Vasectomy with complications – A couple’s story

Steve’s Story

I’m a guy who views himself as always “doing the right thing.” I agreed to have a vasectomy in July of 1999, and share my story in the spirit of the fact that I wish I had this information before making an almost irreversible decision. My wife’s current opinion of vasectomies can be found below. This is quite a change in attitude. I had this surgery at her insistence with misgivings.

My symptoms over the last 2 1/2 years:

I had a vasectomy in July 1999. I planned to leave my job in August to join an internet start-up (I knew that my position was about to be eliminated as a result of re-organization and downsizing) and figured that I might as well have the insurance company that I worked for pay for this. I followed all the post-surgery instructions to the letter. I lay on the couch for 2 days with an ice pack on. I didn’t experience the post-surgery discomfort of some men.

Within a couple of weeks, I developed a lot of discomforts related to what I felt to be pressure in my testicles which was centered in the epididymis. I went back for my post-vasectomy checks and the urologist told me not to worry about it, that the pressure would “eventually” go away. I tried to find information about the pain I was experiencing, but there was nothing in the local university’s library and very little information on the web. The only references I could find to post-vasectomy pain on the web indicated that it was “extremely rare” (that 1% number again) and “usually” went away after six months. Over a period of months, this pressure developed into almost constant pain. The epididymis on both testicles swelled to ~10 times their normal size – the epididymis on my left testicle swelled to the point that it was almost the size of the testicle itself. I felt that I had clamps attached to the back of my testicles. In retrospect, this isn’t surprising. We had taken a healthy organ producing millions of cells per hour and closed off the only outlet for these cells. One urologist admitted to me that they do this surgery expecting that men’s testicles will stop producing so much sperm, and mine didn’t.

Nothing seemed to help. I took both over-the-counter and prescription anti-inflammatories. I constantly felt like I had just been kicked in the balls. On top of that, I would occasionally experience intense flashes of pain that I speculate were the result of ruptures in the epididymis as it became so pressurized that it couldn’t cope, in spite of its increased volume. It was especially “interesting” in that this usually occurred in the midst of sex. Needless to say, that was the end of that sexual encounter. I was definitely having the ruptures as I developed granulomas, caused by sperm entering the body. Our sex life virtually ended. I frequently found myself curled up in a fetal position with my hands between my legs saying to myself, “I hate my life, I hate my life….” I began to drink excessively late into the night – at least my balls would quit hurting after 4 or 5 drinks – and I was unemployed – so no reason to get up in the morning. I spent most nights on the couch in the basement.

After about six months, I finally found some relief – the pain went away! The research I was seeing on the internet said that the pain usually went away after 6 months or so – I felt that I had a new lease on life. After about 2 weeks it came back – worse than before. The pain settled into cycles where it would last months, then go away for a week or so. At first, during the times when the pain went away, I felt almost “normal,” with virtually no discomfort. During most of 2001, even in times when the cycle of pain was gone, I experienced a level of discomfort that was constant. While it wasn’t the intensity of the pain I experienced before, it only went away after I went on testosterone therapy. After about three months of testosterone therapy, I talked with my doctor about a reversal. He agreed with me that since I had responded well to the testosterone therapy, that I would probably respond well to a vasectomy reversal.

I had the reversal in mid-January, 2002. 5 years after having the vasectomy. My doctor had warned me that, given my history of pain, I might not respond well and have a lot of pain as a result of the surgery. It was amazing. The pain I experienced after the first 3 or 4 days was no worse than the average day since the vasectomy. I was pretty sore the first few days – a reversal is much more invasive than the original vasectomy – but Percoset helped! The biggest problem I had is that no one warned me that Percoset tends to cause constipation, and I developed hemorrhoids – more painful than the post-surgical pain. I recommend a Metamucil chaser with Percoset!

I am now about six weeks post-vasectomy (March 4, 2002). Our sex life is good again – it’s more pleasurable than before the vasectomy! I am emotionally healing as my body continues to heal. I still have a low level of pain in my left testicle that is especially noticeable about one day after sex, but it’s something I can live with given the hell I’ve been through. I hope that this goes away over time as I continue to heal.

