Joe’s experience: Do your homework!

I had a vasectomy 3 months ago and have had a difficult time dealing with what I went through and continue to experience. I decided to post my story in hopes that someone currently considering a vasectomy might benefit from my experience. Do your Homework! Sadly, I was very uninformed when I went in for my initial consult with a urologist, got checked out, was given only brief information, and told that the vasectomy would be a day surgery at the hospital, and we scheduled it for 3 days later. Unfortunately, it was only afterward that I started looking for more information on the web.

Luckily, I found the vasectomy-information web site. Sure wish I had found it before my experience. All told this is the best location I’ve seen for a very informative and balanced discussion about vasectomies, and I have developed a great respect for the posters and information here.

The Decision

My wife and I had our second and last child 19 years ago, and have loosely discussed the snip or a tubal on several occasions since then. I’d put off doing it for a number of personal reasons, and neither of us really pressed the issue. My wife only made it 2 years on the pill before side effects got too bad, so we’ve been with the “barrier” program (diaphragm) for the last 23 years. Not very pleasant or spontaneous, but it sure worked! Well, on Mothers Day the subject came up again, I asked for the doctor’s name and phone number again, got a curt response about already having the number, and I decided I didn’t want to hear about this anymore and would get it over with.

So I finally called four days later and scheduled the doctor’s visit. I’m going to see the urologist that the wife says everyone at her hospital says is “good”. Although she works there, she knows nothing about vasectomies and has never met this doctor. I’ve never been in the hospital for anything, and only had my equipment checked by a doctor once 25 years ago for a physical exam, so I’m kind of intimidated by all this since I’m fairly modest, except with the wife. Thus, here I am going through all this to have a vasectomy, at the ripe age of 46. Weird as it seems, I see this as sort of a life event. Not that I’m afraid of it, and I know my day in the sun has passed for having kids, but old dreams and hopes are staring me in the face. I always wanted 3 or 4 kids but knew the wife could often not handle two kids, let alone any more.

The Consult

I truly believe and know that my doctor lied to me about what was going to happen at the hospital, and the only risks discussed were the need to take it easy for the first week afterward, and the need to be checked five to six weeks afterward to make sure I was sterile. He never mentioned any possible long-term effects, or changes, etc. As far as reasons for the procedure, I don’t recall ever being asked if I ever wanted to have more children, if my wife was near menopause, etc. Worst of all, he told me he would do this at the hospital, and give me a little something to “relax” me. Everything came across as a “Sure, OK, don’t worry, we’ll take care of it for you” approach, with not a lot of information relayed. Except, of course, the same little cartoon-like booklet that the Hospital would also give me, which was very much pro-vasectomy. Interestingly, since then I’ve seen a men’s health booklet given out by the hospital that states that vasectomies are generally done in a doctor’s office.

Counseling was probably average in the doctor’s mind, but the 2 questions I remember asking were quickly covered and dismissed. Those were about the Vasclip procedure, and the possible link between vasectomies and prostate cancer. Both were quickly dismissed with generic answers, including commentary about doing it the regular way. Snip, tie, fold over ends, and tie down. Main emphasis was on sterility, pictures of how the male equipment worked, and how the procedure would not affect the workings of the equipment. Also, I didn’t know whether to laugh or cry when the Doctor said it would take 20 to 30 times to clear the pipes out for good, and he’d see me in 5 or 6 weeks. I was busy doing the math, thinking about my “average per week, and didn’t ask or hear much more after that. Then to end it all, the customary equipment check and prostate check.

Hospital Pre-assessment

My experience at the hospital pre-admission was also somewhat the same. It was the day after my consult with the doctor, and I had quietly left work over a long lunch to take care of this, hoping no one would find out what I was about to do. The procedure would be 2 days later on a Friday off from work, with hopes of a weekend recovery. To my recollection, the only disclaimer shown to me for my signature was at the hospital, and I did not receive a copy to review and read. It was pushed at me for signature, with little time to read, and only a quick, average sort of explanation. However, imagine my surprise when I start getting asked to sign all sorts of things, and I’m asked about a physician’s directive or living will. All of a sudden, what I thought was going to be a simple procedure at a doctor’s office has turned into a big event at the hospital involving a doctor, anesthesiologist, nurses, perhaps a few observers, and maybe even filming. This was not what I had wanted to have happened to me! Unfortunately, I was so stunned, intimidated, and depressed by the whole thing that I could not even think rationally about what I was doing from that point forward and I just went along in a daze. I was also worried about the expenses incurred and time already away from work.

