Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome

Abstract

This study was conducted to assess outcomes (according to patency) of vasectomy reversal (VR) in qualified patients with postvasectomy pain syndrome (PVPS). A total of 32 patients with PVPS undergoing VR between January 2000 and May 2010 were examined retrospectively. Of these, 68.8% (22/32) completed a study questionnaire, either onsite at the outpatient clinic or via telephone interview. Preoperative clinical findings, preoperative and postoperative visual analogue scale (VAS) pain scores, patency and pregnancy rate and overall patient satisfaction were analyzed. For the latter, a four-point rating of (1) cure, (2) improvement, (3) no change or (4) recurrence was used. The mean age was 45.09±4.42 years and the mean period of follow-up was 3.22 years (0.74–7.41). Patency rates were 68.2% (15/22) and pregnancy rates were 36.4% (8/22). The mean VAS was 6.64±1.00 preoperatively and 1.14±0.71 postoperatively (P<0.001). The difference in the mean preoperative and postoperative VAS was 6.00±1.25 (4–8) in the patency group and 4.43±0.98 (3–6) in the no patency group (P=0.011). A significant difference in procedural satisfaction with surgical outcome was observed between patency and no patency groups (P=0.014). In conclusion, in PVPS patients requiring VR, a significant difference was observed between the patency and no patency groups in terms of pain reduction and the degree of patient procedural satisfaction.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Schwingl PJ, Guess HA . Safety and effectiveness of vasectomy. Fertil Steril 2000; 73: 923–936.

    Article  CAS  Google Scholar 

  2. Lee KM, Park NC, Yan BQ . Surgical Outcome of 153 vasovasostomies on 10 years or more after vasectomy. Korean J Urol 2003; 44: 109–114.

    Google Scholar 

  3. Tandon S, Sabanegh E . Chronic pain after vasectomy: a diagnostic and treatment dilemma. BJU Int 2008; 102: 166–171.

    Article  Google Scholar 

  4. Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK . Analysis and management of chronic testicular pain. J Urol 1990; 143: 936–939.

    Article  CAS  Google Scholar 

  5. Ahmed I, Rasheed S, White C, Shaikh NA . The incidence of post-vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management. Br J Urol 1997; 79: 269–270.

    Article  CAS  Google Scholar 

  6. Schmidt SS, Free MJ . The bipolar needle for vasectomy. I. Experience with the first 1,000 cases. Fertil Steril 1978; 29: 676–680.

    Article  CAS  Google Scholar 

  7. Shapiro EI, Silber SJ . Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia. Fertil Steril 1979; 32: 546–550.

    Article  CAS  Google Scholar 

  8. Selikowitz SM, Schned AR . A late post-vasectomy syndrome. J Urol 1985; 134: 494–497.

    Article  CAS  Google Scholar 

  9. Christiansen CG, Sandlow JI . Testicular pain following vasectomy: a review of postvasectomy pain syndrome. J Androl 2003; 24: 293–295.

    Article  Google Scholar 

  10. West AF, Leung HY, Powell PH . Epididymectomy is an effective treatment for scrotal pain after vasectomy. BJU Int 2000; 85: 1097–1099.

    Article  CAS  Google Scholar 

  11. Padmore DE, Norman RW, Millard OH . Analyses of indications for and outcomes of epididymectomy. J Urol 1996; 156: 95–96.

    Article  CAS  Google Scholar 

  12. Calleary JG, Masood J, Hill JT . Chronic epididymitis: is epididymectomy a valid surgical treatment? Int J Androl 2009; 32: 468–472.

    Article  CAS  Google Scholar 

  13. McCormack M, Lapointe S . Physiologic consequences and complications of vasectomy. CMAJ 1988; 138: 223–225.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Choe JM, Kirkemo AK . Questionnaire-based outcomes study of nononcological post-vasectomy complications. J Urol 1996; 155: 1284–1286.

    Article  CAS  Google Scholar 

  15. Nangia AK, Myles JL, Thomas AJ . Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation. J Urol 2000; 164: 1939–1942.

    Article  CAS  Google Scholar 

  16. Easley S, MacLennan GT . Vasitis and epididymitis nodosa. J Urol 2006; 175: 1502.

    Article  Google Scholar 

  17. Myers SA, Mershon CE, Fuchs EF . Vasectomy reversal for treatment of the post-vasectomy pain syndrome. J Urol 1997; 157: 518–520.

    Article  CAS  Google Scholar 

  18. Huang HC, Hsieh ML, Huang ST, Tsui KH, Lai RH, Chang PL . Microsurgical vasectomy reversal: ten-years′ experience in a single institute. Chang Gung Med J 2002; 25: 453–457.

    PubMed  Google Scholar 

  19. Lee JY, Lee TY, Park HY, Choi HY, Yoo TK, Moon HS et al. Efficacy of epididymectomy in treatment of chronic epididymal pain: a comparison of patients with and without a history of vasectomy. Urology 2011; 77: 177–182.

    Article  Google Scholar 

  20. Hori S, Sengupta A, Shukla CJ, Ingall E, McLoughlin J . Long-term outcome of epididymectomy for the management of chronic epididymal pain. J Urol 2009; 182: 1407–1412.

    Article  Google Scholar 

  21. Siu W, Ohl DA, Schuster TG . Long-term follow-up after epididymectomy for chronic epididymal pain. Urology 2007; 70: 333–335.

    Article  Google Scholar 

  22. Sweeney P, Tan J, Butler MR, McDermott TE, Grainger R, Thornhill JA . Epididymectomy in the management of intrascrotal disease: a critical reappraisal. Br J Urol 1998; 81: 753–755.

    Article  CAS  Google Scholar 

  23. Chen TF, Ball RY . Epididymectomy for post-vasectomy pain: histological review. Br J Urol 1991; 68: 407–413.

    Article  CAS  Google Scholar 

  24. Sweeney CA, Oades GM, Fraser M, Palmer M . Does surgery have a role in management of chronic intrascrotal pain? Urology 2008; 71: 1099–1102.

    Article  Google Scholar 

  25. Heidenreich A, Olbert P, Engelmann UH . Management of chronic testalgia by microsurgical testicular denervation. Eur Urol 2002; 41: 392–397.

    Article  Google Scholar 

  26. Devine Jr CJ, Schellhammer PF . The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg 1978; 70: 149–151.

    PubMed  Google Scholar 

  27. Levine LA, Matkov TG . Microsurgical denervation of the spermatic cord as primary surgical treatment of chronic orchialgia. J Urol 2001; 165 (Part 1): 1927–1929.

    Article  CAS  Google Scholar 

  28. Cadeddu JA, Bishoff JT, Chan DY, Moore RG, Kavoussi LR, Jarrett TW . Laparoscopic testicular denervation for chronic orchalgia. J Urol 1999; 162 (Part 1): 733–735.

    Article  CAS  Google Scholar 

  29. Bijur PE, Silver W, Gallagher EJ . Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001; 8: 1153–1157.

    Article  CAS  Google Scholar 

  30. Holdgate A, Asha S, Craig J, Thompson J . Comparison of a verbal numeric rating scale with the visual analogue scale for the measurement of acute pain. Emerg Med (Fremantle) 2003; 15: 441–446.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S W Lee.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J., Chang, J., Lee, S. et al. Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome. Int J Impot Res 24, 202–205 (2012). https://doi.org/10.1038/ijir.2012.17

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2012.17

Keywords

This article is cited by

Search

Quick links