While I have done a good bit of research on vasectomies and post-vasectomy pain over the last couple of years, I am struck by the lack of research on the subject. Most of the research that is being done is in Europe or Canada, where the urologists aren’t financially incensed to continue to cut (I’m in Atlanta, GA-in the US). Most of the articles you find are from the British Journal of Urology. I am certainly not a fan of socialized medicine – my career over the last 15 years has been in the HMO industry – but the urologists in Europe have done some research while those in America seem to refuse to recognize the problem and are not doing the research.

Research in the ’80s and early ’90s indicated that the incidence of post-vasectomy pain (PVP) is about 15 – 20%. More recent studies find a higher rate of incidence – closer to 30%. Conclusions in the later studies I have seen is that of men surveyed 4 to 5 years post-vasectomy, about 1 in 3 have chronic pain, about half of these indicating that the pain affected the quality of their life, with about a third (~10% of the total) indicating they would not have had the vasectomy if they had the decision to make again. This is consistent with the research on this site, where 5% of those who have taken the survey regret having done so because of medical problems. This research, combined with other research published in the medical journals, indicates that somewhere between 1 in 20 and 1 in 10 regrets having had a vasectomy. If I had known this before my vasectomy, I certainly would never have made the decision I made.

There is even less research about the treatment of post-vasectomy pain. One study I saw indicates that approximately 1 in 100 men with a vasectomy actually go through a reversal in an attempt to deal with PVP (as opposed to those who go through a reversal for fertility reasons) – usually at their own expense as this procedure is not usually covered by insurance. That’s quite a different message than any of the urologists (and I’ve seen 4 in the last 2.5 years) would admit until I saw the one I have seen for the last six months. He said I had “classic” symptoms of PVP, and suggested a rather structured treatment plan consistent with treatments that I have seen in my own research. Interestingly enough, the majority of his practice is in infertility. Quite a different message from “it’s mostly in his head” – what the third urologist I saw told my wife. Her response was, “I think that the problem is a little lower than that.” She immediately went to work trying to find another urologist for me. She called all urologists in Atlanta mentioned in one of the “best of …” books, including some at Emory. They all declined to accept me as a patient. She found the current urologist I am seeing by talking with someone she met on the web who has post-vasectomy pain (do a “google” search on “post-vasectomy pain”), who referred her to someone he had talked within the Atlanta area, who had been treated by my current urologist.

The urologists in the US (and evidently other countries, based on the stories I’m seeing on the web) continue to ignore this as a problem. The guy down the street had a vasectomy a couple of months ago. He was on the table and told the urologist that I was taking testosterone injections due to PVP. The urologist laughed, said he had never had a patient with a problem, could not imagine what the doctor was thinking that put me on testosterone, and continued to cut. My neighbor went back a month or so later with several problems – an infection in his incision and testicular pain. The doctor said that he could just remove the testicles and the pain would “probably” go away… a commonly used scare tactic used by the urologists mentioned by all four of those I have seen. The most unkind interpretation of this is that they want us to quit “whining,” go home and keep our mouths shut.

Given my experience and the research I have found since having a vasectomy, I cannot imagine a situation where I could in good conscience recommend this as a risk any man should take. Once the cut is made, there are very few options. While I appear to have a good result from a reversal, the research indicates that only about 80% of those having a reversal due to post-vasectomy pain have a good outcome. While this sounds positive, the Medical Director at my HMO (where I am the Marketing Director) told me that you really want 90+% success rates for surgeries like this…which underlines the fact that the decision to have a vasectomy is a potentially life-changing one that is irreversible in many cases. Other men who go through this see urologists who insist on removing the epididymis, a surgery with even less success than a reversal, and which is even more disturbing – once the body parts are gone, they can’t be put back, and the resulting pain has virtually no resolution. Ultimately, orchiectomy (the removal of the testicles) is the only treatment left for some men – a surgery that brings about even more complications.

I hope that my story brings information to men who are considering a vasectomy so that they can make a more informed decision than mine. If I had known what I know now, I certainly would not have agreed to have a vasectomy. I also hope that my story offers hope to men who are going through the hell of post-vasectomy pain. Stick with it. Find another doctor. Find one who will admit that post-vasectomy pain is a problem for some men. If your doctor recommends orchiectomy, run. Try testosterone therapy. If you can’t find a doctor who will prescribe this, keep looking. If you’re in the US, there are only a couple of urologists that I am aware of whose practice encompasses the treatment of post-vasectomy pain. Dr. Michael Witt is my doctor. I thank God for him and recommend him to anyone who finds himself in the unfortunate position I have been in.

