Dissatisfied with vasectomy, what to do?
June 20, 2015 3:00 PM Subscribe
I had a vasectomy a month ago and am not satisfied with the outcome. When should I consider seeing a different doctor and how should I do that effectively?
I'll put in all the details since this is anon, skip to the bottom if you want the short version.
My procedure was the no-scalpel, cut, cauterize, and double tie method. The actual surgery seemed to go normally. I was even able to watch most of it. In the following days I had a lot of swelling and skin discoloration (which I now recognise as a hematoma) and an infection. I was seen again by the doctor who blew me off with bullshit about waiting awhile and doing a 7 day course of antibiotics.
When the swelling subsided I was able to notice two lumps on either side superior to and larger than the testicles, and from one of these I could trace a rubber band-like tube up directly to the puncture site.
Now a month after the surgery, one lump is now just about pea-size, while the other is still larger than a testicle and, most concerning, still has this tube thing going to the puncture site. Like it's undeniably attached, and tugging on the puncture site causes noticeable tightness all the way back to the inguinal canal.
I feel like I've been super communicative about this with the doctor who did the surgery and I'm really fed up getting blown off as if this is no big deal, when I have yet to get an explanation of what the fuck this tube thing is, even after an ultrasound, and no time frame for expected complete recovery.
It's still very sensitive to move everything around, too, and I don't feel like I'm being listened to. For instance, the ultrasound tech focused almost entirely on the testicles, which I never complained about, and literally at the end of the procedure was like "OK so show me that lump you mentioned" and took a few passes over it.
I think I want to go see someone else about this. I think a vas deferens tube is attached to the puncture site, and I'm freaking out about how to proceed if that's the case.
If I should go see someone else, how do I do that and keep everything normal with insurance and paperwork? I've never fired a doctor before, so I don't know how it works. Is there a type of specialist I should be considering? Is there any good reason to say something to the current doctor or the organization itself?
I'll put in all the details since this is anon, skip to the bottom if you want the short version.
My procedure was the no-scalpel, cut, cauterize, and double tie method. The actual surgery seemed to go normally. I was even able to watch most of it. In the following days I had a lot of swelling and skin discoloration (which I now recognise as a hematoma) and an infection. I was seen again by the doctor who blew me off with bullshit about waiting awhile and doing a 7 day course of antibiotics.
When the swelling subsided I was able to notice two lumps on either side superior to and larger than the testicles, and from one of these I could trace a rubber band-like tube up directly to the puncture site.
Now a month after the surgery, one lump is now just about pea-size, while the other is still larger than a testicle and, most concerning, still has this tube thing going to the puncture site. Like it's undeniably attached, and tugging on the puncture site causes noticeable tightness all the way back to the inguinal canal.
I feel like I've been super communicative about this with the doctor who did the surgery and I'm really fed up getting blown off as if this is no big deal, when I have yet to get an explanation of what the fuck this tube thing is, even after an ultrasound, and no time frame for expected complete recovery.
It's still very sensitive to move everything around, too, and I don't feel like I'm being listened to. For instance, the ultrasound tech focused almost entirely on the testicles, which I never complained about, and literally at the end of the procedure was like "OK so show me that lump you mentioned" and took a few passes over it.
I think I want to go see someone else about this. I think a vas deferens tube is attached to the puncture site, and I'm freaking out about how to proceed if that's the case.
If I should go see someone else, how do I do that and keep everything normal with insurance and paperwork? I've never fired a doctor before, so I don't know how it works. Is there a type of specialist I should be considering? Is there any good reason to say something to the current doctor or the organization itself?
Hydrocele is a possibility too with the hematoma being something that typically resolves itself (which is why the doctor is being dismissive).
May be something to bring up to the doctor. You don't want to self-diagnose and obsess but unfortunately sometimes doctors need gentle reminders that they may not be thinking of everything, and if the doctor knows their stuff they'll explain in detail why your concern is not valid -- I think it's important to have the sort of doctor who respects a patient that brings in informed concerns, but it's not always something you get to pick and choose especially with specialists.
posted by aydeejones at 3:27 PM on June 20, 2015 [1 favorite]
May be something to bring up to the doctor. You don't want to self-diagnose and obsess but unfortunately sometimes doctors need gentle reminders that they may not be thinking of everything, and if the doctor knows their stuff they'll explain in detail why your concern is not valid -- I think it's important to have the sort of doctor who respects a patient that brings in informed concerns, but it's not always something you get to pick and choose especially with specialists.
posted by aydeejones at 3:27 PM on June 20, 2015 [1 favorite]
how do I do that and keep everything normal with insurance and paperwork
This is entirely going to depend on whether your insurance considers urologists specialists and/or if urologists require referrals.
If you want to be sure, you have to call the insurance company and ask. They will tell you what you need to do.
As long as they approve it, I'd say make an appointment with the new urologist, tell them you're coming in regarding some concerns post-vasectomy, and give them the name and phone number of the old urologist's office to call over for your records. You may have to fax something to the old urologist to release the records. I would not start making threats or even especially unhappy noises until you're sure you don't need the old doctor anymore.
posted by Lyn Never at 3:44 PM on June 20, 2015 [1 favorite]
This is entirely going to depend on whether your insurance considers urologists specialists and/or if urologists require referrals.
If you want to be sure, you have to call the insurance company and ask. They will tell you what you need to do.
