Robert’s experience: Vasectomy problems

In hindsight, my story begins back in 1974 with my wife, June, and I decided to start a family. We consulted our G.P. and on questioning June and me she told us that because June had been on the Pill for eight years without a break it would take time for her to fall pregnant. Imagine our delight when we found that June missed her next period due to her being pregnant. In later years we found that this was a significant factor in my problem. June carried easily and when she went into labor, the medical team had to give her an injection to slow the birth down so they could prep her.

In March 1977 we decided to try for another child and June once again fell pregnant straight away. During this pregnancy, we decided that after the birth of this child we would not have any more children and June brought the subject up with her gynecologist who told her that at the birth of this child he would assess the situation and perform whatever procedure he deemed necessary and least intrusive to achieve this wish. June went into labor at 3.30 A.M. the day after Christmas and, as this is a holiday in Australia, she was handled by the on-call gynecologist and not her own. I got her to the front door of the hospital and she was taken in hand by the staff, and by the time I parked our car, organized our daughter for the wait with me, and arrived up at the maternity ward, June had delivered our son. As the team who delivered our son knew nothing about her wish to be operated on for sterilization they refused to carry out our wish.

By the end of 1980 I brought up the subject of one of us undergoing sterilization and I said to June that at this stage it would be easier for me to have a vasectomy than for her to undergo an operation. June argued this point with me, telling me not to do it but I felt that I should, and with June’s reservations talked to our G.P. about it and the feedback from him was nothing but positive all the way through the consultation regarding this. He sent me to a specialist who also spoke to me in glowing terms of how good vasectomies were. At no time did I hear of anything negative about them and so I decided to go ahead and have it done. June came with me to the specialist on the day I was operated on and even to the last as I was going in she told me to think about it again. I did but still came up with the answer that it would be easier for me than her. A local anesthetic was used and twenty minutes later I walked out to June and we went home. About two hours later I felt a little off and I laid down for about half an hour and that was it, I did not have any more trouble at all. This was done in January 1981.

In January 1983 we moved to the country, at the time about six hours west of Sydney, and started a new life. I had got work within two weeks of moving and we started planning for our house which we were going to build. On getting out of bed one morning in February of that year I was crippled by pain in the testicular area. It was so severe that I almost passed out with it and I just made it back to bed. I couldn’t work that day and spent the morning in agony which, as the day progressed, diminished in intensity. By the afternoon I was up and about so I did not seek medical advice concerning the incident. Two months later I suffered another bout of pain, just as intense as the first only lasting longer. As soon as I could I consulted a G.P. regarding this and disclosed to him that I had had a vasectomy just over two years earlier.

After giving me a physical examination he stated that there was nothing out of the ordinary and prescribed anti-inflammatory medication to overcome my problem. This had absolutely no effect and consulting him again explained this to him. He tried another course of the same medication and left me to it. These periods of pain came and went periodically over the rest of that year without the medication having any effect. At the end of the year, I applied for employment with a government department and this necessitated undergoing a physical examination. The doctor conducting this noted that my blood pressure was slightly elevated but put this down to the anxiety of the examination. I started this job in 1984 with these periods of pain becoming more frequent and even more painful. The G.P., after realizing that his regime of medication was failing to achieve anything, referred me to a urologist who, after examining me and finding nothing, suggested a prostate massage.

I was booked into the hospital and the procedure was done without anything conclusive being found. At his post-operative consultation, he suggested to June and I that a holiday in Fiji would fix my problem and then told me to go back to my G.P. and his follow up letter to the doctor would explain everything to him. This was done but the G.P. was at a loss as to where to go now. He once again prescribed anti-inflammatory medication and left me to it. This medication failed to elicit any response and so back to the G.P. He was not happy to see me again and on this consultation referred me to another specialist. On seeing this doctor and explaining all the facts to him, he conducted another physical examination on me. During this examination, I felt slight pain when he handled my testicles and I informed him of this. His reply to this was “They’re no good to you now, so we’ll cut them out.” To June and I this seemed a rather drastic step and we both thought that there must be some other solution rather than go down that road. At this point, my pain had become more intense and more frequent so we once again consulted the G.P. June and I both sensed slight hostility from him during the consultation and he prescribed medication to help with my pain and now elevated blood pressure.

