Post Vasectomy Pain Syndrome = TMS?

Hello everyone.

First of all, I myself don't have any chronic pain. I'm just a man with an interest in a syndrome that occurs in a minority of men after a vasectomy.
https://en.wikipedia.org/wiki/Post-vasectomy_pain_syndrome (Post-vasectomy pain syndrome - Wikipedia)

So a certain percentage of men (up to a third) will develop testicular pain, ranging from mild to severe after a vasectomy which can last a lifetime. Some men also report pain upon ejaculation or worsening of the pain during intercourse. The cause of this pain however, is very poorly understood by doctors, there are only theories:

1. Congestion: One theory is that because there is now a blockage, the epidydimis gets congested with sperm and that this is what causes the pressure-like pain that some men report. It 's well known that this congestion can also cause ruptures and that sperm then leaks into the blood causing autoimmune reactions (since the body has never seen sperm before). Treatment for this kind of pain is sometimes vasectomy reversal. However, there are problems with this theory in my opinion. First of all, studies have shown that this congestion and the ruptures are asymptomatic in the vast majority of men. Studies have also shown that the autoimmune response to the sperm in vasectomized men is clinically insignificant as men with vasectomies have the same rate of autoimmune disorders as men without. Also, if it was really the sperm causing the pain, shouldn't that be easily treatable with some testosterone injections or other things that stop the production of sperm? There are even plants that contain natural spermicides like papaya seeds that can actually make you infertile. However none of this has ever really been shown to resolve PVPS. Reversal has also never really been proven to work from my perspective. Ther have been some studies to show it provides relief but the follow up was usually just a month. Not enough to rule out a placebo or TMS in my opinion.

2. Nerve damage: The other theory is that nerves get damaged during the vasectomy and that this can cause long-lasting or life-long pain. But doesn't that sound similar to the kind of theory that the mainstream has on back pain and other kinds of pain? John Sarno said that in TMS, the mind causes a nerve to get pinched somewhere in the body. He even referred to it as "real nerve damage caused by the subconscious mind" and that this is what causes the chronic back pain or other kinds of pain people have.

Another thing is that many men also report their libido decreased after a vasectomy, their ejaculate volume decreased or their orgasms felt less intense... But there really is not a single bodily process that would explain this. Studies show very clearly that vasectomy does not affect testosterone levels and some even show an increase.

Men with PVPS are really very similar to people with chronic back pain. They visit dozens of different doctors, try many different medications, undergo different surgeries like vasectomy reversal, denervation, orchiectomy and in some extreme cases, have one or both testicles removed. However, very few men really seem to get better in my opinion. Some men say that the medications or surgeries help to a degree but not fully, other men report having undergone one of the surgeries and became pain-free only for the pain to return a few months to a year to a few years later...


Could it be that this chronic testicular pain that occurs after vasectomies is TMS? I contacted many TMS therapists and asked them about this recently and not many, but a few said that they had indeed seen a few patients with PVPS and they claimed that they were able to resolve the pain that way... Another interesting and little known fact is that it's been noted that men with PVPS in many cases already had a history of chronic pain synptoms elsewhere in the body...

Before you reply: Please don't just throw some information at me about some study showing a link between vasectomy and cancer. I want this thread to be about whether PVPS = TMS. However, if any of you have had chronic pain after any kind of surgery and were able to resolve with the TMS approach or know anything about that, I'd like to read about that too.


Thanks for reading and thanks for your replies in advance.

 

Hi, Eric79. I have not had a vasectomy but I do believe most of our ailments come from TMS repressed emotions. A nephew had a hip replacement operation and felt pain in different places afterward. He told himself it was from his emotions and the pains went away. I suggest you stay positive and patient and you will heal totally.

Have a very merry holiday.

 

Seems like you already have your answer from some TMS therapists. I'll just add that it is very common for TMS to start following an injury or surgery. And given that there are likely many emotional issues surrounding vasectomy, it seems that PVPS is likely to be caused by psychogenic issues, and therefore, is TMS.

 

Yes, it is from TMS and not uncommon (as long as it has been cleared). I remember doing a show a few years ago with Dr. Harry Fisch, called Man up with Harry Fisch! He performed vasectomies and told me that he felt the post surgery pain was a mindbody effect. He said on the show that those guys who were more reluctant to do the operation, ie, unconsciously angry, were the ones who had the most post surgical pain.