The Wait

The short wait was extremely long, and I was quite depressed by all of this. I was ok with the procedure itself, but now it seems like some sort of “out-patient” scam that I’m in the middle of. Why do I need a crowd of people to watch, to laugh at my nakedness, and to maybe put me under anesthesia, with an IV jammed in my arm? My wife had said, of course, they would have me under some sort of “twilight” anesthetic, no big deal. However, I didn’t understand what was going to happen to me, and we had no meaningful discussions about any of this.

So I signed a medical living will to basically leave me alone and let me go if anything bad were to go wrong with all this. Never been under, or cut on in my life, and here I am voluntarily doing this, for my wife, and putting myself at risk. Definitely no upside for me, but I’m sure she’s tired of her end of the bargain all these years. Would have done this many years ago if thought it would have made much difference in things. I felt very alone through this week, the doctor visit, hospital visit, the wait, no sex for the previous 2 weeks (wife feeling bad part of the time), test driving myself one last time at 2 am in the morning the day of the snip, and looking at another week before any test driving or joyriding.

The Vasectomy

I went for a run beforehand to wear myself down, especially since I wouldn’t be running for a week or more. Didn’t really want to do this but couldn’t bring me to say no and back out for a while, just hoped it would all end soon. My wife kept saying several times that I didn’t have to do this, and then just about ripped my heart out by making a comment about whether I really wanted a third child. The entire situation was very embarrassing to me, and I was worried about what everyone would say and think if I walked out from where my wife worked, so I just politely told her to shut up. Where was all that 15 years ago? That was probably one of the low points of my life.

I was obviously having strong doubts about all this, still thinking about saying NO before the surgery started, but that chance for a change of mind was not possible since I was knocked out even before I made it to the surgery room, or else my mind was erased by the anesthetic used. It wouldn’t surprise me that even if I had objected at this point the doctor would have gone ahead anyhow since I would have no memory of what had happened.

All went quickly though, and I know nothing about what really went on. Got to the hospital around 11 am, in-room at 11:15 am, a Urologist came by around 12:15 pm, and they took me around 12:30 pm. We were in the day surgery room, IV in hand, hospital gown on, and a nurse and the anesthesiologist got me out the door and down the hall, we went. The doctor was talking to my wife by 1 pm. All I remember is going down the hall, then waking up in recovery around 1:30 pm, and checking to see if the snip was done. I found myself in a jock, with ice, and Mr. Happy frowning at me! Went to a room at about 2 pm, checked out, and went home at 2:15 pm. Of course, when I got home the Diet Coke that I had drunk promptly came up. Luckily that was the only time I threw up. Then, ice, sleep on the bed, ice, lie on the couch, ice, and watch TV, ice, and lie in the chair, ice, more TV, etc for 3 days. What a drag. No running for a week, no ejaculations for a week, no nothing, no life for a week. Just had a black, bruised, peeling sack, and lots of groin-pull feeling, etc.

One Week

We carefully followed all instructions during the recovery period and had no major problems. Then there’s the stubble that will bother you for a while. Not sure that I got a good stitch job on the left side, but I pulled it partially apart the next week and it healed flat and fine. I took a test drive on Friday morning, then the real deal finally on Friday pm.

The Samples

When I took a specimen into the doc’s office 5 weeks later, the receptionist was real sad-faced about it and said the doc was not in yet that morning due to emergency surgery. Anyhow, he came in shortly afterward, checked it, and it was clear of swimmers. Now we need one more sample taken to the hospital, for an extra precaution, and more money for the hospital.