I was now having to take a lot of time off work due to the situation which was only getting worse. I was failing to respond to the medication and the G.P. was not happy with me at all. On the last occasion that I saw him, I had an appointment with him at one o’clock which would have given me time to see him and get to work for the afternoon shift that I was to do. On coming out of his room to call his next patient he saw me waiting there and on his way back to his room consulted his appointment sheet for the day. My allotted time came and went with other patients who came in after me going in before me. As I was going to the receptionist to inquire as to why I had to wait I suffered another painful attack and collapsed on the floor. The staff wanted to call an ambulance but I knew that if I could ride out the attack, I would be alright. The staff gave me all the help they could and I recovered before the G.P. finally called me into his room. As I sat down he told me in no uncertain terms that if I was there to obtain a certificate for being off work he was not going to issue me one, not being aware of what had just happened in the waiting room. He wrote me a referral for the previously seen urologist and after giving it to me showed me the door, literally. I couldn’t attend work that afternoon so drove the 35 km home, very despondent. When June saw me she had figured out what had happened with the doctor. For the first time, we opened up the referral and read what was written. “Here’s our friend again………”. We guessed that said it all.

Another G.P. was consulted but we got nowhere with him. Another was seen and after three consultations we realized we were once again getting nowhere. We saw just about every G.P. in various surgeries in the small city that was near where we lived and failed to get anywhere with them. Unfortunately, their attitude became that if I failed to respond to their treatment, then the problem that I claimed to be suffering from was not real and in my head only. My problem appeared to June and me to insult their expertise and therefore they wanted nothing to do with us. Once again another G.P. was seen and he tried to work on the problem. At least he was responsive to my plight and really tried to help, unfortunately, he was to take his annual holidays and would not be able to see me for quite some time. Another G.P. in the same surgery was seen and she tried a few medications but they failed to achieve anything. She then referred me to another urologist and so an appointment was made to see him.
After he examined me he thought that somehow there was a build-up of sperm and that it was this that was causing my pain. He admitted that he did not know where to go from there but he was sure that this was the problem. At least June and I felt elated that finally someone really believed us and admitted that there was a problem. At work, I was placed in a position where my work involved constant contact with the medical staff there. They were aware, as was everyone else at work, that I had a real medical problem. They suggested that I see a specialist who dealt with these problems, with his consulting rooms in Sydney. I asked my then G.P. for a referral and her answer was “But I don’t know him.” I replied, “Neither do I but I’m not getting anywhere here.” She wrote a referral and I made an appointment to see him. This was done at the end of 1986 and on seeing him June and I was impressed. He knew what he was talking about and identified my problem stating that he had had several men come through to him with the same problem. He explained that I would have to undergo a vasovasostomy (vasectomy reversal to both vas). He told us to think about having the operation but cautioned us that we needed to make a decision quickly. While we were there he dictated his letter to our referring G.P., starting off with “I can assure you that the pain that the patient you referred to me is quite real.” So, what had the G.P. written?
A few days after seeing this specialist I collapsed at work creating a security risk and had to be taken to hospital by ambulance. On explaining to the medical staff in the emergency room at the hospital about my problem, one of the doctors told me to have the operation as he thought my problem would only get worse, not better. The day after I was released from the hospital I made an appointment to have the operation done but as it was over the Christmas period I would have to wait six weeks. Due to the nature of my work I could not go back until I had had the operation and recovered.

At the end of January 1987, I went to the hospital to have the operation. As I was being admitted June was told that we would have to pay the doctor’s fee of $A 4,000.00 upfront and this did not include his consultant, anesthetist, operating theatre nor hospital fees. Somehow June found the money, not an easy thing at four o’clock in the afternoon especially as we had gone through most of our money with my time off work but somehow she did it. This was the first operation that I had undertaken and so I was like a babe in the woods. The next afternoon I came out of the effects of the anesthetic, numb from the waist down.

Several other men were in the ward who had undergone vasectomy reversals because of their desire to have children again for whatever reason. We were all done by the same doctor in the same morning. This was micro-surgery on a production line. It was too late to do anything about it but this should have been a warning. We were told by one of the nurses that we had to use the bottle for a urine sample and if we didn’t the surgeon would have to place a catheter up us to get the desired effect. I tried, along with all the others, but because of the effect of the epidural, I couldn’t do it. I decided that if I couldn’t feel anything I wasn’t going to feel the catheter. Most of the other men could go but I told the surgeon when he came to me that I couldn’t. He lifted the sheet and then spent five to six minutes just trying to find my penis, I was that swollen. The bruising was unreal, it spread from my navel down to the calves of both my legs. Finally, he started the urine flowing and he couldn’t stop it. By what he said to the nurse I gathered that there was quite a lot more than he anticipated. That was the last time I saw the surgeon. I didn’t see him before I was discharged nor for a post-operative consultation. I had three days to recover in hospital and then I was discharged.

