Post-Vasectomy Pain Syndrome

Volume: 7
Issue: 7
July 15, 2012
Post-Vasectomy Pain Syndrome

Dear Colleagues:

Last month’s newsletter was about sexual dysfunction and its relationship to interference fields. It included a case report of a man whose long-standing erectile dysfunction was cured by treating a vasectomy scar with neural therapy.

My guess was that vasectomy scars rarely cause problems of this sort and I asked readers (now over 1000 subscribers) to report if their experience was different. I generally receive a satisfying amount of feedback from readers about these newsletters, but not this time. No-one reported seeing this complication of vasectomy.

Dr. Robert Banner of Canada made this observation:

I have not come across vasectomy or circumcision scars as being interference fields and only once have I found an episiotomy scar to be an interference field.  My thought for this was that they were rarely a problem because of the generally good blood supply there.  It may be that I have not been as thorough in looking however.  Sexual dysfunction is not one of the reasons someone would come to see me but this is very good to keep in mind as a possibility.

Dr. Margaret Taylor of Australia had this case to report:

I had a case of terrible pain and diarrhoea from a scrotal scar in a 15 year-old boy from an operation to remove a necrotic testis after a missed torsion of testis. The brave lad put up with 6 treatments until the pain went completely, as well as the diarrhoea. The first treatment only relieved it for 19 hours – but we figured that was enough to keep going. I had to treat the stump in the scrotum as well as the scar.

Dr Banner’s observation that interference fields are rare in tissues with good blood supply matches my experience. Vasectomy scars also benefit from a second rule about interference fields: that elective surgery is much less likely to result in interference fields than emergency surgery, presumably because the decision for surgery is voluntary and less accompanied by anxiety or misgiving. (This may not be entirely true of vasectomy scars, if the paper mentioned in the last newsletter is significant).

Dr Taylor’s case report supports this second principle in part. The patient’s scar was in a well-vascularized location, but it likely contained the painful memory of the testicular torsion, the missed diagnosis and the subsequent surgery. It is interesting that treatment of the stump was also necessary. The stump would likely have also experienced some impaired circulation from the surgical procedure.

Pain may be a rare complication of vasectomy (probably <1 in 1000 vasectomized men), but vasectomies themselves are exceedingly common (4 million/year world-wide). As a result, “post-vasectomy pain syndrome” or PVPS is gaining increasing attention in the urological literature.

The pathophysiology of PVPS is controversial. Long standing obstruction of the spermatic duct, with extravasation of sperm and a resultant inflammatory response is the most widely accepted theory. Specific treatments are generally directed at reducing spermatogenesis (testosterone therapy), relieving pressure (vasectomy reversal), removing inflamed tissue (epididymectomy or orchiectomy) or denervation. All treatments have their failures and one wonders how many of these might be due to undetected interference fields. And even in those successfully treated, how many had pathology brought on by interference fields? In other words, why in some cases of vasectomy did the spermatic duct obstruction lead to extravasation and inflammation and not in others?

This situation is similar to another common post-surgical pain syndrome, the post-cholecystectomy pain syndrome. Although a variety of functional disturbances can be diagnosed to explain symptoms in some of these patients, many have post-surgical pain of “unknown” origin. Experienced neural therapists know that many of these are due to interference fields, in the cholecystectomy scar(s) or the “energetic” gall bladder itself. An interesting paper in the mainstream medical literature reports that at least some of these cases involve spinal cord sensitization.  We can wonder if the autonomic nervous system plays any part in this sensitization.

Post-surgical pain syndromes are a risk in many types of surgery. It is high time that the basic principles of neural therapy be taught in all surgical training programs and that interference fields be sought for in all cases of chronic post-surgical pain.

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