Post vasectomy pain syndrome is usually related to the sudden build-up of pressure in the vas deferens attached to the testicle as the testicles continue to produce 10-15 million sperm a day. The tying or blocking off the ends during a traditional vasectomy “closes the system”. This can lead to a cascade of inflammation and serious scarring of the microtubules (these store sperm) that make up the epididymis leading to congestion related pain.
This pain can commence within 1 month of the procedure or as late as years after the procedure. Pain may be on-going. The pain can be short lived and settle with anti-inflammatory tablets, however it can become protracted and chronic. It can be mild to moderate chronic pain and in some rare cases patients can experience debilitating pain where patients can be suicidal.
We are one of the very few clinics treating post vasectomy pain with success. Ultrasound assessment will focus on the cause of the particular pain experienced.
Using anti-inflammatories can help in simple cases, some advocate the use of antibiotics however an infection is not generally the cause of the pain. A revision of the original vasectomy to an Open Ended vasectomy may help and a vasectomy reversal is highly effective in treating congestion related pain providing there is not significant microtubule scarring. Our final option of treatment is a vasectomy reversal.
The most important message is to prevent this pain by performing an Open Ended vasectomy with a proper reconstruction. This avoids destruction and prevents the cascade of inflammation that occurs by suddenly obstructing the vas deferens ends attached to the testicle that usually produces 10-15 million sperm a day. This procedure takes longer and involves more operating skill and experience. In some extreme circumstances nerve ablation, removal of the epididymis or testicle is required. Dr Lekich has found with his personal experience of scrotal ultrasound scanning over 3000 sides of vasectomised males that this modality significantly improves the success of surgery treating post vasectomy pain from other clinics.
**An important note is that there has not been a case of post vasectomy congestion pain resulting from a Metrocentre vasectomy that required surgical intervention, as the condition is prevented by providing a highly specialised form of vasectomy inspired by the microsurgery in reversing vasectomies. A quick snip vasectomy performed by almost every vasectomist may seem simple however the consequences are rarely appreciated by patients and rarely discussed with any detail by doctors performing vasectomies.
Semen is produced by glands located in the pelvis called the seminal vesicles and the prostate, and this is added to the sperm to create normal ejaculate. This seminal fluid makes up about 95% of the ejaculate and so men who have undergone a vasectomy may not notice any difference in the volume of ejaculate.
The testicles will continue to produce sperm after a vasectomy, so if both vas deferens have been tied off, the stream of sperm is simply blocked in the vas tube.
The Owen 3 Layer Micro-Surgical Vasectomy Reversal is a highly viable option for men who would like to reverse the contraceptive effects of their previous surgery
This procedure re-connects the vas tube to allow the sperm to mix with the semen once more to create fertile seminal fluid. There are few viable alternatives to this procedure apart from IVF.
When selecting a clinic to perform this procedure it is highly important that you examine the success rates (not simply the pregnancies) that each clinic experiences.
We perform high volume Owen 3 Layer Micro-Surgical Vasectomy Reversals and vasectomies, making us one of the largest clinics in Australia performing these combined surgeries.