The seven-hour car trip back home was the worst I’ve ever undertaken. June had to drive slowly because I felt every bump in the road and because of the bruising, the blood had congealed whilst I was sitting in the car and it took fifteen minutes for June and our children to get me out of the car and into the bedroom. The next morning June took me in to see our G.P. who, on inspecting the results of the operation, sent me straight up to the emergency rooms at the hospital and the on-duty surgeon who attended me, the same one I first saw years ago and told me to ‘get rid of them’, on seeing my condition, uttered “F..k, what a mess.” He plunged a huge needle and syringe, after a local anesthetic and started drawing congealed blood out of the scrotal area. He worked on me for about 15 minutes before he was satisfied and then he told me that that was the best he could do. I was sent home with six weeks to recover before going back to work. The bruising took six months to fade and that was with the aid of Warfarin, a blood thinner.

About three months later I started to get twinges of the old pain back and over the months, once again, they started to increase in intensity. What was wrong? The operation was to fix this and I’m starting to go down the same track again. I saw my G.P. again and I was referred to a pain clinic attached to a hospital in Sydney. Once again June and I took the trip down. The doctor, on being told the story so far and examining me, told me he was going to give me a canal block. Without any finesse, he shoved a needle into my lower groin area and twisted it around until he found the inguinal canal and then injected the nerve with an anesthetic. You can imagine how I felt after the twisting of the needle. June couldn’t watch after a couple of seconds and apparently, when I got up from the table I was white as a ghost. Bugger, it hurt. He arranged for me to see an anesthetist near home and on consulting him found out that I was to have a series of these until I became well or the course of these injections ran out. I asked him how many I would have to undertake and he told me that 12 would be the magic number. I was to have the injections bilaterally every month until the pain ceased or twelve injections came up, whichever was first.
I was admitted to the hospital on the day of the first injections with him and was taken into the operating theatre after the day’s operations were complete. He spent time swabbing me down with a sterilizing solution and with a nurse in attendance, proceeded to do the right side. Anesthetic can’t be used because I had to tell him when he hit the nerve. The needle going in was alright but the twisting around until he found the nerve was very painful. At least he was as gentle as possible but it certainly is a very painful procedure to undertake. After I recovered June would then have to drive us back home. Although I underwent these injections for six months they had no effect, but my ability to undergo the procedure was waning. After the first one I went back to work the next day but by the time the eleventh and twelfth injections were done I had to take a week off just to recuperate. The whole procedure failed and so in March 1988, I was referred back to the urologist who put forward the theory of why I had problems in the first place.

He did a prostate massage just to be sure that everything was clear in that department. He then suggested to me that he do a Lower Groin Exploratory operation. He felt that because he had seen my scrotum distend and contract during his examination, he thought that the movement may be causing my pain so therefore he would open the scrotal sac and clean all muscle, flesh, and fatty tissue and try to kill the nerves on the spermatic cord. This was done, first one side and then the other but before being discharged from the hospital I suffered another bout of pain, showing that this procedure had failed. However, the testicles, having all their protection with the muscle, flesh, and fatty tissue removed is, every time the scrotal sac contracts or distends or even just walking, rubbing up against horrific scar tissue which makes these movements very painful indeed.

At this time June and I were back to the problem of contraception. In theory, I could impregnate June and we didn’t want any more children, as previously stated. I recalled one of the nurses coming through the ward after we all had our vasectomies reversed and telling us that just because we had it reversed it didn’t mean that we could father children. This thought stayed with me and so I brought it up with June that possibly I may not be able to father any children and we may be using contraception for nothing. June agreed with me so the next time I saw our G.P. I put it to him that I have a sperm count. He refused to do it, for some reason he would not issue the necessary paperwork. I went to several other doctors with the same request and received the same answer but not a reason for not doing it. In sheer frustration, I went to the Women’s Health Centre and put the idea to them. Once again they refused me without an explanation and just before leaving I told the woman I was speaking to “Well, in that case, June will have to go back on the Pill.” At that, the paperwork came out faster than I’ve ever seen paperwork move. It was a nasty trick on my part but how else could we have got it?

I gave the sample and a week later we received the results. At this time seven years had elapsed since having the original vasectomy. My sperm count showed a count of over 90% motile sperm. June and I just looked at it in disbelief, 90%! I rang the hospital to confirm the results and to make sure that they were not mixed up. Because of the rarity of doing a sperm count, it was done under strict supervision and with quite a lot of different people so they could get practice at doing it. There was no mistake. Now things started to fall into place, how easy June fell pregnant both times and especially the first time after the long period of being on the Pill and why I was having the pain. After having a vasectomy a man keeps on producing sperm and the body can only ‘wash away’ dead sperm so any live or motile sperm stays in the system. As it can’t go anywhere it starts to build up and eventually something has got to give. The body over time slowly stops producing motile sperm or what it does produce is accommodated in the system and when it dies is flushed from the system by the blood cells.

