Keith’s experience: My story

I appreciate the resources that you and other sites like yours provide! I wish that I had known of these websites a few years ago. I may not have had a vasectomy if I had read the stories in your forum first.

I had a vasectomy between 2 and 2,5 years ago. About ten days after the surgery I resumed having sex and was surprised to find a very reduced sense of pleasure during orgasm. The best way to describe the feeling would be to say that the sensation within the testicles was far less pleasurable, especially near the end of the orgasm, followed by a slightly uncomfortable feeling of what seemed like the testicle contracting. I just wrote this off as the first time after the surgery and thought it would be back to normal the next time. Unfortunately, it didn’t go back to normal.

Over the next month, I had ups and downs with my libido and after the first month had past, my libido remained lower than pre-vasectomy levels. I thought this was all very strange because everything I had heard before deciding to go through with my vasectomy indicated that this could not happen. I still want sex and do have sex, but I never crave it like I used to, or enjoy it as much as before. Of the people in my circle of friends, three of us have had post-vasectomy problems, all different though. One with P.V.P. syndrome, another with his testicles swelling to the size of oranges, and me. Maybe the numbers of post-vasectomy problems are higher than reported.

I think that the best way to describe my symptoms would be to say that I feel exactly the way I would have felt pre-vasectomy if I had already had sex and could do without for a few days. The orgasm also feels much the same as it would have felt if the system was low on semen from previous orgasms, except for that strange contracting or squeezing sensation. That was new altogether. That is how I feel all of the time. Just take a moment to think about every aspect of the way that you feel after a weekend of sex. If the opportunity for more sex comes along, what is it like? Get it?

Since this has happened I have been for the standard testosterone test and bio-available test, with levels right in the middle of normal on both counts. I have had the blood test for pituitary gland function come back normal. I have done a questionnaire to assess whether I am depressed. I am not depressed! I am not under any new stress and would say that I am less stressed now than I was three years ago. Don’t get me wrong, this situation does bug me.

The most interesting and surprising things I have learned through this process, have come from the doctors. The doctor that did my vasectomy told me that since he began specializing in men’s problems and doing vasectomies, he has seen about one patient like me a year, of which two or three were proven to have low testosterone. The first urologist I saw said that orgasm is a function of the brain and not related to the surgery. The second urologist said that I am not alone and he sees about one of me a year. To quote him, he said “we all do”, meaning all urologists. Shouldn’t this be setting off alarm bells somewhere? Maybe if this happened to a doctor it would. He suggested that I have a reversal for this, if I am willing to pay, as our healthcare plan will not cover reversals under any circumstances. Even for P.V.P. syndrome. The odds though in his opinion are only about 20 to 25% chance of going back to normal, or just move on and get on with life. He concedes that it is not known why my condition should be caused by a vasectomy, but tells me that studies done conclude that the cause is psychological, even though they have failed to prove one way or the other what the cause is. He says that because no physical cause has been found, it is assumed that the cause is psychological. Doesn’t sound like very scientific methodology.

Check out www.pubmed.com and search their site for post-vasectomy erectile dysfunction to read a report on a study. I contacted one of the doctors by e-mail involved in conducting this study and asked him if the further study had been done on this topic. He replied and said that he hadn’t done any more himself. I think that at first he was flattered that someone was interested in his work. I politely asked him in another e-mail if the numbers were available to support the success of psychological therapy curing these patients and he did not reply.

Unfortunately, it seems that due to the ignorance of much of the medical community or unwillingness to admit that there may be something new to learn on this topic, cases like mine are largely ignored and written off as psychological due to the fact that patients in these studies have been stressed about the surgery, or overpressure put on them by their spouses to have it done, or what have you. Now can anyone truthfully say that the men without side effects have no stresses in their lives? Like the second urologist asked me when we discussed stress, “who isn’t?” (under stress) Men like me know that this is not just coincidence. Just read the postings on the net.

My theory is as follows: I have an open-ended vas, which means that the end coming from the testicle is left open. The other end is clamped with a titanium clip and cauterized. I think that in my case, my testicles are unable to fill with sperm due to the open vas. The sperm continually drains out as it is produced and as a result the mechanism that tells the brain that the testicles are full and that it is time for sex can’t work. I think that it is also the reason, the sensation of orgasm is poor. There is little or nothing in the testicle at any given time. The strange contracting feeling may be the equivalent of a dry heave of the testicles. In another forum on the internet, a man described his testicles as feeling detached from sex after his vasectomy. It is possible that most men don’t have my symptoms, because of a difference in their testicles preventing the testicle from emptying with an open vas, except during orgasm.

At birth one of my testicles was undescended. This was corrected at the age of three or four. Could there be a link to this, combined with a vasectomy? Who knows? Also since the surgery, the formerly undescended one has shrunk, to two-thirds of its pre-vasectomy size. No reason according to the doctors. In any case, I have been seriously considering a reversal. I also give you permission to post all or part of my story on the web. I have read Jeff 3 & Jim 2’s postings and would like to hear from them. I would post my story under the long term and regret given the choice. Just a footnote. The strange contracting feeling went away about four months ago. It gradually lessened leading to disappearing altogether. I don’t know what that means.

