I had a vasectomy on 12/18/03. I was
pretty excited about having this done.
My girlfriend of 5+ years talked to her doctor about getting a tubal ligation. We looked into a vasectomy and realized that
there were less risks, local vs general anesthesia, no
hospital stay, etc. so we decided for the vasectomy. I found out that there was a No-Scalpel
Vasectomy with fewer risks than a regular vasectomy, so I went with that. The day arrived and I took a Valium one hour
before my appointment (as instructed by the urologist’s office). Right after I took the Valium, the doctor’s
office called and asked if I could come in earlier because the doctor had an
emergency to go to. I went in, and the
doctor handed me the release to sign, I looked at it and held onto it expecting
him to start talking about the risks involved (since the release says something
like “I’ve been informed of the risks”).
He started reaching for the release as if I had signed it. I went ahead and signed it. My girlfriend asked if I was going to need to
put ice on my scrotum after the procedure.
He said probably not, but he’ll tell more after he’s done with the
procedure. My girlfriend asked of risks,
and he mentioned the only risks were hematoma and
infection due to the surgery, but those are easily treated. He sent me to another room where the
vasectomy was to be performed. He
started by cleaning the area, then injecting a local into the scrotum (a little
groin pain that lasted 5-10 seconds or so).
He then cut me to start the actual procedure. He told me that he uses titanium clips
instead of cauterization (burning of the vas deferens). He pulled out a vas deferens. Note that on each vas deferens, after he
pulled them out, it felt as though he let the tool dangle from the vas deferens
(it felt like a pendulum hanging from my scrotum that would sway back and
forth). When he finished the first vas,
he had to shoot me with another local (same pain as the first local). When he was almost done with the vasectomy, he
said “I might set a personal record.
That would have been bad if before the operation I said ‘I’m going to
try to set a personal record, huh?’”. He
finished and I stood up. He was going to
show me what he did, and noticed I was bleeding, so I lied back down and he
stitched me up (maybe 3-4 stitches?). I
went out to meet my girlfriend. She had
already paid so we left. When I walked
out the door, I saw the urologist leaving in his truck. I had a few pains from the surgery during the
next couple of weeks (some pinching in the groin and of the testicles). A day after the vasectomy, I had a bruise
running the entire length of my scrotum on the right side. I showed my girlfriend this, and she asked if
that was normal. I said that I read
where some bruising is normal. The bruise
was gone within a few days. I ejaculated
3 times over that period of time (2 weeks).
On 01/03/04,
I had a lingering discomfort in the scrotum throughout the day like a dull
ache, but definitely bothersome. That
evening, I noticed a small soft lump above my left testicle in the scrotum that
hurt to touch. On the morning of 01/04/04 (9:30am), my girlfriend and I had intercourse (still experiencing
discomfort). I looked up stuff on the
internet as to what the problem might be and found Post-Vasectomy Syndrome
(PVS), which can be anything: inflammation, sperm granuloma,
epididymitis, depression, etc., etc. After reading more and more on PVS, my first
thought was sperm buildup that's causing pressure and pain like epididymal congestion. That same day around 12:15pm, I started feeling light-headed. I lied down for a few minutes, and then got
up to go to the bathroom. Right as soon
as I stood up, I experienced substantial pain in the scrotum/groin area (mostly
on the right side). This pain was the
worst pain I’ve ever felt in my entire life – screaming and bent over. It seemed to hit hard every 15 seconds or
so. Throughout the following 30 minutes
or more, the pain diminished every few minutes. I called the urologist who
performed my vasectomy. He said he
couldn’t get to his office until 2:00pm. I said, “I hope I can make it that
long.” I called my girlfriend and told
her she had to come home and take me to the doctor. This pain still came and went (although not
as excruciating as it once was) for several more hours (even after he saw
me). We arrived at the doctor’s office
at 2:00pm. He evaluated me as I was trying hold back the
screams. He thought it might be an
infection. He put me on an antibiotic (Ciprofloxacin)
for infection for 7 days. He mentioned
that it seemed odd for infection to appear 2 weeks after the procedure. He also gave me Hydrocodone
for pain if I needed it. I wasn’t there
for more than 5 minutes. I was skeptical
that infection was the problem. I took
the Hydrocodone occasionally when I was having more
pain than “normal”. The Hydrocodone didn’t seem to do the trick unless I took 2 of
them and even then, the pain would only diminish for about an hour. I had (and still have) a constant pain that
fluctuated in severity throughout every day.