The pain was now extremely intense to the point that almost every day I would pass out with it, regain consciousness, and pass out again. This would happen over the period, so I was told, of about an hour every time. I was constantly in pain, never getting any relief. My blood pressure, because of the pain, was registering at 190/150 consistently and I was even feeling pain in the solar plexus in the chest. One day whilst I was at work I collapsed in pain, rolling around the floor holding my groin in one hand and my chest with the other. The medical staff arrived and said that I was suffering a heart attack and called the ambulance. Trips to the hospital from work were now so commonplace that I was on a first-name basis with the para-medics. On this day they took twenty minutes to stabilize me and then transport me to the hospital. On arrival, the staff took my blood pressure, which I knew had stabilized from what it was when I started to have this attack and they got a reading of 210/180. They stated there and then that I had suffered a heart attack. I tried to tell them that I was not suffering from a heart attack but their figures proved I must have. When the enzyme results came back they showed that indeed I had not had one. On returning to work a couple of weeks later one of the medical staff suggested that I confer with another doctor down in Sydney so once again off June and I went.

Once again, after giving him the story to date he very gently examined me and then said to me “This might hurt.” and then touched me again. The pain was so intense that I came close to passing out. After getting dressed he said that my epididymis would probably have to be removed but because of the irreversibility of this operation June and I needed to talk it over. By now June and I had read quite a lot of articles on the male reproductive system and we had a good idea of what was going to happen. The next bout of pain decided us as there was no other alternative so we booked in to have the operation. In November 1988 the surgeon operated on the left side of my scrotum. What he found, as he told me afterward, was that the scrotum was half full of sperm, this being accommodated by the removal of just about everything during the last operation. He also found that the epididymis had swollen to about three times its expected size and had been rupturing and trying to heal itself cyclically over a period of time.

Suspecting that this mess might be cancerous he sent a specimen off to be checked before closing the sac. In December he operated on the other side and found it to be in an even worse state. Whilst cleaning up the damage and once again removing what was left of my epididymis he found that part of the vas had calcified for a distance of about twenty millimeters. I had felt something there before the operation but I didn’t mention it as I thought he might have enough to do. I am very lucky that he was very thorough in his work and discovered this. During my post-operative consultation with him, he brought to my attention that the scar tissue on the inside of the scrotal sac was a mess and he had no doubts that this would be the cause of a lot of irritation to the testicles resulting in a lot of pain to me. In other words, part of the vasectomy reversal had failed to take and allow the sperm clear passage up through the vas.

Although I was not passing out from the pain now felt I was still in a lot of trouble. The tricyclic anti-depressant medication was thrown into the cocktail of medication I was on daily for the pain and high blood pressure. To attempt to go to work under these conditions was ludicrous, I couldn’t drive a car or even attempt to do simple things. I was in a mess both physically and mentally. I was in constant pain and with the clouded mental capacity, I started to become suicidal. I was hospitalized for this and new medication was given. It was noted that the size of my testicles was increasing rapidly and becoming if they could, even more sensitive. Steroids were given to me in an attempt to reduce the production of sperm. At this time it was also noted that my Autonomic Nervous System was dysfunctioning. This was noted by one hand swelling for no reason, I was still in hospital at the time, and then that hand would resume its normal size, and then the other hand would change color. That the system is dysfunctioning is not in doubt but the why is. Some have stated that it somehow occurred during the reversal operation but how is not know. Towards the end of the year, marital problems between June and I came to ahead and I tried to overdose on medication. I was taken to hospital and revived and although suicide has been attempted on other occasions I have failed to succeed. It has not been for lack of trying. June and I overcame our problems for which I am thankful.