20 November 2004 update

I went back to the urologist that admitted my symptoms are known to doctors back in April. As you can see in the discussion forum I have had quite a few guys in contact with the same complaints.

I told him that I was back because I was seriously considering a reversal since he had suggested it and mentioned that he sees about one patient a year like me who stands a chance of improvement with a reversal. Oddly the urologist changed to saying he sees one every several years?! I guess even doctors memories aren’t perfect. I followed up with a list of questions to help me decide if getting a reversal is the way that I should go. He pretty much talked me out of it due to the risks of surgery. This includes going under general anaesthetic, which he says about one in 40,000 die as a result of complications caused by going under anaesthetic. Reversals are far more invasive than vasectomies, hence the need for general anaesthetic. The odds of improvement are poor, about 20% in his opinion and he doesn’t even seem to be convinced himself that the vasectomy can be the cause in the first place. At least he has an open mind unlike most doctors. He said that the risk of losing a testicle to a severe infection or abscess is a real one. Even flesh-eating disease. He says that testicles are almost never lost due to vasectomy, but they (doctors) do lose testicles due to reversal. Because reversals pay well he thought that it would be easy to find doctors that would try to talk a guy into doing it without being honest about the risks. In a worst-case scenario, I might be away from work for weeks or even months and end up being in worse shape than I am now. The reversal might not even be possible depending on the condition of the vas due to scarring. This cannot be determined until they cut you open and have a look.

I am starting to think that I should be happy that I didn’t end up with severe PVP syndrome. From what I have read and heard from my friend that had it for about 14 months, it can be far worse and last year. It really angers me that it has come to this! I told the urologist that he shouldn’t even be doing vasectomies if he hasn’t had one himself and that the risks of vasectomy are downplayed by doctors and shouldn’t be. I even asked him if he had been vasectomized and he angrily told me that I had no business asking him such a personal question?!

I thought that he might suggest referring me to the local sexual medicine dept. but he said that they wouldn’t have a different course of action than he. I decided to call sexual medicine myself to inquire. They told me that they definitely have treated patients with my symptoms but couldn’t tell me anything specific on the phone. There is an eight to ten-month wait to get in to see them and only if they accept you after your doctor submits a form to them. The next time I see my family doctor I am going to ask him to request the referral and see what happens. It takes two months just to find out if you are on the waiting list.

8 November 2008 update

It has been a long time since I updated my story and I have been intending to do so again for some time because I have been to a few appointments that are worth mentioning to your readers.

My doctor referred me to an endocrinologist and I was able to see the rookie quite quickly since the veteran with the long waiting list was on vacation. After consultation and the doctor reviewing my test results for testosterone levels, she concluded that even though my tests were well within the normal range that there would be no harm in trying a low dose of testosterone to see what happens. The risk is that it could cause thickening of the wall of the heart muscle and I would require monitoring with blood tests since in some patients a blood condition can occur. I am sorry that I do not remember all of the specifics because it has been about two years, but it was something like clumping of one of the things (maybe platelets?) that makeup blood. Sounds a bit risky to me. I had a follow-up visit with my family doctor and he told me that under no circumstances would he recommend testosterone therapy for someone with my testosterone level and that prescribing testosterone is not without risks. Here we go again with doctor’s opinions differing. I decided that the risk of this causing a new problem is too high for me at this time.

Well, finally I was accepted by the Dept. of Sexual Medicine and given an appointment. The doctor I was sent to see is a Psychologist which annoyed me since I already know that I do not have a psychological issue. He was a nice guy just the same and interested in hearing my story. In the end, he agreed that they just do not know why men are affected by vasectomies the way I have been but agreed that I am not the only one and that he too would not prescribe testosterone to me. He told me that he would not recommend a reversal, that none of the doctors within his dept. have a special interest in cases like mine, and that the urologist that suggested a reversal as an option and backpedaled later on his suggestion and the frequency of cases like mine as well as omitted these details from the letter he sent to my family doctor was probably just “being careful” by not putting all of the details of our discussion in writing. I think what he meant was that the doctor’s peers could or would think the urologist is a quack if he were honest and didn’t toe the industry line. As I probably said in my original story it, took a lot of persistence from me to get this urologist to actually discuss the topic of my symptoms being anything other than psychological and admit that the cause is unknown and unproven. In the end, the Physiologist concluded that the medical profession largely believes that since they cannot find a physical cause it is assumed to be a psychological problem. That is twice now I have been told that. Strange that so many cling to the opinion that there is no possible way the vasectomy could be the cause. He said that my symptoms are probably either due to nerve damage which is not reversible or provable or a psychological problem. Twice now that I have heard the nerve damage theory. As a psychologist, he looks for and would be happy to discuss the psychological option further with me since that is what he does for a job, as long as this possibility of the psychological cause is on the table for me. It is not! Of course, it would have to be at a future appointment.

I have decided not to pursue this issue any further at this time and I am happy that I have taken my story to all levels of the medical profession that I could. I told two of the doctors (my family doctor & the physiologist) that I wanted to make sure they are aware of guys like me and that I wanted to make sure that they know we do not believe in the physiological BS that the industry is putting out there.

Thanks very much for your hard work on the website and I hope you can find the time to add this update for me.

Submitted by Keith