I didn’t sleep much the night before taking the last sample into the hospital. It’s sort of embarrassing carrying around a container with your sample in it, sitting in the waiting room, doing paperwork, finally taking it to the lab, getting that look from them. Spouse was able to pull up the results after lunch, and we were clear for the second time. Somehow, we managed to have no celebration that night for bringing in an all-clear. It was fitting since I’ve been pretty much alone through the whole thing. Ten days later, when checking back with the doctor’s office for the “official” report of the results from the hospital lab, I discovered the results had been in for a couple of days and had been put away in my file. Seemingly they were not going to contact me about the results and acted surprised I was calling to check.

Aftermath

The thing that bothered me most was being under. I really do not like not knowing what went on, what’s the last I really saw and said, vs. my memory. Who was there, who did what, how long, did they laugh or joke, etc. Did I say anything funny or stupid, etc? Not sure I actually had a “general”, but whatever I was given by the anesthesiologist put me out and totally erased my mind of about a one-hour time frame. I probably should have known better, but by the time I knew what was going to transpire I was extremely depressed by all the turn of events from my original idea of the vasectomy process that I couldn’t bring myself to bail out and go find another doctor, etc. I had also pretty much used up my time from work for doctor visits, hospital pre-assessment, procedure, etc., and had already incurred costs. It’s really scary to think that you can be given something to cause permanent amnesia and put you out for a while, especially when you were not really told what to expect. Can’t believe the amount of trust we place in other humans to do this professionally and correctly.

The physical aftermath is that I have had a fair amount of pain for three months afterward now, not major or excruciating pain, but enough to definitely be a concern. Have ongoing testicular pain, sort of low to moderate, which is sometimes worse especially when I’ve been sitting for a while. Has been worse when driving in a car for more than an hour or two. Worse pain is felt at end of one testicle, and I suspect maybe a little bit of epididymis. Overall, still feel sort of like I have a groin pull-type ache, or residual pains as though I’d been “racked”. Torso end of the vas also tends to hurt if I’m not careful where I scratch, etc. I’m hoping that things improve and will not be nagging long term. The good news is that everything is ok for happy times with the wife!

I would be quite happy if I could just get to the point where all this was not constantly on my mind every day, and occasionally keeping me awake at night. Emotionally and mentally this has been the most devastating thing I’ve ever been through and probably dropped me into a state of “clinical depression” from the start. How many people have you had told you that they were so despondent about how things had evolved that they were praying they would just die when they were wheeled off to their “elective” surgery? I have anger and bitterness now that I have never experienced before, and have somewhat of a broken spirit because of how this all evolved. I have followed up all of this with a few letters and e-mails to the doctor, hospital, and local media, bringing up complaints and offering suggestions for making things better for future patients.

Conclusions

As is obvious, I did not have a good experience from start to finish. I will also acknowledge that I did have an elective surgery/procedure, and could have walked away at any time if I had possessed the courage to do so. However, like most patients, I placed my trust in the hospital, staff, and associated doctors and expected that all pertinent procedures and risks would be fully disclosed to me, and I would understand what I was in for.

In summary, my dissatisfaction is a result of several things. I was given very little information by all involved to help make an informed decision. The information flow and disclosure was quite lacking. The hospital arrangement with the doctor for this particular procedure appears to be for everyone’s benefit except the patient. I believe that my life was unnecessarily placed at risk, however low, by the use of anesthesia for this procedure. Based on my experience, it appears that the medical system is indeed a business, and mostly about money, with patients a secondary concern. Generally speaking, I feel like I have been ripped off, taken advantage of, and victimized. For these reasons I’ll do everything, I’m able to in order to avoid dealing with doctors and hospitals ever again after this experience.

My suggestion to others is to not get in a hurry, do your homework, and be as informed as possible. Everyone should know exactly what is going to happen, and not have any surprises. Everyone should also consider all the risks along with the expected benefits of this procedure. Discuss thoroughly with your spouse, don’t be afraid to “Fire” a doctor, and chose the vasectomy procedure and circumstances that are really best for YOU! I failed in all of the aforementioned, and yes, there’s plenty of blame for me also, but the results are that even though I am free of “swimmers” I have lots of deep anger and bitterness about the entire situation, not to mention some pain and body changes. I don’t really regret getting a vasectomy, but I do regret the entire process I went through, and would choose to do almost all of it in a different fashion if I had it to do over.

