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Vasectomy

Many patients report that their chronic prostatitis problems began after they had a vasectomy. Doctors and scientists have not provided any evidence which firmly disproves or proves that vasectomy can lead to chronic prostatitis. As is usual with issues unresolved by science, we're not going to tell you what to think, but just present the several arguments and let you make up your own mind. This file contains a number of newsgroup comments and private e-mails on the topic. Most of the names and e-mail addresses have been removed. -- Webmaster.
I've been suffering with pain and a "non bacterial" prostatitis diagnosis for 5 years now, following a painful vasectomy.
I too have had a vasectomy, but I had my first run-ins with prostatitis before the vasectomy. I date my chronic prostatitis (continuous symptoms for 9 years now) to the time I was catheterized for unrelated back surgery. I think the catheter introduced drug-resistant, hospital-bred bacteria into my prostate. But who can prove such a thing?
My feeling is, with millions of men have vasectomies, and millions of men having prostatitis, there will be many cases of both whether prostatitis is causative or not.
Besides, the main thing we have to work on is getting back control over our lives and urinary and sexual functioning, right?

Subject: A Vasectomy Can Cause Prostatis and Epididymitis
Date: Sat, 03 Jan 1998 07:12:00 GMT
Organization: [deleted]
Reply-To: [deleted]

If any of you out there in cyberland have had a vasectomy and then developed acute and chronic prostatis or epididymitis your treatment needs to be handled alot differently. Your Dr. will probably not recognize the corelation between the two for medicolegal reasons.It can be an awful condition.It is called A Late Post Vasectomy Syndrome. Journal of Urology March 1985 Vol. 134 Drs. Selkowitz and Schned.
The truth is out there!--


Subject: Chronic Post-Vasectomy Pain a Reality
From: [deleted]
Date: Wed, 24 Jun 1998 15:43:17 -0000
Breaking my own rule about staying on topic, I bring you this news as a service to the many people who recently posted here about testicular and SV pain. Without their own NG it must be tough.
Tuesday June 23 1:47 PM EDT

Chronic pain rare side effect of vasectomy

NEW YORK, Jun 23 (Reuters) -- Some men may experience chronic pain after vasectomy, however, the evidence still shows that the surgical procedure does not increase the risk of prostate cancer, according to a National Institutes of Health (NIH)-sponsored meeting that took place recently in Bethesda, Maryland.

Dr. Harry Guess of the University of North Carolina in Chapel Hill noted that an NIH expert panel concluded in 1993 that there was no biologic mechanism for a link between vasectomy and cancer. Studies that suggested an association were inherently flawed, he said.

Noting that prostate cancer screening, and prostate cancer incidence, have increased markedly in the last decade, Guess commented, "The more you look, the more you find."

Vasectomy has several known potential complications, including hematomas (bleeding) and sperm granulomas (an inflammatory response to sperm leakage). Chronic pain syndrome may also be a side effect of the procedure, Guess said.

Pain syndrome -- defined as chronic testicular pain lasting longer than 3 months after the operation in men who had no similar type of pain before the procedure -- was first defined in 1985, noted Dr. Allen Seftel, an associate professor of urology at Case Western Reserve University, Cleveland, Ohio.

The incidence of the syndrome is unknown, but it probably affects 6% or fewer of the 500,000 men who undergo vasectomy in the US each year. It is more common after a "difficult" vasectomy. The pain could be due to surgical trauma to the structures around the vas deferens, resulting in "chronic neuralgia," according to a statement from Seftel's group. In affected patients, pain may occur "anywhere along the epididymis or vas deferens. The pain may (also) radiate to the groin."

The condition can be treated with reverse vasectomy, the drug gabapentin, which relieves pain in about 30% of cases, or a nerve block, which can help another third of patients, according to Seftel.


Subject: Re: Chronic Post-Vasectomy Pain a Reality
From: [deleted]
Date: Thu, 25 Jun 1998 19:49:42 GMT
The condition can be treated with reverse vasectomy, the drug gabapentin, which relieves pain in about 30% of cases, or a nerve block, which can help another third of patients, according to Seftel.

Thanks- Some of this info is correct, but some incorrect. A reversal is not going to work. An epididymectomy or vasoepididymectomy are the 2 treatments that may cure this morbid condition.Many are not cured and live a life of chronic testicular and ingunial pain. Most docs do not put on their informed consent the chance of having Post Vasectomy Syndrome. All you guys Don't Mess With Nature.


Subject: pain after a vasectomy....
From: [deleted]
Date: Tue, 14 Jul 1998 19:01:42 GMT

I don't know if anyone here can help me, but maybe they can lead me in the right direction....

