I was thinking about pain in the vas deferens, can you actually feel it, is it the vas deferens that actually is hurting, etc. This brought me to an article describing the role of patency in vasectomy reversal for patients suffering from PVPS. Most guys, including me, who undergo a vasectomy reversal are hoping the reconnected plumbing will remove the back-up congestion. Thus, relieving the stress on the epididymis.
An article in the International Journal of Impotence Research in September of 2012 looked at this very issue of patency. The article is entitled, "Efficacy
of vasectomy reversal according to patency for the
surgical treatment of postvasectomy pain syndrome" by JY Lee, et al in Seoul, Korea.
They isolated 32 patients who underwent a vasectomy reversal for PVPS over a 10 year period. Of the 32 patients, 22 participated in the study. Patency was achieved in 68% of the men or about 15/22. The overall satisfaction with the procedure was scored categorically as follows: (a) cure, (b) improvement, (c) no change, or (d) recurrence.
There was a significant difference in this satisfaction score based on patency; those with patency reported higher satisfaction than those without patency. The authors go on to conclude that patency achievement with vasectomy reversal in PVPS patients has a direct relationship to surgical satisfaction and overall pain reduction.
So the goal for vasectomy reversal for PVPS patients should be the same as those looking to reverse their infertility, patency of sperm.
Showing posts with label study. Show all posts
Showing posts with label study. Show all posts
Monday, December 17, 2012
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.
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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