rbungay

I've decided to have a vasectomy conversion to open-ended or a complete
reversal. My GP is researching doctors in the Ottawa, Toronto or, Montreal.

Is there anyone out there who knows a physician who can do either of these
two operations in these areas and who you would recommend?

I've come to this decision after much research and correspondence with some
very kind people through this forum. It may shock some to learn that I've
only had PVP for 3 months but for me that is more than enough. It will
likely take a minimum of three additional months to find a doctor and
arrange the procedure so I'll be looking at 6 months then. Perhaps the
problem will self correct by then and I can always cancel. However, my gut
feeling is that this is a long term problem with a high possibility of
future complications. I want a reversal or conversion before my body starts
its drastic measures caused my the blockage of sperm the vasectomy has
caused. Not to mention, I want my life back.

Thanks,

Richard Bun***

capricious

I can not help you with your quest for a doctor, but
if I were to be in your positon, I would try the "open"
conversion first; cheaper and easier than the reversal,

However, keep in mind that it is believed (but not known)
that other factors may cause this pain, and further
surgery may not only fail to cure the problem, but could
possibly add to it.


As to "only three months," my opinion is that 3 months
should be more than enough time for recovery from a "safe and simple,
20 minute procedure that requires 2 days off from work, and
a week away from strenuous activities."

I wish you well and request that you keep us updated.

Capricious

david

I would contact Dr Pollock - he claims to be one of the few specialists in
treating PVP. It might be worth contacting Greg (who posts here sometimes)
who is a Canadian PVP sufferer and might have more names.

http://www.pollockclinics.com/questions_post.html for Dr Pollock

http://www.vasectomy-information.com/support.htm for Greg's contact info

David
http://www.vasectomy-information.com

trifold1

I suggest going for reopening the vas first--cheaper and less prone to
complications. As Capricious says, though, other factors may be to
blame for your pain. But reopening the vas might be the least
intrusive diagnostic tool available. If it works, then you know sperm
backpressure--or coping mechanisms--are the cause. If not, maybe you
need to look into pinched nerve or something like that. 3 months is
generally considered the point at which post vas pain is considered
"chronic." So now is the time to start looking for a solution. (BTW,
those "drastic measures" you mention are not all that drastic: they
work for most men with no bad consequence.)
trifold http://www.vasectomy-information.com

joiners

Hi, Richard. How is the canadian insurance system treating this? I
assume you are going through a lot of paperwork/phone calls to get
this covered - especially if you are seriously considering a reversal.
Don't give up there - reversals were ********ly excluded under my
insurance policy but I got an exception due to pvp. The reversal
surgery was covered completely by the HMO coverage... I guess my
point is that you shouldn't give up on getting the surgery covered if
you initially are told that the gov't won't pay for it. Part of the
reason it took over 2.5 years to resolve my situation is that I knew
I'd never be able to afford the very expensive reversal surgery
($20K-30K), and wasn't willing to submit myself to other surgeries...
You should have some rights of appeal if you get an initial denial,
and should exercise those....

My symptoms lead me to go with a reversal rather than conversion. I
felt that in addition to the backpressure symptoms I had, much of my
pain was being caused by autoimmune issues. I also didn't want to
risk 2 surgeries if the conversion didn't work - which theoretically
would cause autoimmune issues to get worse... If you decide to go
with a reversal, insist on getting an infertility specialist who has
done hundreds of reversals. IMHO, you don't want the average
vasectomist/urologist doing a reversal for you...

Good luck - keep us informed. There is hope!

Steve

rbungay

I will try to respond to the various questions in this post.

I have learned that doctors who do conversions are rare (in Canada.) The
only doctor I have found is Dr. Pollock in Vancouver. I'm still looking and
there may be one in Quebec city but I have not confirmed this yet.

I am not sure if conversions are covered by OHIP (public health insurance in
Ontario) but I assume they are. If I ever find a doctor willing to do it, I
will certainly ask.