Because I was unable to work I had to leave my place of employment and was on Sickness Benefits that Australia provides. This went on for six months and at last, things seemed to be getting better. I found employment again and started work which was a boost for my esteem not to mention financially. Unfortunately, this wasn’t without a pain-free existence. It was decided that the anesthetist who gave me the canal blocks thought that he might try to ‘kill’ the offending nerves to the testicles where they leave the spinal column. I had to take time off work to have this done and initially, the results appeared to be working. The trial injection gave me relief for a few hours and so it was agreed to kill them completely. Another hospital stay was had whilst he performed the procedure.
However this time nothing happened to improve things. Within weeks of having it done, I was back in pain. Another surgeon was consulted and he proposed to go in and physically sever the nerve at the spinal column. Unfortunately, a clip was left on the right side during this procedure and this also causes pain. Before I had my post-operative consultation with him, my G.P. had told him that the procedure had failed. He told me that the nerve had ‘jumped’ onto another track and as such he didn’t know which nerve trunk to sever to achieve the wanted results. He spoke with colleges in Sydney and one of them suggested, after being thoroughly briefed, to apply Nitro-Bid to the scrotal sac to try to increase the blood flow. This was done and it became a horrendous period of the headaches associated with it. If any gains were achieved from it they were negated by these headaches. A side effect from this treatment was that a problem that I was born with manifested itself big time. I had thoracic compression (a situation where the clavicle and the first rib are very close together and cut into the arteries, veins, and nerves as they go to the arms.) In dilating the cardio-vascular system it was just enough to cut the blood supply to both arms. This became so bad so quickly that doctors and specialists in this field feared that unless corrective surgery was done immediately I could lose the use of my arms. This was carried out very quickly, from the recognition of the complaint to operation took five weeks. The operation could not correct this problem, only prevent it from getting worse. However because of the autonomic system dysfunctioning, my entire thoracic region is in constant pain, just another thing to cause discomfort.

At this stage, due to the vicious and constant pain, the doctors introduced me to Oxycodone hydrochloride tablets, a narcotic medication. The side effects of this medication are not pleasant. Constipation is just one of them and it is a battle just to overcome this. The other side effects are not nice but by taking this medication I am at least gaining some quality of life. I hate taking them and it is a constant battle with June although she realizes that without them I would be in that much pain life wouldn’t be bearable. The medical profession has told me that they can not do any more operations because there is nothing more to operate on. Several years ago I was so distraught with pain that I told the G.P. I have now that I was willing to undergo an orchidectomy (removal of the testicles). June and I fought this operation for years but I had just had the pain and I just wanted to remove the source. However, it is now noted that men undergoing this procedure are having problems with pain and other complaints that all I would be doing is swapping one problem for another.

In 2004 June and I attended yet another pain clinic in Sydney and I underwent their regime of procedures in an attempt to get on top of my problem. The final two procedures were an infusion of more narcotic drugs and when they failed, the introduction of a spinal stimulator into the spinal column. This failed and so they tried to introduce it into the inguinal canal. I thought those days were over but for just 45 minutes they inserted needles and twisted them around in an effort to find the nerve. In 2005 I had to have my gall bladder removed and there was one stone weighing a quarter of a pound. This was one of quite a few. During the post-operative consultation, I mentioned to the surgeon that apart from feeling sick I did not suffer any pain from that complaint but for the previous year my testicular pain had been on the increase to a point that I almost couldn’t take it anymore. As he has operated on me over the year and knows all about my problem with the vasectomy he has drawn the conclusion and I don’t take anything he says lightly, that my brain is so used to testicular pain that any pain felt anywhere else on and in my body automatically registers as testicular in origin. That has disturbing ramifications.

I don’t think I could have got to where I am today without the love and help from June. She has been a tower of strength to me and I consider myself very lucky to have her. It has been very hard on our children through their formative years to see me in constant pain, they know me no other way. June and I have lost a lot of our friends due to them not being able to stand seeing me in pain. The few that have stuck by us are great. I am disappointed with the medical profession in that if they had a) believed me in the first place and b) researched everything about my problem (doctors have reported problems with men with vasectomies as far back as the early seventies that I have found out about) and just put themselves out to try and do something. Even though I may still have had my problem, their attitude of “You don’t respond to my treatment so you aren’t really sick” is really a blot on their profession for every doctor that adopts that attitude. I still face disbelief from members of the medical profession today when telling them about my problem. I am lucky that I have now gained terrific medical support but it has come too late for me.

Last, but not least, I to this day tell anyone “Yes, have a vasectomy but look at your lifestyle and have a sperm count done before you go there. Also have the money set aside to pay for a reversal straight away if it comes to it”. June and I have never been given a medical answer as to why I am in the position I’m in. We had to scour the medical books in libraries and purchase books to find out what went wrong. I never smoked nor do I consume alcohol, two things that inhibit the growth of healthy sperm and I used to get out and do things, not sit around doing nothing. It is ironic that had I done these things, smoked, drank, and just lazed around, possibly this would never occur. Well, we’ll never know.

Submitted by Robert