The next day, I got light-headed again, and had to lie down for a few
minutes. These two times are the only
times I’ve been light-headed. I have
gotten sick to my stomach a few more times, but nothing major. Upon completion of the Ciprofloxacin, I
called him again (01/12/04). He evaluated me again and wasn’t sure what
the problem was; he seemed baffled by the whole thing. At this point, the bulk of the pain and
swelling was coming from my right side.
He gave me some Vicodin for the pain and said
to give it time. The Vicodin
helped the pain for longer periods of time than the smaller dose of Hydrocodone he originally gave me. I haven’t taken it much (only one every few
days) since he said it can be addicting.
At this time, I noticed that I’ve had problems going to the
bathroom. For example, it would take
about 15-20 seconds to start urinating. Plus,
I’ve had to get up in the middle of the night to go. I’ve never had this problem before.
On Saturday (01/17/04),
I had sex again for the first time since my immense pain (light and quick). I had a little pain in the scrotum and
testicles, but not much worse than the constant ache (not even close to what I
initially experienced on 01/04/04). The following Monday (01/19/04), I called a urology center to see if
they would see me for a second opinion.
I explained my situation and they said they’d call me back. They didn’t call back so I went to see my
urologist. I explained more of my
bathroom problems such as start/stop problems as well as the length of time it takes for me to start urinating. He did a urine test in a centrifuge and found
nothing (I’m not sure what all he checked for).
I also mentioned that it seems like one of the vas deferens (from the
right side of the scrotum) seems to go up to the op site and seems stuck
there. He could tell what I was talking
about, but didn’t seem too concerned about it.
He said that it might be a vas that hasn’t “fallen” yet. Basically, it’s immovable. He suggested trying hot baths to see if it
helps. He also said that I might have a
sperm granuloma.
I’ve read that a granuloma is hard, so I
didn’t think that was my problem, but I guess it’s a
possibility. He gave me a prescription
for a 2-week supply of Bactrim (for a possible
urinary tract infection). I took this
for the full 2 weeks. My bathroom
problem seemed to diminish a little. I
seem to not have to go as frequently as I once did, plus I only have to get up
every 2 nights or so to go. The
start/stop problem only happens rarely and the initial length it takes to start
is down to about 5 seconds. The urology
center I called did call back the following day and said that I needed to go
back to the urologist that performed my vasectomy (a little upsetting).
I called my urologist again on Monday, 02/02/04, and asked if there was anything else he
could do. He said there were no more
tests that he could run on me. He said
the only other option was to go back in there and investigate, but he didn’t
want to do that until I gave it more time.
That’s fine because I don’t want to go under the knife again just to
find out what this thing is. He
mentioned that my problem still might be a sperm granuloma,
which will eventually go away on its own or could later be surgically
removed. He also mentioned that it could
be pressure from sperm build-up that hasn’t reabsorbed yet. Lastly, he mentioned that he hasn’t done
this, but he’s heard of men converting to an open-ended vasectomy. I started wearing an athletic supporter 24/7
and that has helped on the pain; especially when I walk. I also started taking 15 minute hot baths
when I can (probably 4-5 times a week). I
started taking 600mg Ibuprofen 3 times a day.
I can’t tell if this is making any difference as of yet, but I’m hoping
it helps the swelling. I’ve kept my boss
informed of my dilemma. She had been
going to the same urology center I had called and that wouldn’t see me. She called someone she knew there and
explained my doctor was done with me, but they still didn’t want to see me. As of 02/11/04, I’ve ejaculated (no
intercourse) several (maybe 6-8) more times since my initial pain, and after
each time it feels like my testicles are bruised all over; they get extremely
tender to touch or move. A few hours
after ejaculating, they seem to be back to the “normal” pain that I constantly
feel.
