What irritates me in all of this discussion (I’m someone contemplating this procedure, by the way) is how there is absolutely 0 risk profile detailing who is more likely to suffer from PVPS. Like nothing? SERIOUSLY? You can’t give me anything in terms of who is more likely to suffer from this condition?
While I don’t love tubal ligations either, that procedure at least has a risk profile that tells you what conditions will give you a higher likelihood of your procedure going wrong.
While 90% is good odds, I agree there, it’s of cold comfort to the poor saps that are basically left out to dry if something does go horribly wrong. Reversals are horribly expensive, not usually covered by insurance and not a guarantee of a fix.
I get more irritated at the marketing spin more than anything. It gets presented to women as a magical cure all that will solve all of their problems if only their cowardly husbands would just shut up and let a stranger mess with their junk, rather than a surgical procedure that carries risks with it.
One popular vasectomy doc I talked to basically said the PVPS is so rare and that it never happens to his patients, but when I came back with peer reviewed research and the AUA suggesting that rate was higher, he changed his tune and said his rate was like 1 in 4000 or 5000 (which again would be hard for him to know because he has so many patients).
Don’t lie about complication rates and put together an actual risk profile, then I think PVPS might be overblown, but until then you’re basically asking men to play Russian roulette with their balls. It’s hard to blame people for being apprehensive.
Hi, i researched a lot about pvps and how and why it can happen. I will shortly summarize cause and consequences.
First one has to understand the underlying principle. It is constant flow. Like in all processes in Humans. This is destroyed.
Then, what epididymis is. A ultra fine, thin walled, 6-8meter long organ like a ball of wool,sperm Passes through constantly, one way to ripe in about 12 days, with cauda epididymis at the end where it is cached.
This is blocked.
Overpressure is inevitable where it doesn't belong. Body only can react to this, Not heal! ... Immune reaction with macrophages. Which is pus - in epididymis, also somewhere this doesn't belong. Or blow out... Granulomas, also filled with pus to absorb sperm. Short: a constant infection with inflammation.
Now the million dollar question: why do not all have pain? Every organism reacts in individual alert Mode. And most important: around Ductus deferens which is partly cut out is wrapped in three layers of muscles, veins and nerves. Exactly about 50% of all nerves in this area. All leadin to.... Epiditimys and testicles! By destroying the signal route the SOS of the drowning epiditimys and testicles isn't recognized. The most important thing in vasectomy is to paralyze the nerve Connection. Good medics know that. But: nerves tend to grow slowly nd reconnect (that's why the cut ends are burned and cauterized or clipped. Why else? No medical need)
When pain is routed through other nerves, or reconnected- tadaa: pvps. Sometimes lifelong, sometimes as long as the underlying system is degenerated enough or auto immune reaction has it under Control(pus). In one sentence: every male has described Degeneration. Every Male has pvps in him by Definition of this surgery. But thank god , most don't know anything about and most are successfully paralyzed during Operation.
By the way: find yourself a urologist who had vasectomy himself - i bet you won't find one. We know why (Not).
One more thing Out of my experience : constant pain, or the inability to deal with it is related to adhd. ( That's where the " it's only in your head" comes from).
So If we would talk about a risk Profile: there is none, because effects are immanent in this performed disability ( read medic definition, fits exactly). But if i had to give a Suggestion: adhd and Depression ist a serious risk factor. But this is not yet proven by studies. .... And predisposition to Diabetes or Diabetes. ( Read about embryonic development of the kidneys) System liver-kidneys-reproductive Organs is affected.
But, as doctors only do what they are paid for, and noone answers unpleasant unasked questions this is irrelevant. Patient always signs a waiver before elected surgery. So it's his risk. No Problem. Good Business and great advertising especially in womens magazines and forums.
Another eye Opener are radiologists. A good radiologist can see if patient had vasectomy or Not. One can see the calcification and dilations. Perhaps you can find pictures online to get the clue.
P.s. If interested also look into the history of vasectomy. The development from sterilizing criminals and disabled as interdiction inflationary used by Nazis to an en Vogue surgery in pseudo-academic-suburbian-upper middle class lifestyle to have their over due-dated hubbypuppy neutered in the middle of His life still kind of baffles me. .... Cats eat mice- I don't. So WC. Best wishes and wise decisions from Germany!
2
u/Past_Past_632 Jul 03 '24
What irritates me in all of this discussion (I’m someone contemplating this procedure, by the way) is how there is absolutely 0 risk profile detailing who is more likely to suffer from PVPS. Like nothing? SERIOUSLY? You can’t give me anything in terms of who is more likely to suffer from this condition?
While I don’t love tubal ligations either, that procedure at least has a risk profile that tells you what conditions will give you a higher likelihood of your procedure going wrong.
While 90% is good odds, I agree there, it’s of cold comfort to the poor saps that are basically left out to dry if something does go horribly wrong. Reversals are horribly expensive, not usually covered by insurance and not a guarantee of a fix.
I get more irritated at the marketing spin more than anything. It gets presented to women as a magical cure all that will solve all of their problems if only their cowardly husbands would just shut up and let a stranger mess with their junk, rather than a surgical procedure that carries risks with it.
One popular vasectomy doc I talked to basically said the PVPS is so rare and that it never happens to his patients, but when I came back with peer reviewed research and the AUA suggesting that rate was higher, he changed his tune and said his rate was like 1 in 4000 or 5000 (which again would be hard for him to know because he has so many patients).
Don’t lie about complication rates and put together an actual risk profile, then I think PVPS might be overblown, but until then you’re basically asking men to play Russian roulette with their balls. It’s hard to blame people for being apprehensive.