Mar 242018

Book page

Vasectomy is widely promoted as a “safe and simple procedure.” Rarely are men or their spouses informed that a life long pain condition, known as Post-Vasectomy Pain Syndrome (PVPS), is caused by the procedure. Months or years after being vasectomized, close to 15% of men will experience pain in one or both testicles, with the pain being severe in approximately 5%. Frequently, the pain is worsened by sex and other physical activities, motivating the sufferer to avoid pleasurable pursuits. Too embarrassed to speak up about the problem, many men suffer in silence, and if they do raise the issue with a physician the problem is often misdiagnosed, particularly when years have passed since the vasectomy. In third world countries where vasectomy is intensely promoted as a “safe and simple procedure,” effective treatment is essentially non-existent. Treatment for PVPS often involves sophisticated microsurgery that is very expensive, not covered by most health insurance plans, and not widely available. For those lucky enough to access treatment there is often no resolution of the pain, as it can recur on the treated side and arise in a seemingly unaffected testicle. Vasectomy: The Cruelest Cut Of All (The Modern Medical Nightmare Of Post-Vasectomy Pain Syndrome) debunks the “safe and simple procedure” myth and calls for an end to vasectomy.

The book was published in 2006, and in many areas of medicine this would mean that much of the information is outdated. However, consistent with how the “safe and simple procedure” rhetoric persists in urology and the larger medical community, an intensive search of the scientific literature almost ten years later failed to reveal any studies that actually significantly advanced our understanding of PVPS. Debate still carries on as to the best treatment, with the same old focus on removal of structures. More encouraging is the experimental application of robotic and computerized controlled surgical techniques, offering the potential of more effective vasectomy reversal in the future.

Feb 122017

It has been 10 years since I published Vasectomy: The Cruelest Cut Of All, The Modern Medical Nightmare Of Post-Vasectomy Pain Syndrome. Has the problem vanished maybe because urologists and prospective patients actually get it and refrain from performing and accepting the procedure, respectively, or medical advances have occurred that fully correct the problem? Absolutely not! In some locations vasectomy counselling must now precede the procedure by at least a day, but otherwise nothing. I still receive emails from those vasectomized who have developed ongoing pain, asking for my advice. The latest was from a mid-twenties man, who is somewhat in denial attributing it to short-term complications. Adjusting to the reality of life-long chronic pain from a procedure that never had to occur in the first place is very difficult, and even more when you might be facing 60+ years of pain!


I find it amazing that such a barbaric procedure continues largely unabated, and how so many men fall victim to it despite the information that is out there in my book and other writings. Unfortunately, the money made from performing vasectomies and vasectomy reversals makes it too appealing to physicians. In addition, given that most men who have the procedure do not develop PVPS, and how it can arise years after being vasectomized, it is easy for physicians to downplay the significance. However, approximately 15% of vasectomized men develop some degree of PVPS, with maybe 5% severe and intractable pain. Based upon how men’s health issues, other than for prostate cancer, seem to rate somewhat below dog and cat health problems, I am not too optimistic that the message will get out. However, there is always hope and once again I call for an end to vasectomy. When this becomes a reality I will actually believe that men’s health issues are truly valued.