My current symptoms are the following:
1) Left
side of scrotum – very small lump (hardly noticeable) above the testicle that
is a little tender to touch. I only
occasionally feel pain coming from my left side. Currently, I rarely feel pain from the left
side – maybe once a week.
2) Most
of the pain I’m having is in the right half of my scrotum. There is a bigger soft lump (feels like a
firm squishy ball – if that makes sense).
This lump (or the area surrounding it) seems to swell at times during
the day. It is at the top of my testicle
and can be moved around. It causes pain
when I mess with it. It is not attached
to the scrotum, and it doesn’t seem to be directly attached to the
testicle. It could be attached to the epididymis/testicle by some tissue. The right testicle is a little tender to
touch. The constant ache I have is
mostly on the right side. I have since
found out what this problem is (read on).
3) Also
on the right side, there is a small (maybe 1/8” in diameter) round tube that
seems to go up to the base of the penis at the op site and seems stuck
there. I can’t seem to follow it after
that. Following that tube in the other
direction, it feels hard and rough (prickly) and seems to go behind my testicle
towards the bottom end of the testicle.
I lose it about 2 inches down. It
seems to cause pain as well when I mess with it. This could also be contributing to my
constant ache. It could be something
that is normal and supposed to be there, but it’s just inflamed or something? This “tube” is now only hard in one small
spot.
4) At
the base of the penis where the op site is, I get a prickly feeling at times
during the day (not often, but it bothers me).
Also, that prickly, discomforting feeling appears when I have an
erection. It seems like I’m stretching
part of my skin that shouldn’t be stretched (if that makes any sense). This prickly feeling has since greatly
disappeared.
5) Sometimes
(not often) during the day, the pain on my right side becomes more and more
discomforting and I tend to constantly adjust my genitalia hoping that it’ll
feel better. After ejaculation, there is
a little more pain than “normal” and both testicles feel bruised all over and
are very tender to the touch and movement. This bruised feeling in the
testicles still exists after ejaculations – however, the bruised pain has
diminished.
6) After
urination, there is a little more pain in the scrotum than normal, but I
believe that’s just be caused because I’m having to move my genitalia in and
out of my underwear (so it aggravates it).
7) The
simplest little accidental hit on my testicles causes pain. I have to be very careful.
8) At
some point during the day, I get a pinch above my pelvic bone (higher in the
groin). This usually doesn’t last long
(a minute or so). It’s like somebody
pinching something in there, then letting go, then doing it all over again (at
2-3 second intervals or so). It usually happens
once or twice during the day, but there has been one day so far (02/14/04) where this happened several
times throughout the day. It happens on
either side. As of now, this pinching
feeling only happens once a week.
02/12/04
– My thinking of the situation:
Surely it’s not a tumor or anything like that, right? Could it be the titanium clips that are
causing something?
Rupture of the epididymis due to
congestion? I have had no health
problems until this happened. I rarely
ever go to a doctor. I rarely get sick
(even a cold). I definitely have not had
pain in the scrotum area before my vasectomy.
Unfortunately, I have no idea what the initial excruciating pain I had
is contributed to, but a sudden onset of the pain could mean epididymitis, testiticular tumor,
or testicular torsion. Plus, I have no
idea what that “stuck tube” is.
On Friday, 02/20/04,
I called my primary care physician. I
explained my situation and he saw me that same day. He evaluated me, looked at and felt my
testicles. He did a urine test which
came back negative, and he ordered an ultrasound. He also put me back on Cipro
(10 day prescription). He mentioned that
Bactrim isn’t for all of the internal organs down
there. His office called the hospital to
arrange for me to have an ultrasound. I
went in the following day (02/21/04)
to have it done. The lady that did it
started the ultrasound on my right (the most problematic) side. A couple of minutes into it, she said,
“You’ll hear a noise, but that’s just blood flow going to your testicle.” I heard nothing, but I didn’t think anything
of it. She later went to the left
side. A few seconds later, I heard a
noise denoting blood flow. She spent
maybe 2 minutes on the left side and then went back to the right. I again heard nothing, so I was scared. After she was done, I cleaned up and she
showed me the way out.