24 February 2004 Update

I’ve decided to update my story with some information about my recent visits with two urologists regarding some of my ongoing problems. Apologies in advance for the length, I tend to get wordy on occasion. Let me also say a big THANK YOU to Steve and Lisa, and to some of the other recent posters on recent threads about looking for a urologist. I did my homework this time, knew what problems and treatments I might be dealing with, and generally knew what to expect. I benefited greatly from Steve’s post about going through several urologists that had no clue, and eventually going to an infertility doctor. Hence, I had no surprises this time around.

Summary of this update is that I’ve experienced some problems after my vasectomy, found and made an appointment with a new urologist, but first decided to return to my original uro who did the vas to see what he might be able to do. I faxed the following letter to Uro #1 prior to the return visit.

PART 1 (Letter to Urologist #1)

Dear Doctor,

After much consideration, I have decided that I should contact you before going to visit another Urologist concerning several ongoing problems I am having after my vasectomy last June. I have waited until now because I was hoping that several of them would eventually get better, and quite frankly, I’ve been too distressed and embarrassed to really want to discuss all of this with anyone. Anyhow, here is a brief summary of the problems I am continuing to experience:

1. Sore testicles fairly regularly, especially around the epididymis. Always seem swollen and hard, and usually, swelling after any prolonged exertion. Could this be from the congestion of the epididymis, or sperm absorption being too low?
2. Groin pull feeling, in the abdomen behind and above the scrotum, especially on the left. Could this perhaps be from pulling on the vas during surgery?
3. Weaker ejaculations, seemingly less volume.
4. Less feeling and sensation.
5. A moderate amount of erectile dysfunction. Loss of erection sometimes occurs, shortly after insertion or when the spouse is on top. Have also experienced one instance of inability to ejaculate, approximately 36 hours after the previous one.
6. Loss of my libido, urge for sex, sense of relief, etc. Could this be due to a drop in testosterone?
7. Left hand, wrist, and forearm tingling & numbness (fairly regular), and elbow ache. I’m guessing most of this resulted from having an IV in my hand, or something that happened while I was under.

I would be interested to know what you think might be causing each of the above, and what type of remedies/treatments might be possible to deal with any or all of them. I know that there may be a variety of factors causing or contributing to these problems individually and collectively, but I want to emphasize that I have NEVER experienced any of these problems or symptoms prior to my vasectomy. The reason I am contacting you in this manner is that I know we both are very busy people, and I would prefer not to waste your time or my time if you believe that your likely answer to these problems is going to be that they are not related to the vasectomy, that I should stop all running and physical exertion, or it’s all just a mental thing.

Your response would be sincerely appreciated if you have any specific ideas regarding tests or treatment of some of these problems. I would be interested to find out what sort of post-vasectomy problems you have encountered with other patients, and what the results and improvements have been. If you believe an office visit would be beneficial to address this, I would like the opportunity to discuss this by phone in order to understand what sort of examination, tests, etc. might be necessary so that I will have a clear understanding of what we will be doing.

However, if you prefer not to follow up on this with me, I will certainly understand your position. In that case, I would appreciate a referral to one or several other Urologists in the Medical Center or Houston area if you know of any that specialize in dealing with post-vasectomy pain and related issues. Thank you for your consideration.

PART 2 (Visit to Urologist #1)

Visit with #1 went as I suspected it would. He had his receptionist call me to make an appointment, so he had at least seen the faxed letter. However, it seemed as though he hadn’t read much of it or else was poorly prepared. He appeared perplexed the entire time as to why I was there. We went through my list quickly. He quickly groped around my scrotum, said the testicles were fine, no atrophy, thought epididymis fine-not as congested as they normally would be after a vas (So why wasn’t I told to expect congestion in the epididymis at the initial consult?). He didn’t think I squirmed enough during his check to be having pain. Checked for a hernia, all ok.

