OP: Post-Vasectomy Pain Syndrome (PVPS)?

As you, Red, I had never heard of this until your post. Or, if I had in some urology course, I had forgotten it. So, off to the urology department to get educated. What the urologist friend, a male, told me was that, yes, it is real in perhaps two or three percent of all cases. As with any surgical procedure, there are risks. This is one that should be discussed with doctor before the snip. In most cases the symptoms can be addressed with some corrective procedure that does involve another, similar surgery; in fact, most resolve themselves within a few months. There have been a few in the medical literature that have never been resolved. My reference states that he has never heard of late onset problems; any issues will show up within a month or so.

He also said that there is a noisy minority, similar to the anti-circumcision group that attacked the Board a few years ago, who think that messing with the body is wrong. There are enough who have experienced some post-surgical problems to fan the flames. As for the article you cite, it is a gross overstatement. The urologist told me directly that anything with one-in-three problems would not be performed by any responsible urologist. As for the list of diseases purported to be related to vasectomy, most are absolute rubbish. MS? No way. Multiple myeloma? Same. Even I recognized this.

WebMD has a more balanced discussion of vasectomy and its risks. For several years there was a suspicion that prostate cancer was somehow related but subsequent, long term research has debunked that myth. As for the statement in your link that sperm in the bloodstream is dangerous, nonsense, but part of the urban myth surrounding male sterilization. Excess sperm in all men who do not discharge it frequently is reabsorbed into the bloodstream exactly as occurs after vasectomy.

I have never performed a vasectomy - not common in trauma surgery - and have only followed a few cases. All that amounts to is sperm count a few weeks after the procedure and reminders to pack it in ice if swelling begins. My reference has been a professor of urology and has taught the procedure for over thirty years. The bigger problem, in his view, is the number of men who impregnate a woman between the procedure and the clearing of all sperm from the system above the cut.

OP: Brandye 11/11/2012

Posted: 23 Sep 04:35

Great that you consulted an experienced colleague on this! :)

So, if I understand this correctly, the issue of this 2-3% is pain? Which in most cases will go away or can be corrected
You write that the most of the list of deceases mentioned on the linked site is absolute rubbish. May I conclude that the rest of this list is very unlikely?

Yes, I do think there may be a "messing with the body is wrong" minority who only create fear just to reach their goal. Which is very sad. I actually find it despicable. Since it creates wrong information and unnecessary fear.

But I also think there is a minority of people who are genuinely in pain and who mean to warn others. Mixed with the anger of not being told themselves, such "warnings" may even take excessive shapes. And include symptoms/deceases that are really rubbish. After all; for these people it may be hard to trust a doctor on that other symptoms/deceases they experience can't be caused by their vasectomy, when they weren't warned about the pain-symptoms that are. Or even; told in advance there were no risks when they explicitly asked their doctor to tell them. The trust is simply damaged. In other words; I think there are people who genuinely believe they are warning people about real consequences, when they really aren't. Catch my drift?

In general; I do think that -as you've pointed out yourself as well- doctors should take educating their patients very seriously, as well as answering their questions. Even though it seems like a waste of time to warn the 97% of patients that will never encounter any of the risks that come with a procedure. It's to ensure that the bond of trust isn't damaged. And I believe that trust may actually be the most important thing between a doctor and patient.

RedRoses

Posted: 23 Sep 04:36

As usual, Red, we are in agreement. For any medical procedure there are risks and these should be spelled out for the patient in all cases. This, vasectomy, even includes a very unpredictable, but easily dealt with risk.

In a relatively obscure study on quality of sex life following vasectomy, I think in the U.S., a very small number of wives involved were discovered to have become, at least temporarily, non-orgasmic. Clearly a psychological thing. When the researchers dug into it they discovered that some women were feeling short-changed or not getting all they had coming to them with the sperm now absent. It was a simple matter of educating but, if the women had anticipated this, it would likely have been prevented.

Brandye

Posted: 23 Sep 04:36

Yes, I have heard of that too. Guess it points out once more how sex starts in the mind :) Why sex is fun and exciting to a person, is something we usually don't question, but can have interesting effects when the situation changes.

I've also seen a casestudy about a couple of who the wife had become really uninterested in sex after his vasectomy. While he was all up for it as soon as he was cleared, it seemed like her sexdrive had been snipped. She hadn't expected this, didn't understand it and just had sex to not hurt his feelings. But he could sense something was wrong. So frustrations started to rise and weigh down heavily on the relationship, leaving both of them close to depression. They were about to call this vasectomy the thing that ruined their relationship.

It turned out that subconsciously the main excitement of having sex to her was the possibility of becoming pregnant. She had her first child young and had 4 babies, so sex and sexuality had always been intertwined with pregnancy. Even though she didn't want another baby and they had been using birthcontrol for the past years now. It was just the (subconscious) thought that it could still happen. As soon as she realized this, she could start the process of giving sex new (main) meaning. It took her a while to shift her mind around that. As it did for him (through this revelation he did understand her better, but it also made him feel like he had been a sperm-machine all these years and felt sexually unattractive now). But with counseling they became a happy couple again.