The following Monday, 02/23/04, I called my doctor’s office at
10:00am and explained that I was scared about the ultrasound results and was
hoping they would follow up with me as soon as possible. I called again at 3:00pm. They said
they’d call around 4:00pm or 4:30pm. No word from them still. I called again on Tuesday, 02/24/04, at 10:00am. They called at 2:30pm
and said the “ultrasound came back normal, there is no mass, and it’s probably
just an infection so continue taking the Cipro.” I was a little disappointed. I called them back and asked if there was a
way someone could explain how my ultrasound came back normal or if they could
show me that it’s normal. They are
giving me a copy of the ultrasound (they never gave me a copy – read on…).
Tuesday, 03/02/04,
I finished the 10 day Cipro and called my general
doctor. He wanted to see me again. I went in and he prescribed another 10 days
of Cipro. On
Sunday, 02/29/04, I finally
thought there might be an end in sight.
I really could tell there was a difference. Right now, I’m going to contribute it to this
round of Cipro (that’s why I went back and got
more). There is still pain, and it seems
to be irritated when I move it (ie: going to the
bathroom, etc.) I still have not received
copies of the ultrasound, but I’m growing less worried about them. As of 03/02/04,
I probably feel 60% better than I did when this pain started. I would say I’m 40% better since I went to
see my general doctor. Things are
looking up!
I finished the 3rd round of Cipro,
and there has been no improvement. In
fact, a couple of days after I got off of the Cipro,
I started having pains on my right side again (like they were when I first went
to my general doctor).
03/17/04,
I turned in a sperm sample to the hospital lab to see if I was sperm free. Since I was there, I requested a copy of the
report from my ultrasound. The report
said that everything was normal: No masses, vascular flow was normal, both
testicles look normal. I got the results
back from the sperm test on 03/19/04. It was a 4 ml sample and it came back “No
spermatozoa seen.” Good news I thought,
until my girlfriend said stuff like “Do you think that it’s ok now, or should
we wait longer and get another test…” I
was a little perturbed because I’ve gone through all this and so far have paid
twice as much more for the pain problem than I did for the vasectomy (vasectomy
cost $500.00 – aftercare adds up to just over $1000.00). Needless to say, we’re not having unprotected
sex as of yet, and if she doesn’t get over her “worried” state of mind, who
knows if we ever will (ok, we did later).
On 03/23/04,
I went back to my regular doctor and he referred me to a
urologist. I saw the urologist on 04/02/04, and he immediately said that
I have a spermatocele, which was caused by
backpressure of sperm. This caused my epididymis to burst and leak out sperm. The body doesn’t know what sperm is so it
attacks it. Basically, there’s no cure
for this besides going in there and cutting it out. Since more surgery could cause other problems
and might not fix this problem, I’m opting to live with the pain for now. I’m probably feeling 70% healed now. That urologist also said I have tethering,
which is basically one of the vas deferens is stuck to some tissue. That’s what the stuck tube is that I
mentioned earlier. I don’t know if
there’s a way to fix that. I would guess
they could tear some of the tissue away, but I didn’t ask. By the way, I’m getting to have unprotected
sex now since we know it’s not an infection.
We’re just not doing it during her “ovulating” time of the month.
Update (08/13/04):
For the past few months now, I’ve felt tons better. I would say I’m over 90% back to normal. The pain is hardly ever noticeable. The spermatocele
doesn’t seem to grow in size and it only hurts when I touch it or move my
scrotum around quite a bit.
Quick Timeline:
12/18/03 Vasectomy
performed (non-scalpel with titanium clips – no cauterization) – stitched up at
op site (doctor had an emergency to go to afterwards)
01/03/04 Lingering
discomfort (constant ached) throughout day.
Noticed lump above left testicle.
01/04/04 Sex in the morning. Immense sharp pains (mostly on the right
side) started 12:15pm that came and
went every 15 seconds – lasted 30 minutes, then pain diminished slowly
throughout the rest of the day.
