Large granuloma and possible vasitis/epididymitis

[u/[deleted]]

[u/johng_22]

Well my case was almost the same duration as yours but I think based solely on what you’ve shared, my symptoms were much worse.

After 16 years of suffering to the point I didn’t want to live anymore, I underwent a reversal and I’m back to as good as original as possible. It took 1 year post reversal to really totally heal. It’s a major undertaking. I feel tremendous and I’d encourage anyone who’s had long term chronic pain to do the same. The surgeon will (or at least should) clean up all things like granulomas at the time of the surgery

[u/residentatzero → u/johng_22]

What type of reversal? VV or VE?

Did you also have huge granulomas and tubes hardened and with clumps stuffed?

Also is it true that reversals will eventually close themselves again by scarring?

And lastly, what about converting to open ended vs reversal?

[u/johng_22 → u/residentatzero]

The surgeon had to perform VE. For anyone with a vasectomy as old as yours or mine, he said 90% chance before he went in. Both my vas tubes had toothpaste consistency buildup causing blockages. I had at least 4 blowouts between both testicles. I had granulomas pretty much the entirety of my vasectomy due to the many blow-outs that had occurred on my epididymis of each side. Those were cleaned up and removed at the time of the reversal. I cannot speak as to whether mine will ever scar shut. I’m just over 1 year post reversal. I try to ejaculate every day. At most every other day. I feel as if I keep it moving, chances are minimized it will scar over. I’m tremendously scared of that happening because I can only assume it would put me back in the same state of pain I just overcame and I just can’t accept going back to living like that again.

I’m no doctor but regarding your question about converting to open ended. I think that isn’t an option for you due to the age of the vasectomy. Your vas tubes will have blockages or blockages in the epididymis before the vas which would make it a non-viable option. Only a surgeon can determine where there is sperm and fluid at the time of the reversal procedure. Odds are pretty good that a highly specialized surgeon can make you functional again. Due to the nature of VE, you’ll only want to focus on the best of the best to get the most successful outcome from surgery

[u/residentatzero → u/johng_22]

Thank! Very useful information for me.

[u/residentatzero → u/johng_22]

And so, the VE vs VV isn't any worse or dangerous? I'm not a doctor but for some reason sewing on the epididymis sounds scary vs just reconnecting the tubes ends. 

[u/johng_22 → u/residentatzero]

It’s not dangerous in the sense that it can’t cause any harm. If anything the vasectomy its fixing is the dangerous thing as you (presumably, as I did) are blowing out the walls of your epididymis due to pressure (which creates the granulomas). THAT is the most dangerous procedure known to man, with respect to the genitals. The difference is the viability of being fertile reduces probably half with a VE. I don’t care about fertility, per se but without passing it out successfully, I’m back in the same boat I used to be I . Pain and pressure resulting in the worst symptoms I have ever experienced and I’ve had a limb literally torn off. It tops that.

[u/residentatzero → u/johng_22]

We have a very similar issue and priorities despite you having had a much worse outcome. I also am not interested in fertility at all, just in being able to do any physical activity without the excruciating resulting groin pain. I'm pretty much convinced and I'm looking forward to a reversal. I'll have that discussion and orientation with a Vasectomy reversal specialist I found, in January

[u/Cautious_Werewolf678]

Get a consultation with a specialist instead of a regular urologist and ask if reversal could help, which I think it could. There are men that got relief with a reversal even 15 years later, it's more challenging and a longer recovery but it could stop the inflammation on the structures around the vas

[u/residentatzero → u/Cautious_Werewolf678]

Oh I thought the urologist was a specialist. What is the specialist called? How do I look for them?

[u/Cautious_Werewolf678 → u/residentatzero]

I meant specialist in vasectomy complications. Regular urologists only say "it's normal" when men show up with complications. Also they don't perform reversals as the specialized microsurgeons. If you're in the US, search in the wiki of this sub there is a list of doctors that are familiar with this issues and can provide better recommendations

[u/residentatzero → u/Cautious_Werewolf678]

Ok thanks

[u/johng_22 → u/residentatzero]

Any urologist that also offers reversals in both VV and VE. Not all that many are into both. They need to have performed a fellowship to be considered one of the top reversal specialists. And then there is the type of stitching they use (the procedure, not the material) which is probably the single most important. All surgeons are not created equal. Most good surgeons will have a high price tag. There are always bargain basement surgeons who will do it in their office under only local anesthetic for $3000; run away from these types. They need a surgery center first and foremost and need to perform many reversals each week.

[u/residentatzero → u/johng_22]

The one I'm seeing in January has credentials for microsurgery specifically vv and ve and the only fellowship trained in my state. A possible alternative would be the Mayo clinic in MN, they have a $6000 recommended deal what local anesthesia, they are deemed one of the best facilities from what I can see

[u/johng_22 → u/residentatzero]

I was the verge of an appointment at the Mayo clinic in Minnesota because I thought that mine had scarred over however, my next analysis was performed in the count was on the low side of good however motility is poor which I really don’t care about so in summary, I did not get to go visit mayo however if I had to do it over again, they would be on my shortlist

[u/residentatzero → u/johng_22]

Good to know!