Reversals are not covered by OHIP and all the doctors I have found (One in
Scarborough, One in Ajax and one in Ottawa) charge $3500 which seems to be a
bargain compared to US prices. However, I contacted OHIP today and found
out that they will cover it if they give prior approval as a medically
necessary operation. This has to be established by a physician. According
to OHIP it is at the doctor's discretion and there are no pre-determined
criteria. (sounds simple - I hope it really is)

My GP admits she knows little about conversions and reversals but she is
researching it for me in the hopes of finding a doctor in Ottawa to do a
conversion. If I have to get a reversal because a conversion doctor can't
be found, I will find that quite disappointing. However, a reversal is a
better option than continuing to live in pain. I can't really afford the
$3500 but I can live with that debt if it buys me a solution.

I will keep the group updated on what I learn.

Thanks to all for the ongoing comments and encouragement.

Richard

giraud

Remember that you just might become fertile again if you get a reversal.
Personally I would do everything in my power to prevent that! How
depressing that the original vasectomy would become totally without
purpose if you had to go back to condoms or whatever!

Probably the drawback of open-ended conversion is that they would have to
cut more tube off, which would then give them less to work with if you
decide later for a reversal.

Just as another data point: I had mild aching in [mostly] my right
testicle, and it went on for much longer than 3 months. In fact, it still
happens sometimes, but frequency seems to be slowly waning.

My uro said, when I went back to him after about months, that some guys
take a year to resolve, and some never do. I consider his words much more
honest and "in tune" than many uro stories I've heard here. What he said
makes perfect sense, and I feel he was very frank about it.

He wanted me to wait a full year, and then consider open-ended
conversion. He seemed to think it would be no big deal to do this if
necessary, but it might just go away eventually.

From my 20-year-ago experience of testicle pain, I know it took about 3
years for that to go away, but it finally did. It also came and went
just like what I experienced after vasectomy. My intuition says that was
also backpressure, but of a natural sort (I had my vasectomy only a year
and a few months ago). It was also my right testicle.

I don't know [remember?] the severity of your pain, but if it's an aching
that you can stand, I would wait the year to see if it resolves. Just
having my uro say there was a course of action was helpful to me.

Giraud

mrtweets45

Richard,
I wish you the best in your solution .My doctor does the OE
coversions with very good success.

All good medicine,
GREENFEATHER

trifold1

As another data point, I had similar experience. (Of course, the dull
ache was never debilitating and seemed related to specific behavior
that I valued more than the absence of the very mild soreness it occasioned.)

A good point, Giraud.

trifold
http://www.vasectomy-information.com

rbungay

I really appreciate all the comments received including those who suggest a
conservative approach. I think this is sound advice in cases of tolerable
pain.

While my pain is tolerable at times, at others it is not. As an example,
last evening, after averaging about 5 hours of sleep since the weekend, I
went to bed exhausted. However my pain was quite bad so I took two Tylenol
#3 and a sleeping pill. The sad end to the story is that I got to sleep
around 4:00 a.m. and I had to get up at 6:00. The Tylenol had no effect and
the sleeping pill didn't work. I got up "hung over" and still in pain with
two kids to take care of and no relief in sight.

To my a reversal at this point is the most likely end to my story but I'm
hoping for a conversion. I couldn't give a hoot about being fertile again.
I've been using condoms for 20 years and if I have to use them for the next
20 it will be a small price to pay to rid myself of this pain. *** with my
wife was always great. Yes, the intercourse was better when we didn't use
condoms but the *** (ie. the intense emotional and physical exchange of
pleasure) was great even with condoms. I wanted the vasectomy to increase
pleasure and to prevent unwanted pregnancy but even if an "accident"
occurred after a reversal, that would be the way it was meant to be and I'd
love that child as much as the two daughters we have now.

Luckily I will be seeing a Urologist in six weeks (for those of you in the
US that is pretty quick for Canada). If he won't do a conversion, I'll take
a reversal and run.

Thanks for all the thoughts - keep them coming,

Richard