 

Thanks for your replies! Keep 'em coming.

 

Sorry for bumping this thread. I have a question for Steve Ozanich, have you actually helped anyone with PVPS?

Also, I've done a little more research and found out that female sterilization (tubal ligation) also has side effects that doctors have no clear explanation for. It's called "post tubal sterilization syndrome". Here's an anti TL site that lists all the symptoms:
http://tubal.org/symptoms-of-pts.htm (Symptoms of Post Sterilization Syndrome and Post Tubal Ligation Syndrome (PTLS))

Studies are however unable to really consistently show a link between TL and hormonal changes. Some Doctors believe the syndrome exists, while others simply blame it on giving up birth control pills... This is a very controversial issue. If any woman here can share their experience with TL and whether they think that could also be TMS or have a TMS component, I'd be thankful.

But isn't it interesting how both male and female sterilization have associated conditions and symptoms that are very controversial and that noone seems to have a clear explanation for?

 

Bump

 

Sorry to resurrect this very old thread, but I thought my comments might be useful. You see, I’ve had post-vasectomy pain syndrome (PVPS) for almost 9 years now. As you might imagine, I could write a very long post, although I’ll try to keep it short.

I’ve been through lots of physiological and psychological treatments during this rather long journey. Currently, I’m going through the book The Divided Mind by Dr. Sarno. I’m also seeing a pain psychologist online once a week. I brought up Dr. Sarno’s book. My shrink agrees with Dr. Sarno to an extent about the mindbody connection but disagrees beyond that point. My shrink lives in NYC and says that pretty much everyone there has anxiety, anger, and psychological problems, but not everyone there has physical health problems. My psychologist is more oriented towards CBT.

I want to comment on the original poster’s statement about reversals. I had a reversal of the left side. My pain was always just on the left side. The reversal reduced my pain level by about 5-10%. This reduction in pain level remained for more than 5 years. Not a placebo effect if you ask me. The reduction in pain remained until I had another procedure, which raised my pain level through the roof. This was late last year, and it resulted in me getting an orchiectomy on the left side.

On PVPS forums on the web, I have read many stories of successful reversals. In fact, it is the single most successful procedure I know of. There was a study I read recently (https://pubmed.ncbi.nlm.nih.gov/22622333/ (Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome - PubMed)). It concluded that PVPS patients who are patent after reversal (i.e., sperm in the ejaculate) have lower pain levels after reversal compared to patients who aren’t patent. This in my mind seems to support the congestion theory. The mean period of follow-up was 3.22 years. As for me, I was inspected for congestion, but the result was negative.

Since my orchiectomy, I have had pain on the right side for the first time ever. Also, the pain didn’t disappear on the left side, either. So now I have pain on both sides for the first time since vasectomy. Terrible story, I know.

After the failure of the orchiectomy, I revisited the psychological interpretation of this whole thing because that was all that I could really conclude. I had been to shrinks before for this but didn’t get much out of the treatment.

I’m going to go through this book The Divided Mind. I’m following the treatment plan outlined in Chapter 4. I have already found some aspects of myself in all of this:

· Previous history of psychosomatic illness

· Indecisive about getting the vasectomy in the first place

· Perfectionist personality

· Difficulties with parents during childhood

I can already hear my pain psychologist, “Oh, yea, but there are lots of people with childhood issues and perfectionist personalities. I see them every day. Not all of them have health problems, but not all of them have been in car wrecks, either.”

I will read this book. If I get a good result, you will hear back from me.

 

Interesting, @Oddball, and a great analysis. Your ambivalence about the vasectomy in the first place is probably significant.

It occurs to me that this pain psychologist appears quite determined - if not desperate - to fit everyone into the same paradigm, perhaps because it's too hard to work with the fact that everyone is different. The first difference that occurs to me is that, as described by Dr Sarno, most TMSers can be described as goodists. This alone is a singular characteristic that clearly can not be applied to everyone with chronic pain.

I encourage you to check in to Alan Gordon's ongoing work - he and Dr Howard Schubiner are at the forefront of the very latest neuroscientific discoveries and treatments that build upon Dr Sarno's original theories. Alan's has a new book which incorporates the very latest, called The Way Out.

~Jan