Semen jockstrap

Infertility affects about 15% of couples and is due to a male factor alone in 20% and a combined male and female factor in 30 to 40%.
World Health Organization estimates between 60 and 80 million couples are affected.
The population in different regions have varying amounts of infertility.
In 25% of couples no clear cause of infertility can be identified.
Male infertility refers to a sexually mature male’s inability to impregnate a fertile female.
It accounts for 40–50% of infertility.
It affects approximately 7% of all men.
Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.
There is a decrease in sperm concentration as men age.
90% of seminiferous tubules in men in their 20s and 30s contain spermatids, whereas men in their 40s and 50s have spermatids in 50% of their seminiferous tubules, and only 10% of seminiferous tubules from men aged > 80 years contain spermatids.
In a random international sample of 11,548 men confirmed to be biological fathers by DNA paternity testing, the oldest father was found to be 66 years old at the birth of his child: generally male infertility ceases above age 65-66.
Factors relating to male infertility:
Immune infertility
Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.
Antisperm antibody production is directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, impair fertilization, influence on the implantation process, and impaired growth and development of the embryo.
The formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.
Chromosomal anomalies and genetic mutations account for nearly 10–15% of all male infertility cases.
Klinefelter syndrome is one of most commonly known causes of infertility, affects one in 500–1000 newborn males.
Klinefelter syndrome is a chromosomal defect that occurs during gamete formation due to a non-disjunction error during cell division.
Resulting in males having smaller testes, reducing the amount of testosterone and sperm production.
Males with this syndrome carry an extra X chromosome (XXY), meaning they have 47 chromosomes compared to the normal 46 in each cell.
This extra chromosome directly affects sexual development before birth and during puberty.
A variation of Klinefelter syndrome is when some cells in an individual have the extra X chromosome but others do not, referred to as mosaic Klinefelter syndrome.
Testosterone concentrations in the seminiferous tubules are 20- to 100-fold greater than circulating levels and are required to mediate spermatogenesis.
The reduction of testosterone in the male body normally results in an overall decrease in the production of viable sperm for these individuals thereby forcing them to turn to fertility treatments to father children.
Y chromosomal infertility is a direct cause of male infertility due to its effects on sperm production, occurring in approximately one in 2000 males.
Y chromosomal infertility affected men show no symptoms, although they may have smaller testes.
Y chromosomal infertility may be associated With azoospermia (no sperm production), oligozoospermia (small number of sperm production), or they may produce abnormally shaped sperm (teratozoospermia).
Y chromosomal infertility occurs during the development of gametes in the male: affected males have genetic deletions in the Y chromosome.
These deletions affect protein production that is vital for spermatogenesis.
Idiopathic oligospermia, or unexplained sperm deficiencies, account for 30% of male infertility.
Pre-testicular factors are conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health including:
Varicocele is a condition of swollen testicle veins, which is
present in 15% of normal men and in about 40% of infertile men.
It is present in up to 35% of cases of primary infertility and 69–81% of secondary infertility.
Obesity increases the risk of hypogonadotropic hypogonadism.
Men with celiac disease may have reversible infertility.
In men, celiac disease can reduce semen quality and cause immature secondary sex characteristics, hypogonadism and hyperprolactinemia which causes impotence and loss of libido.
When evaluating infertility it would best include assessment for underlying celiac disease, both in men and women.
Strenuous bicycle riding, horseback riding are associated with male infertility.
Medications that affect spermatogenesis such as chemotherapy, fluoxetine, anabolic steroids, cimetidine, spironolactone, and those that decrease FSH levels such as phenytoin, and those that decrease sperm motility such as sulfasalazine and nitrofurantoin.
Tobacco smoking may damage the testicles and kill sperm,
but their effect on male fertility is not clear.
Smoking tobacco increases intake of cadmium, which is chemically similar to zinc, and may replace zinc in the DNA polymerase, which plays a critical role in sperm production.
Inherited variants in genes that encode enzymes employed in DNA mismatch repair are associated with increased risk of sperm DNA damage and male infertility.
Aging is associated with a decline in semen quality, and this decline appears to be due to DNA damage.