Lisa’s story

Like most women, I thought it was time my husband did his part. I carried the three kids and was responsible for birth control throughout our entire marriage. I thought the least he could do was a quick snip in the doctor’s office. He decided to go ahead and have the procedure in July of 1999. He was planning to leave his corporate job, and go with the internet start-up in August, so he’d have the old job insurance pay for the surgery.

The procedure went smoothly. I had a cold beer waiting for him in the car for the trip home. He spent the rest of the day on the couch with an ice pack and his remote. He had a little soreness at first, but we figured it was post-op and would fade soon enough.

After about a week, marital relations resumed, and although “everything worked fine,” there was a lot of discomfort involved. We waited and waited for the discomfort to go away… weeks turned into months. The new job was a bust, so on top of being unemployed, he was also in constant pain. He sank into a major funk. I spent a lot of time on the phone with the urologist’s nurse. When I finally convinced him to go back to the doctor, we found that with our new insurance, we couldn’t see him. We went to a new guy. He dismissed the symptoms and offered antidepressants. We started to see a therapist and our marriage was getting very rocky, between no job and constant pain.

Sometimes there were periods of little pain, never no pain. Those were great times, everyone was happier. But eventually, the pain would return. Our therapist urged us to see a new urologist. We went to one recommended by our PCP. He began a regimen of antibiotics, followed by anti-inflammatories. He suggested a cord-block. He really had no clue. I called him one day to speak to him about realistic options and hopes. He basically said it was in my husband’s head. I knew it was much lower than that!

I started my own web search. My husband had narrowed his search to research and diagnosis. I wanted to find other people with constant vasectomy related pain. I found this website among others. I got names of doctors, and someone suggested Michael Witt in Atlanta. Amazing, a doctor in our town! We called his nurse and she spoke with the doctor. He was anxious to help us! (I had already called four doctors in the book Top Doctors in America, and none of them were willing to help!). We’ve been seeing Dr. Witt for about a month, and have been on testosterone injections for 2 weeks. They seem to help the pain and have the added benefit of increasing his energy level. We met Dr. Lou Zanovich via the web (he’s in Australia), and he suggested testosterone months ago. We are trying to precertify with the insurance company for a reversal, based on chronic pain. Our therapist has sent info as well toward this end. If the testosterone works, we won’t do the reversal but are trying to cover all bases.

What is my point in all of this? I have several:

1. Do not allow this procedure to be done to someone you love.
2. Post vasectomy pain is real and can ruin your life.
3. If your urologist suggests removing your testicles, run to the door, and do not go back.
4. Get help other than medical. The therapist and the pastor have been invaluable. After the fact, I was told that it’s not really bad on my body to be on the pill forever. Thanks a lot.

I have 3 sons, and they will never have this done to them if I have anything to say about it. I would much have preferred 3 more children, than to have my husband live through this pain, and for my family to live through this hell.

If you are reading this, I hope it’s part of your pre-vasectomy research. Do not do it! If you already have and are in pain, you are probably as mad as we are that no one told you it was a possibility. I am very sorry. Sorry to sound so bitter, but life is hell married to a man who feels like he’s been kicked in the balls!

Update of 6th February 2002

It’s been 4 weeks since the vasectomy reversal surgery. The procedure went very smoothly. The doctor was able to do a simple reconnect, as opposed to the more complex one that connects the vas to the epididymis. While “in there” the doctor found several granulomas, which he removed. The initial post-op soreness was pretty intense, but Percoset helped a lot!

It was three weeks before we tried out the new plumbing. It’s amazing. No pain at ejaculation, no pain afterward. There is still some soreness at the incision sites, as it is a fairly invasive procedure. My husband is not walking around in pain, feeling like he was “kicked in the balls.” We are cautiously optimistic that we have had a successful reversal!

You can only imagine how happy we are to hopefully be through with the nightmare known as “vasectomy.” Please, please, please, DO NOT let anyone you care about have a vasectomy… it’s not worth the risk. Thank God for competent surgeons like Mike Witt in Atlanta, and God Bless this site, for keeping people informed and encouraged!

Summitted by Steve & Lisa