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The book was published in 2006, and in many areas of medicine this would mean that much of the information is outdated.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.