DNA fragmentation and increased susceptibility to denaturation upon exposure to heat or acid are characteristic of apoptosis of somatic cells: DNA damage is an important factor in male infertility.
Environmental factors that change an individual’s epigenetic markers can be seen in their grandchildren, suggesting that environmental factors that influence fertility can be felt for generations even without changing the DNA.
Post-testicular factors that can decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation:
Vas deferens obstruction
Lack of Vas deferens, often related to genetic markers for cystic fibrosis
Infection-prostatitis, male accessory gland infection
Retrograde ejaculation
Ejaculatory duct obstruction
Hypospadias
Impotence
Diagnostic evaluation:
Medical history and physical exam.
Typically two separate semen analyses will be required.
Medical history includes: prior testicular or penile insults such as torsion, cryptorchidism, trauma, infections including mumps orchitis, epididymitis. environmental factors like excessive heat, radiation, medications, drug use with anabolic steroids, alcohol, smoking, sexual habits, frequency and timing of intercourse, use of lubricants, and each partner’s previous fertility experiences are important.
History of loss of libido and headaches or visual disturbances may indicate a pituitary tumor.
The past medical or surgical history may reveal thyroid or liver disease diabetic neuropathy related retrograde ejaculation, radical pelvic or retroperitoneal surgery, absent seminal emission secondary to sympathetic nerve injury, or hernia repair with damage to the vas deferens or testicular blood supply.
A family history may reveal genetic problems.
An examination of the penis, scrotum, testicles, vas deferens, spermatic cords, ejaculatory ducts, urethra, urinary bladder, anus and rectum is performed.
A measure of testicular volume, is associated with both sperm and hormonal parameters.
Semen sampling:
The optimal sexual abstinence for semen sample obtaining is of 2–7 days.
The first way to obtain the semen sample is through masturbation.
Two different samples have to be analyzed with an interval between them of seven days to three months, as sperm production is a cyclic process.
The sample should never be obtained through coitus interruptus for several reasons:
Part of ejaculate could be lost.
Bacterial contamination could happen.
The acid vaginal pH could be deleterious for sperm motility.
Semen analysis:
The volume of the semen sample must be more than 1,5 ml.
The approximate number of total sperm cells, sperm motility/forward progression, and % of sperm with normal morphology are measured.
Hyperspermia has a high volume more than 6 ml.
Hypospermia has a low volume less than 0,5 ml.
Semen deficiencies are labeled as follows:
Oligospermia or oligozoospermia – decreased number of spermatozoa in semen
Aspermia – complete lack of semen
Hypospermia – reduced seminal volume
Azoospermia – absence of sperm cells in semen
Teratospermia – increase in sperm with abnormal morphology
Asthenozoospermia – reduced sperm motility
Necrozoospermia – all sperm in the ejaculate are dead
Leucospermia – a high level of white blood cells in semen
Normozoospermia or normospermia – normal values of all ejaculate parameters and is unexplained Infertility.
Teratoasthenozoospermia, which is reduced sperm morphology and motility.
Low sperm counts are often associated with decreased sperm motility and increased abnormal sperm morphology.
Common hormonal testing includes determination of FSH and testosterone levels.
Genetic causes of infertility: Klinefelter syndrome, a Y chromosome microdeletion, or cystic fibrosis can be detected.
Scrotal ultrasonography may detect signs of testicular dysgenesis, (which is often related to an impaired spermatogenesis and to a higher risk of testicular cancer), testicular lesions suggestive of malignancy,
decreased testicular vascularization characteristic of testicular torsion, hyperemia observed in epididymo-orchitis or in some malignant conditions such as lymphoma and leukemia.
Doppler ultrasonography useful in assessing venous reflux in case of a varicocele.
Dilation of the head or tail of the epididymis is suggestive of obstruction or inflammation of the male reproductive tract, and abnormalities in the texture of the epididymis are associated with abnormalities in sperm parameters.
Scrotal and transrectal ultrasonography (TRUS) can detect uni- or bilateral congenital absence of the vas deferens, which may be associated with abnormalities or agenesis of the epididymis, seminal vesicles or kidneys, and indicate the need for testicular sperm extraction.