Then gave me his (apparently) standard comments about sperm being only 2% of the volume, everything is the same and not affected by the vasectomy. Discussing the ED in point 5, he asks if I’ve noticed a drop in my libido, then eventually he realizes that’s my next point. He obviously didn’t prepare to see me or review my letter before coming into the room. He mentions some of this might be psycho-somatic, which I expected to hear. He then waves off my question about my wrist and arm, saying there shouldn’t be any problem with having an IV. Of course, this wouldn’t be a problem if he didn’t put all his patients under general anesthesia for the procedure.

Finally, he gives me his memorized speech about how men in their forties and above should start having their prostate checked every year, and asks about doing this. I’d have been ok with this if he was concerned that some of my symptoms might be the result of Prostatitis, but it was obvious I was getting a memorized speech for an annual check. Sad thing is, part of the original consult was this same speech and his policy to do tube/prostate checks before doing a vasectomy. He obviously didn’t look back at my chart to prepare for my visit, else he would’ve known we did this last June. In the end, he recommends a testosterone check and offers to prescribe an antibiotic even though he tells me he doesn’t think I need one. Says to return when the antibiotic finished, and maybe we’ll discuss pills for the ED if things aren’t better.

My conclusion is that he wasn’t prepared, doesn’t think I have a problem, doesn’t know what to do, and doesn’t really want to deal with me. He claims he does 2-5 vasectomies per week, for 7 years, and I’m only the second one to return with a problem and the first after any amount of time. With that success rate, I would think the entire town would use him! I know that some of my problems probably have a mental aspect, but the pain and several of these problems are definitely not psycho-somatic, and NONE of these things have ever happened before my vasectomy. IMHO, he’s in this for the money primarily, his ego’s larger than the room we are in, and HE’S FIRED!

PART 3 (Visit to Urologist #2)

The good news is that I found a doctor to see in the Texas Medical Center-Houston (one of the finest groups of hospitals and medical facilities in the world, IMHO). I found him through the web searching for reversals, investigated his web site, and sent an e-mail for information about his dealings with PVP issues. He’s a renowned infertility urologist and does both vasectomies and microsurgical reversals. I had also contacted another doctor in town, along with Dr. Pollock in Vancouver.

The first impression of my Urologist #2 was positive, as I received an e-mail reply several hours later at 10:30 pm that day. Said he often deals with PVP, and call to make an appointment. I went in 8 days after my visit with Uro #1 above and had a totally different experience with #2. I actually saw a younger doctor first, who basically did a prescreening for the senior doctor. Both were very thorough, understood my complaints, and with almost everything we discussed they were telling me that what I was experiencing was typical of people they saw with PVP problems. Their almost immediate diagnosis after a thorough check was congestive epididymitis. Uro #2 did an extremely thorough and gentle grope around of the scrotum and testicles, telling me to concentrate, and asking at each spot if it hurt. Of course, it did at several places, which were at each epididymis.

He stated the groin/abdomen pain was likely referral pain and said some of the other issues like the ED things were likely related to the pain and would probably clear up when we got the pain cleared up. He prescribed an anti-inflammatory for the congestive epididymitis, told me to use supporters when exercising for the next month or two until things clear up, and also gave some magic little pills to help with the ED. Uro #2 definitely said I did not have an infection. I also got a thorough check for any link to Prostatitis after asking about it. The reversal was also briefly discussed, only as a later option if our other treatments didn’t work. I pointed out that although I have pain and some problems currently, the pain is not excruciating and I have no desire to have a knife anywhere around the boys again.

My conclusion with Uro #2 is that he is interested in helping me, he has dealt with this before, and he knows what he is doing. I sensed positive confidence in his approach and plan/steps for treatment to help get things better. I’m able to trade e-mails with him in a timely manner when needed and have a follow up scheduled in a month. Also, much of what he told me agrees with the information I have searched out online relating to vasectomy and congestive epididymitis. Don’t know how soon, or even if things will get better, but it’s good to finally have some hope of making progress. What a difference it makes when you do some research and find a doctor who knows what he is doing! Thanks for reading this far, hope it gives someone else with problems a little hope to find the right doctor and treatment plan.

Submitted by Joe