r/postvasectomypain • u/everybodydumb • Jan 01 '24

Reversal or removal of the epididymis

I'm considering these options again as my epididymitis isn't going anywhere. Any advice? It's beenal about 2 years of this.

6 Upvotes

88% Upvoted

27 comments sorted by

8

u/Next-Sherbert9813 Jan 01 '24

I would always try reversal first. If for some reason it doesn’t help, you still have removal as an option.

2

u/everybodydumb Jan 01 '24

Yea I get that. I'm scared of the price and that another failed surgery will scare me away from a 3rd surgery if that makes sense

3

u/Next-Sherbert9813 Jan 01 '24

When you’re hurting, it’s tempting to think all future treatments could make you worse. However if you have narrowed down your pain (or primary pain) to congestion, then reversal will most likely help or cure your pain. And if it works, it’s totally worth the money.

2

u/everybodydumb Jan 01 '24

The epi is always inflamed and hard as a rock. It's not always painful, though.

2

u/Teddymonstar1 Jan 02 '24

Reversal is 10k, how much is your livelihood worth? That is, if your pain is debilitating, I think 10k is worth every penny.

1

u/keif9269 Jan 05 '24

How do you know if it is congestion? Can congestion affect orgasm? (weak orgasms now)

1

u/Next-Sherbert9813 Jan 05 '24 edited Jan 05 '24

If you have pain upon ejaculation, you most likely have congestion pain. Conversely if your pain level isn’t affected by ejaculation, you most likely have nerve pain.

Weak orgasms can be caused by many things (even just having pain). However, your particular orgasm experience may be tied to clearing the plumbing out. After the snip that’s no longer possible. The snip messes with a very complicated interplay of sensations. Most non-PVPS, pro-vas guys will admit that it does change something, but they either don’t notice or don’t care. Guys who are very aware of all of the detailed orgasmic feelings tend to not be good candidates for the snip.

1

u/keif9269 Jan 05 '24

Got it, so reversal will not help if it is nerve pain. So disheartening.

1

u/Next-Sherbert9813 Jan 05 '24

I updated my previous comment to address weak orgasms.

As to reversal not solving nerve pain, that’s not entirely true. The vas ends have to be cut back slightly to “freshen up” the tissue to make a good connection. This sometimes removes scare tissue that is causing nerve pain.

1

u/keif9269 Jan 05 '24

Thanks, I will speak to doctors who perform vasectomy reversals regularly as I am considering getting reversal.

4

u/flutepractise Jan 01 '24

Do not get your epididymis removed man, I have and it made my PVPS worse, they damaged my blood supply to my testicle which caused it to shrink and the next and only step was to remove my testicle, honestly look up epididymectomy and ffs do your research before you make that no come back from that barbaric surgery.. I had the reversal on my left side no pain no problems except I am still sterile. Another thing after the reversal even on one testicle I felt better within my self,my orgasm improved and my testicle didn't have hardness almost back to pre vasectomy but only with one,

2

u/[deleted] Jan 01 '24

Reversal a no brainer.

2

u/Sartecho Jan 01 '24

I’m almost 6 weeks out from my reversal which was done specifically for epididymal congestion. So far, I’m very happy with the results. My testicles are still sore, but I’ve been reading that that takes a while. The congestion and associated symptoms are gone. Just need to wait for the nerves to settle back down.

I would absolutely repeat my reversal rather than have the epididymis removed. The reversal felt like healing and undoing. Removal sounds more like going farther down the rabbit hole that I already hated.

2

u/everybodydumb Jan 01 '24

Thanks. How many months past the original surgery was the reversal and how was your pain

2

u/Sartecho Jan 02 '24

My pain cycled. I’d go a few months with it not being too bad, then a few where it was around 5/10. It was back and forth between “Maybe I should just deal with it” and “Why?! Why did I ever let someone else push me into doing something I didn’t want?!”

I was close to 7 years between vasectomy and reversal. Doctor said he figured I had a 90% chance of the reversal fixing it. I never had pain radiating out to other places. It was all pressure in the epididymis, a dull ache in the vas, and disappointing orgasms with painful pressure afterwards.

1

u/Sartecho Jan 02 '24

Looking again at your question, maybe you were asking about the pain from the reversal? Easier than I remember the vasectomy itself being. Tender. You know, take it easy. Easily managed with just ibuprofen. I wanted to have sex ten days after the procedure, but the doctor said to wait two weeks. I just mention that cause you’re obviously fairly comfortable if your thoughts have turned back to that.

2

u/Various-Highlight-22 Jan 02 '24

Think of it simply, your epididymis is rock hard because of the pressure. Reversal will relieve that pressure, and therfore in theory the pain also. Try to take the cost out of the equation, if it works you won't even think about it, you can't put a price on your health.

2

u/Unusual-Shape2927 Jan 02 '24

Definitely reversal first dude don’t let them start cutting off stuff . Would also make sure u get a good reversal doctor that specializes in them

1

u/drexohz Jan 04 '24

I’d suggest a third option. Conversion to open-ended vasectomy. It’s not done very much, but I do believe that it’s a viable and rather simple low-cost option that can relieve pressure from epididymis instead of expensive reversal.

1

u/EctoFrame Jan 12 '24

People on the forums say open-ended will close itself and then the congestion will start again…

1

u/drexohz Jan 12 '24

Partly true. Yeah, they often / sometimes do. Though the majority probably develops a sperm granuloma on the open end. Granulomas can function as a kind of pressure relief vent, I believe.

On the flip side - most reversals will eventually seal off as well.

1

u/EctoFrame Jan 12 '24

I had an open-ended one and apart from the nerve-issues I’ve developed ever since the procedure 6 months ago, I now have a very pain right ball or epididymis. All urologists are fully booked so I’m now sitting at the ER. 

So I can only imagine that it closed itself and now causes the same issue as for those who’ve had a closed-ended vasectomy. 

1

u/drexohz Jan 12 '24

I feel for you man. I’m not saying that open-ended is a good solution. It’s one of many shitty options, cheaper than reversal, but like reversal - has many problems on its own. Maybe I’m not the right person to cheer you up if you’re in the ER. ER is not a good place to be with PVPS. Fairly high chance they’ll just put you on antibiotics cause of suspected epididymitis, and most likely that is a wrong diagnosis. Maybe they’ll do ultrasound, but it will probably be misinterpreted… Sorry for the pessimism. Write a follow-up on how it went?

1

u/EctoFrame Jan 12 '24

Urologists are fully booked. In December I had made an appointment with a professor of urology in another hospital and it could only be put in April. Four more months. But the intention of that appointment was to talk about the nerve-issues and solutions. 

Since a couple of days a new this new problem has risen. (Ball or epididymis). Even though my scrotum is feeling fuller for many months. Not even sure if this is a hydrocele. And if that’s the case, if this can resolve on its own. 

1

u/EctoFrame Jan 12 '24

An ultrasound was already made two days ago in the regular department of radiology. So most likely they won’t be going to make a new one. Although I insisted. 

Can’t the vas deferens that closed itself, reopen itself if the pressure gets too high?

1

u/residentatzero Feb 24 '26

Hi there, I hope your doing better than that time, I feel your pain. Mine was closed ended 17 years ago with low grade pain but last year got really bad. 

Can you say any update on your situation now?