TRUS helps assess azoospermia caused by obstruction, and detecting distal congenital absence of bilateral vas deferens or anomalies related to obstruction of the ejaculatory duct, such as abnormalities within the duct itself, a median cyst of the prostate or an impairment of the seminal vesicles to become enlarged or emptied.
Prevention of male infertility:
Avoiding smoking as it damages sperm DNA
Avoiding heavy marijuana and alcohol use.
Avoiding excessive heat to the testes.
Maintaining optimal frequency of coital activity.
Sperm counts can be depressed by daily coital activity and sperm motility may be depressed by coital activity that takes place too infrequently with abstinence, 10–14 days or more.
Wearing a protective cup and jockstrap to protect the testicles, in any sport such as baseball, football, cricket, lacrosse, hockey, softball, paintball, rodeo, motorcross, wrestling, soccer, karate or other martial arts or any sport where a ball, foot, arm, knee or bat can come into contact with the groin.
Diet: Healthy diets rich in such nutrients as omega-3 fatty acids, some antioxidants and vitamins, and low in saturated fatty acids (SFAs) and trans-fatty acids (TFAs) are inversely associated with low semen quality parameters.
Fish, shellfish and seafood, poultry, cereals, vegetables and fruits, and low-fat dairy products have been positively related to sperm quality.
Diets rich in processed meat, soy foods, potatoes, full-fat dairy products, coffee, alcohol and sugar-sweetened beverages and sweets have been inversely associated with the quality of semen in some studies.
Studies relating male nutrient or food intake and fecundability suggest that diets rich in red meat, processed meat, tea and caffeine are associated with a lower rate of fecundability.
Treatments:
Testicular-based male infertility tends to be resistant to medication.
Usual approaches include using the sperm for intrauterine insemination (IUI), in vitro fertilization (IVF), or IVF with intracytoplasmatic sperm injection (ICSI).
With IVF-ICSI even with a few sperm pregnancies can be achieved.
Obstructive causes of post-testicular infertility can be fixed with either surgery or IVF-ICSI.
Surgery may play a role with varicocoelectomy, vasectomy reversal, dand sperm retrieval.
Ejaculation abnormalities, may be treatable by medication, or by IUI therapy or IVF.
Vitamin E helps counter oxidative stress that may be present and is associated with sperm DNA damage and reduced sperm motility.
The sperm count may be improved with a hormone/antioxidant combination therapy.
Giving oral antioxidants to men in couples undergoing in vitro fertilisation for male factor or unexplained subfertility may lead to an increase in the live birth rate but overall the risk of adverse effects is unclear.[54]
Administration of luteinizing hormone (LH), or human chorionic gonadotropin, and follicle-stimulating hormone (FSH) is very effective in the treatment of male infertility due to hypogonadotropic hypogonadism.
Exogenous testosterone therapy is ineffective in benefiting men with low sperm count, because very high local levels of testosterone in the testes are required and exogenous testosterone therapy cannot achieve these required high local concentrations.
Exogenous androgen therapy can actually impair or abolish male fertility by suppressing gonadotropin secretion from the pituitary gland, as seen in users of androgens/anabolic steroids, who often have partially or completely suppressed sperm production.
The suppression of gonadotropin levels results in decreased testicular androgen production with diminished local concentrations in the testes.
FSH is independently critical for spermatogenesis, but LH has little role in male fertility outside of inducing gonadal testosterone production.
Estrogen, at some concentration, has been found to be essential for male fertility/spermatogenesis.
Estrogen levels that are too high can impair male fertility by suppressing gonadotropin secretion and thereby diminishing intratesticular androgen levels.
Clomiphene citrate and aromatase inhibitors such as testolactone or anastrozole have shown effectiveness in benefiting spermatogenesis.
Low-dose estrogen and testosterone combination therapy may improve sperm count and motility in some men, including in men with severe oligospermia.
A study was done in 1992 with men who had never experienced infertility showed that the amount of sperm in semen had declined by 1% per year since 1938: other more recent studies confirm the decline in sperm count, sperm count, motility, morphology and seminal volume.
Other research has confirmed the decline in sperm count and also seminal volume: this has been a worldwide phenomenon.
Some factors may include exposure to high temperatures: A 1 degree increase in temperature will reduce 14% of spermatogenesis.