I'm in my late 20's, and had a vasectomy a few years ago (had 2 children and that's it!). A few months after the vasectomy, I began to have pain in my left sack if you know what I mean. I went to the urologist who did the vasectomy, and he told me I had an enlarged prostate, which could've been caused by my son who gave me a swift kick there one day... He did the usual exams and thought that I should take a medicine also given for blood pressure - Cardura. Well, I've been on that for a while now, and I thought that maybe things should be better right? They were until I tried to lower the dosage (with his approval). Now I'm getting pain again. Sometimes very sharp. But it is only on the left side. I want to get off of this Cardura, but I can't stand the pain either.

Could this be something else? Does anyone have any tips or comments regarding this? Any other newsgroups that it might be good to post this in?

Thanks to anyone for help...

[deleted]


Subject: Re Post Vasectomy Pain From: szeitlin@UCLA.EDU
Date: Thu, 16 Jul 1998 00:58:30 -0700
Pain after vasectomy is often related to the subsequent obstruction and dilatation of the epididymis that occurs when the vas deferens, which is cut and tied off during a vasectomy, is occluded. If, however the patient has a leak at the site of the vasectomy then they usually do not have pain, but will form what we call a sperm granuloma. If the brunt of the obstruction is absorbed by the epididymis then the patient is more likely to experience pain. Most of the time this pain will resolve. All options for the relief of the pain should definitely be exhausted before an additional surgery is contemplated.

Epididymectomy should not be considered for the relief of this pain in most patients and is an operation of last resort. The patient who ultimately comes to surgery after all other options are exhausted can have a simple procedure to simply open the end of the vas that is still connected to the testis and have the sperm merely leak into the scrotum. For patients who want to have a vasectomy, but still contemplate having it reversed sometime in the future we recommend open ended vasectomies and we routinely perform them. They are much easier to reverse should the need arise.

Scott I Zeitlin, MD
Assistant Clinical Professor of Urology
UCLA School of Medicine
http://www.urol.com


Subject: Re: Strange problem after Vasectomy
From: "David L. Casey, MD"
Date: Thu, 4 Jun 1998 18:08:30 GMT
In article [deleted] wrote:

I am a married man, 37 years old with two kids. I had a vasectomy a few years ago and ever since I have not been the same. I noticed soon after that my right testicle was higher and more to the front than it had been but thought no more of it. About six months later I pulled something down there and it caused me great pain. I went back to the doctor (an HMO) and was told there was nothing wrong with me.

Here is what I have been suffering with ever since. My right testicle is enlarged and drawn tight in the scotum. It rests very high like the cords that suspend it have had all the slack taken out. I have almost constant pain from the general area (a dull burning pain) going up into my pelvis. I cannot where tight under wear such as briefs. I can get some relief by letting the testicle dangle with no support. Boxer shorts work good for this. It has affected my marital duties as I cannot perform as well with the pain.

I went back numerous times to the HMO and they did an exam of the prostate and said I had no problem. They did an ultrasound of the testcle and found nothing. What I don't understand is that they keep telling me that nothing is wrong but I can always see it in their eyes when they see my protruding testicle that something is up. The last time I went there I specifically asked to see the doctor who did my vasectomy. He got irritated when I implied that something went wrong and said that to do anything he would have to cut my stomach open and pull my testicles out through the hole. "You don't want that, do you?" he said. He said I have scar tissue. He went on to say that a lot of people live with pain and so does he.

I have recently switched my insurance from the HMO to a PPO. I am going to see a different doctor at a different hospital to get another oppinion. Anyone have any guess as to what my problem is? Is it possible that the doctor messed up my vasectomy and left me with short cords to my right testicle? Is it a tangled mess in there?

[deleted]

Do a search for the term "post-vasectomy syndrome" here on the group or on other groups or on the web...

David L. Casey, MD
Denton Urology
http://dentonurology.com

This communication is intended to provide general information, and in no way is a substitute for face-to-face medical care. No implication of a doctor-patient relationship should be assumed by the reader.

Sorry, but no questions or requests answered by private email.


Subject: Vasectomy
From: [deleted]
Date: Thu, 26 Feb 1998 19:57:32 -0400
[deleted]:

I am a 47 year old male who had a vasectomy in 1980. About 7 years ago I started to have prostatitis symptoms.
These included nocturnia,pain in the right testicle during ejaculation, & stiffness of the right testicle.
I corrisponded with someone who had an epidectomy which resulted in a cure of their prostatitis symptoms which he informed me were quite similar to mine.
He had the surgery done by a doctor in Georgia.
His e-mail address is [deleted]
If you live close by, I live in Pa., and can find a doctor willing let me know who he,or she is.

P.S. [deleted] also had a vasectomy.

dave


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