Keith's experience - added
4th March 2004. Updated 20th November 2004.
My story
Dear Webmaster,
I appreciate the resources that you & other sites like yours
provide! I wish that I had known of these web-sites a few years
ago. I may not have had a vasectomy if I had read the letters in
your forum first.
I had a vasectomy between two & two & a half years ago. About ten days after the surgery I resumed having sex & 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 & 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 & downs with my libido & 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 & 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 & 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 & 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 & bi-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 & 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 & 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 & 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 & not related to the surgery. The second urologist said that I am not alone & 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 & 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 & 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 & asked him if further study had been done on this topic. He replied & 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 & 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 & written off as psychological due to the fact that patients in these studies have been stressed about the surgery, or over pressure 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 & 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 & as a result the mechanism that tells the brain that the testicles are full & 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 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 & would like to hear from them. I would post my story under long term & regret given the choice. Just a foot note. 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 & 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 & 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 & 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 & 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 & heard from my friend that had it for about 14 months, it can be far worse & last years. 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 & that the risks of vasectomy are downplayed by doctors & shouldn't be. I even asked him if he had been vasectomized & 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 & 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 & see what happens. It takes two months just to find out if you are on the waiting list.
Thank you for your time & trouble!!
Keith