Saturday, November 24, 2012

Vasectomy Reversal for Vasectomy Pain

Every once in a while, I will be posting some scientific literature that deals with vasectomy, reversals and/or PVPS. Like I've said before and pointed out in my book, there are just a scattering of articles on this subject, so when I come across one, I will do my best to share it here.

Today's article comes from the prestigious Journal of Urology, Feb. 2012 and is titled Vasectomy reversal provides long-term pain relief for men with the post-vasectomy pain syndrome - by Horovitz, et al out of Mount Sinai Hospital in Toronto, Canada.

The authors start out by making this statement, "The post vasectomy pain syndrome is a rare but serious and debilitating complication of vasectomy." I think it's important to note that this statement of fact comes from an expert in the field of urology from Mount Sinai Hospital and not some anonymous sufferer, posting his experiences on the internet blogosphere.

Dr. Horovitz states very clearly that vasectomy reversal is a surgical choice for men with PVPS after the medical management of the syndrome has failed. The authors recognize, however, the limitations of this claim in the scientific literature, which is the reason for their article. They want to add to the knowledge-base by providing their findings to the urology scientific community.

The article goes on to describe the results of 149 vasectomy reversals performed in a ten year span. Of these 149 surgeries, 23 were done for PVPS. Sadly, only 56% (14) of these men completed a questionnaire to better understand their symptoms and course. This may give us a little bit more insight as to why it is so difficult to get a handle on this syndrome. Men just simply do not want to discuss it.

Here is what the researchers found. Testicular pain occurred on average 19 (+/- 42.5) months after vasectomy and the average age was about 43 years of age. The men suffered pain for about 50 (+/- 34.9) months before having vasectomy reversal. After the reversal procedure, pain improvement was described in 93% of the men, while 50% were completely pain free. There was a 15% recurrence of pain to baseline (2 of the men), however, 79% claimed a durable positive response to the vasectomy reversal.

The results of this study tell us two things. One, PVPS is recognized by the urology establishment as a syndrome associated with vasectomy. Two, reversal is a legitimate, albeit, poorly studied course of action for those suffering from PVPS.

I developed this nerve pain after my reversal. So it is not the slam dunk it may at first seem to appear. More study is obviously warranted. And you know, I'm sure I could undergo some type of "clean-up" surgery to help relieve my pains. But the risk/reward justification isn't quite yet there for me.

As far as my symptoms and pain go, I had a good night last night and this morning all is quiet on the southern front, sort of speak. The ibuprofen I took a couple of nights ago, seems to have helped with whatever racking/nerve pain I was experiencing.

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