Saw urologist who prescribed
Ciprofloxacin (1 week)
Pain is mostly on right side
now with a bigger lump on the right side (left side lump is small)
01/12/04 I’ve
realized that the time it takes to start urinating is taking 15-20
seconds. Saw urologist again. He did not know what my problem was. He prescribed Vicodin
for pain.
Sometime this week I was having a
start/stop problem when urinating, plus the frequency has increased
dramatically (3 to 4 times more than normal, plus in the middle of the night).
Also this week, I noticed a tube
leading up to the op site that seemed stuck there (thought it was a vas
deferens, now it might be normal, but inflamed? – it’s
immovable.
01/17/04 First sex since 01/04/04. No immense pain,
just felt bruised and a little more pain than “normal”
01/19/04 Saw
urologist again – told of my bathroom problems.
Performed centrifuge urine test (negative). Prescribed Bactrim (2 weeks).
02/02/04 Finished
Bactrim and called urologist again. He said there’s nothing else to do besides go
back in there and investigate or give it time.
The bathroom problem I was having has diminished slowly (still there
though).
02/07/04 Started
wearing athletic supporter just about 24/7
02/09/04 Started
600mg Ibuprofen 3 times a day. Haven’t
noticed if it’s helping or not. It seems
like I’m getting better by a miniscule amount every week (hard to tell though). Some days are, of course, worse than others
and some times during the day are worse than others.
02/19/04 Ejaculated
several more times since 01/17/04
(no intercourse since then). Pain
afterwards is a feeling of testicles bruised all over and very tender to touch. Bathroom problem seems to happen only once a
day (start/stop plus time it takes to start).
Frequency has dropped to maybe 1.5 times more than normal. I still have
to get up in the middle of the night 3 times a week.
02/20/04 Saw
Primary Care Physician. Performed urine
test (negative). Ordered ultrasound and
prescribed Cipro (10 days).
02/21/04 Had
ultrasound performed at hospital. Feared there was no blood flow on right side.
02/23/04 Called
general doctor at 10:00am for results
of ultrasound. Called
again at 3:00pm. They said they’d
call around 4:00pm or 4:30pm. No call back from them.
02/24/04 Called
general doctor again at 10:00. They called at 2:30pm. Said the ultrasound came back normal, no
mass, and probably just an infection.
They told me to continue taking the Cipro. I asked how this was possible; they are
giving me a copy of the ultrasound.
03/01/04 Took
last Cipro pill.
Could tell there was a difference (hopefully due to the Cipro). I just
noticed that I feel quite a bit better than 1 week ago, but I just noticed it
(at the end of the Cipro).
03/02/04 Went
back to my general doctor and he prescribed another 10 days of Cipro. Today’s the
first day that I’ve had a smile on my face since my pain started. My doctor did mention the term “epididymitis”. I was
a little relieved he mentioned that word since he still feels like it’s an
infection. I’m starting to believe
that’s what it is. I still have not
received copies of the ultrasound, but I’m not too worried about that any more
since my pain is diminishing.
03/13/04 Took
last Cipro pill (3rd round). Could not tell any
difference.
03/15/04 Noticed
increase of pain where I feel discomfort all day on the right side. I had to take a vicodin
(no help this time). Left side seems to
not have any significant pain. I also
feel pain above the pubic bone (more toward the abdomen on the right
side). Plus, right along, the pubic bone
it seems like blood vessels going across or something; if I rub my fingers
lengthwise along the bone, it seems like there's some pain associated with that
(like that makes any sense).
03/23/04 Went back to my regular
"family" doctor. He referred me to a
urologist.
04/02/04 Went
to the referred urologist and right off the bat he said I have a spermatocele due to back pressure of sperm that made my epididymis burst.
The sperm leaked and that’s what’s causing pain. Basically, there is no cure for this besides
going in and cutting it out. Since that
might cause other problems and is not guaranteed to fix this problem, I’m going
to live with it for now. He also
mentioned I have tethering, which is basically one of the vas deferens is stuck
to some tissue. That’s what the stuck
tube is that I mentioned earlier.
08/13/04 Finally
decided to update again. Feel over 90%
better (for a few months now). It only
hurts if I dig to find the spermatocele or if I move
the scrotum around quite a bit (but when do I ever do that?).