As long as they approve it, I'd say make an appointment with the new urologist, tell them you're coming in regarding some concerns post-vasectomy, and give them the name and phone number of the old urologist's office to call over for your records. You may have to fax something to the old urologist to release the records. I would not start making threats or even especially unhappy noises until you're sure you don't need the old doctor anymore.
posted by Lyn Never at 3:44 PM on June 20, 2015 [1 favorite]
What's your sperm count post-op, after you've "cleaned out the pipes"? Zero means a successful procedure.
If you want a revision to make your balls less lumpy, that's probably going to be on your dime. Realize that scars happen and you will feel them. My experience is that scarring occurs and post-op sensitivity decreases over time.
posted by Cuspidx at 4:39 PM on June 20, 2015 [1 favorite]
If you want a revision to make your balls less lumpy, that's probably going to be on your dime. Realize that scars happen and you will feel them. My experience is that scarring occurs and post-op sensitivity decreases over time.
posted by Cuspidx at 4:39 PM on June 20, 2015 [1 favorite]
Feeling like you don't have good communication with your doctor is reason enough to switch. Get a second opinion. Don't get into it with the first doctor or his staff -- just have the new person have your records sent over. When you call to set up an appointment at a new practice they can walk you through it.
posted by sockermom at 5:31 PM on June 20, 2015 [1 favorite]
posted by sockermom at 5:31 PM on June 20, 2015 [1 favorite]
The larger lump is bigger than your testicle?
One month after surgery? I think some commenters might be missing that.
Getting a second opinion is super common in medical care. You aren't doing anything unusual, and a food Doctor will recommend other specialists in their area. Ask for your records relating to the procedure, or get them sent directly to whichever doctor you pick for a consult.
If your current Doctor takes your concerns more seriously, that would be a bonus, but a second opinion itself, is pretty... standard operating procedure.
posted by Elysum at 6:08 AM on June 21, 2015
One month after surgery? I think some commenters might be missing that.
Getting a second opinion is super common in medical care. You aren't doing anything unusual, and a food Doctor will recommend other specialists in their area. Ask for your records relating to the procedure, or get them sent directly to whichever doctor you pick for a consult.
If your current Doctor takes your concerns more seriously, that would be a bonus, but a second opinion itself, is pretty... standard operating procedure.
posted by Elysum at 6:08 AM on June 21, 2015
I would absolutely be getting a second opinion at this point. if your insurance allows you to self-refer, I would find a new urologist and call and make an appointment. (If not, you may have to go through your primary care physician.) Check with your insurance company, but with every company I've had, the new doctor takes care of getting your records from the old doctor. However, I have to stress this can vary with your insurance company.
There is nothing unusual about this process at all, and although it's understandable that you might feel awkward, you have no reason to.
posted by The Underpants Monster at 6:56 AM on June 21, 2015 [1 favorite]
There is nothing unusual about this process at all, and although it's understandable that you might feel awkward, you have no reason to.
posted by The Underpants Monster at 6:56 AM on June 21, 2015 [1 favorite]
I think a vas deferens tube is attached to the puncture site, and I'm freaking out about how to proceed if that's the case.
Can you explain your specific concern? I'm a doctor, though not a urologist and I have limited knowledge about the vasectomy procedure. I might be able to help allay your fears if I know what you're afraid of.
If I should go see someone else, how do I do that and keep everything normal with insurance and paperwork? I've never fired a doctor before, so I don't know how it works. Is there a type of specialist I should be considering? Is there any good reason to say something to the current doctor or the organization itself?
The insurance thing will be sorted based on how the doctor you see codes the visit, and since you're going to address a complication from a procedure that is unresolved, I don't think there should be any question about it being redundant or excessive (that said, I suppose one can never underestimate the ruthlessness of insurance companies - but you could call them to confirm prior to your appointment if you're worried about it). You don't need to do anything specific to fire a doctor, but I would recommend that when you contact your prior physician's office to get your records forwarded, you mention that you are switching practices because you didn't feel that your physician was responsive to your concerns or communicating well about the diagnosis and plan. You don't have to, as it won't serve any benefit to you, but perhaps the doc will try to do better in the future (It's not always the case, but the vast majority of doctors do want to help their patients and would want to know what they could do better).
The specialist you should see is most certainly a urologist.
posted by treehorn+bunny at 8:16 PM on June 21, 2015
Can you explain your specific concern? I'm a doctor, though not a urologist and I have limited knowledge about the vasectomy procedure. I might be able to help allay your fears if I know what you're afraid of.
If I should go see someone else, how do I do that and keep everything normal with insurance and paperwork? I've never fired a doctor before, so I don't know how it works. Is there a type of specialist I should be considering? Is there any good reason to say something to the current doctor or the organization itself?
The insurance thing will be sorted based on how the doctor you see codes the visit, and since you're going to address a complication from a procedure that is unresolved, I don't think there should be any question about it being redundant or excessive (that said, I suppose one can never underestimate the ruthlessness of insurance companies - but you could call them to confirm prior to your appointment if you're worried about it). You don't need to do anything specific to fire a doctor, but I would recommend that when you contact your prior physician's office to get your records forwarded, you mention that you are switching practices because you didn't feel that your physician was responsive to your concerns or communicating well about the diagnosis and plan. You don't have to, as it won't serve any benefit to you, but perhaps the doc will try to do better in the future (It's not always the case, but the vast majority of doctors do want to help their patients and would want to know what they could do better).
The specialist you should see is most certainly a urologist.
posted by treehorn+bunny at 8:16 PM on June 21, 2015
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posted by aydeejones at 3:21 PM on June 20, 2015 [1 favorite]