my reaction, I think, in that if he suspected I didn’t like sterility, it would have been a better choice.

He agreed that assuming I don’t want a reversal, the open-ended conversion is the best first thing to try. If no relief is achieved, he said removing the epididymis would be the next option, and he said this is often successful.

To answer your question about reversal being on the table or not, for me, I would not consider it, since I don’t want my fertility back. The doctor did not say that doing the open-ended conversion would remove my reversal options, but I was not concerned about it. As for if it’s possible to do a reversal now, I don’t know. Like you, I’d suspect the more vas you remove the harder it is (don’t the balls need some slack in there?); he removed another 2cm or so. Certainly, if one gets his epi(s) removed, I assume reversal is no longer an option!

Another reason I would have been hesitant to get a reversal with my history (and yours, it seems) of pain before vasectomy is that if there is a blockage there anyway, the reversal may not have much effect, at least on that side. It’s an awfully expensive and intrusive option for little or no benefit. But who knows, maybe “partial blockage” can exist, and maybe releasing some pressure can make a difference.

It’s all very mysterious, and all I can do is apply common sense to what I think maybe going on. I doubt the doctor is going much beyond that – the PVP issue is, as admitted by my urologist, not completely understood, but so it is with many facets of medicine (as I got older, I realized that doctors don’t know everything – far from it, and the ones who admit this earn my respect). The key is to find a urologist that is willing to try things. Mine seems to be game, for which I am thankful.

I am back to wearing boxers, which are actually more comfortable (no pressure on the balls!). I biked 26 miles with my wife Sunday, and yeah, it was sore somewhat on the right side, but not too bad; just popped a couple of ibuprofens. Let’s hope for the best – still too soon for me to give reliable info!

Submitted by Giraud