RedRoses

Posted: 23 Sep 04:37

What causes the woman to enjoy the risk of pregnancy? There have been posts in many threads over the years citing risk as a real turn-on. This has usually been related to the risk of getting caught or having sex in unexpected places but the very risk of being a sexual woman is less documented. Every single organ and part of the male body has a direct equivalent or analogue in the female body. We women, however, have two unique organs with no equivalent in the male body. Both genders have nipples and all the same parts that keep us alive. Where the parts are not really the same, they have analogous parts and organs. The Skene's Glads are female equivalents to the prostate; the vulva and scrotum are considered equivalents; gonads are gonads, though the man's hang outside the body while women have ours safely tucked away in the lower part of the torso; the penis is simply a way overgrown clitoris.

But, our two unique organs are internal and each has, through evolution, developed a single purpose. The uterus has no equivalent in the male and is designed simply to grow a baby to the point that it can survive outside the mother's body. The vagina, similarly, has a single purpose (though we sometimes use it for other functions) and that is to extract semen. The extraction is even positioned by the vagina to increase the likelihood of pregnancy. It is this singularity of purpose of parts of our bodies that make us unsatisfied when they are frustrated. I have never had children although I likely experienced one pregnancy at the age of twenty. My uterus, therefore, has never served its intended purpose. I had decided early in life that I did not want to have children and have sublimated those desires, but, there have been sexual encounters (special encounters with special men) that resulted in my lying there wishing fervently to become pregnant. The feeling passed, usually over night. Women who have had their expectations revolve around children will possibly subliminally respond to the absence of sperm in the ejaculate they are receiving. And, they may not even be aware. This is what is referred to above as "being short-changed." It is the special parts of our bodies that we have lived with all our years that drive us to this desire and despair.

Similarly, and this I feel because in not wanting children my vagina has become my focus, there can be an intense satisfaction through sex by receiving the semen in our vaginas where "it belongs." As I matured I found that sex with a condom became less gratifying, not because of the feel (I rarely notice properly placed condoms), but because I was not receiving the semen to absorb into my system and sperm to swim around in me for a few days.

These psychological responses of women to partners having a vasectomy are understandable. Most women simply feel relief that they no longer need concern themselves with pregnancy and the rest could as well if they are prepared for it. Perhaps a few counselling sessions are indicated for both partners. It is interesting that there are no accounts of women having similar sexual letdowns after having their tubes tied. Perhaps because they are the ones taking the action and making the decision, they are more prepared for it.

Brandye

Posted: 23 Sep 04:37

I guess that -as every so often- it seems too black-and-white to call it "just" psychological. From my perspective; I would say there's a complicated system that thoroughly links the mind to the body. Often the hormonal system is the main suspect, since from research it appears this system regulates both many physical functions as much as it coincides with every emotion we go through. Maybe "risk" isn't really the right word in this case. As it seems to be more than thrill-seeking. It seems more of a desire in an instinctual and raw way.

I for one loved one of your posts (which I'm sad to be unable to retrieve now) where you thoroughly describe both the physicality and the romantics of receiving semen; how it absorbs inside a woman's body and becomes part of her.

If I can speak for myself; I can go as far as to say that sex doesn't really feel complete without receiving semen where it belongs. Which may sound very sad from the liberal and feminist point of view ;) But unlike you, I can't be sure if it's really the receiving of semen that makes the difference. I can't confirm that it is because I've had a wish to have children for as long as I can remember. I can't say if it would make a difference if the semen was without seed. Or that it is because the chemistry of the lovemaking simply changes because of the absence/presence of a condom.

Interesting question would be; are there men who experience unexpected (emotional/psychological) effects after their vasectomy? I mean; I know there are men who have this (powerful) urge to procreate, but don't want a child. Some therefor start donating their semen in order to fulfill this purpose. Now I'd think that these men wouldn't opt a vasectomy until they feel they've completed their task. But could the lack of procreation have an effect on other men who weren't as aware of it prior? Or encounter an effect of the re-absorbing of semen? I don't mean in terms of decease or physical pain, of course :) And I'd say the delicate effect of a woman absorbing his material, would make it different from a men re-absorbing his own (I'd think re-absorbing our own materials is a daily practice inside our bodies that goes without noticing), but you'll know that better than I.

RedRoses

Posted: 23 Sep 04:37

Well, I can say for a whole after my second vasectomy and once I was sure sterile, I had an effect I wasn't expecting.

I didn't have any unusual pain, or even a feeling of "worthlessness". However, I noticed my sexual "fun" had decreased, and I personally believe tha it was due to a fair amount of danger exciting being removed. Notated that the birth control via pull or condom or whatnot, you still know deep in your mid that "ok, if we screw up we could get pregnant again". Even things like we'd have sex without a condom randomly when not on the pill and had to count says or whatnot and even a pregnancy test to be sure. Not a big deal as we are astride family already, but none the less.

But now, we could have sex constantly for another and nothing will ever happen. Ever. My mind sees it as that part of my life is over. So without that's meal risk sometimes sex feels too easy. I'm not sure I'm saying this right but it's like the excitement you get from the unknown is gone. I'm just currently trying to supplant that energy with other forms. Being more risky with where we have sex, subtle things like that.

Firmus

Posted: 23 Sep 04:37