There are a variety of social stigmas that surround male infertility throughout the world.
This decline in male fertility: Proposed explanations include lifestyle factors, such as diet, and environmental endocrine disruptors, such as those found in plastics.

I am sharing my experience so that it is accessible to anyone who experiences something similar to me and is looking for a frame of reference. Also, I’m sharing this specifically for anyone who is considering a vasectomy and has a varicocele. This detail will be relevant.
I had my vasectomy in October 2023 with a very experienced urologist at a surgical center.
I had a closed-ended procedure with cautery on the distal end and fascial interposition. I am in my mid 30s. The vasectomy was my idea, and I was very excited to have it done. The day of the procedure I had been joking with a friend that I was getting it done at Home Depot in the aisle where they cut lumber to length, and I sent him the below photo while I was waiting for my procedure.
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https://preview.redd.it/cn67x46qfzqc1.jpg?width=2268&format=pjpg&auto=webp&s=7d8568ab1359ee13a2231bb4a3f4272812230c4d
The procedure itself was much more difficult than I anticipated and I felt a lot more of it than I expected. My entire body became extremely tense, I sweated through my surgical clothes, and near the end my hands and feet went numb. The doctor at one point said he would have to stop if I couldn’t slow my breathing down.
When it was done, I was very relieved and looking forward to lots of unprotected sex with my wife. I asked the doctor if I could take his picture against the backdrop of the operating light while he did a thumbs up. After a very awkward silence he did, but I cannot emphasize enough how incredibly weirded out he was by this request. I won’t post this picture for the sake of his privacy, but take my word for it that it’s very funny.
My wife picked me up and drove me home. I spent the next few days sitting at my desk icing my balls. I didn’t take any medication for pain. I had my first ejaculation 5 days after the procedure (my urologist said to wait 4 days in the post operative instructions). I felt an extreme feeling of tightness in my prostate that wasn’t painful, but was very intense. I waited a few days before having another one, but the feeling was similar.
Generally I felt sore for a few days, and after about 5 days I started to feel like my recovery was taking longer than it should. The procedure had been described to me as such a minor thing that I treated it like getting a haircut. The only precaution I took beforehand was asking my urologist if my very large (grade 3) left varicocele would be a problem. It never caused me any discomfort and didn’t affect my ability to have two kids. He said it would not be a problem.
After a week, I started feeling like I had to pee all the time. It started to keep me from sleeping. After a few days of this, I called my urologist, and he said there was no reason my vasectomy should be causing these symptoms. The procedure did not affect the urinary tract, he explained. But he prescribed a 5 day course of bactrim. The symptoms didn’t resolve after the antibiotics, but after a week to 10 days they kind of went away.
But then they came back. And by then, I had developed a more alarming symptom: a feeling of extreme pressure in my testicles. It felt like they were constantly being squeezed. After a few days of this the urinary symptoms got more intense, and the combination of that and the pain sent me to an emergency urologist on a Sunday night. I had been pacing around my house, panicking that this was how I was always going to feel, and my wife insisted that I get checked out. The doctor checked for UTI and did a bladder ultrasound. He checked my prostate. He told me everything was normal. By that point I had started researching my symptoms, and I told him I was afraid of developing post vasectomy pain syndrome. “There’s no such thing,” he told me. He said my symptoms were caused by anxiety and sent me home.
Over the next few weeks, my pain got worse. It would migrate from one testicle to another, but it seemed to mostly be focused on my left side where the varicocele is. It felt like broken glass trapped in my scrotum. It would stab and sting, or it would throb and ache. Sometimes activity would make it worse, sometimes it wouldn’t. I called my original urologist and he examined me in the office. He was sympathetic - not dismissive - but he observed nothing that would explain my symptoms and told me he thought I would get better with time.
By the one month mark, the list of things I could no longer do included:
Drive long distances Wear jeans Ride a bike Run Hold my toddler son Lean forward in a chair Sit on the floor Wear underwear that was too tight (no jockstraps) Wear underwear that was too loose Ejaculate more than once every four days or so (it always was followed by pain)
I would have a few good days here and there, but the pain was basically constant. Then, I started to get tingling in my lower legs and feet. It seemed to coincide with the rhythm of the aching in my testicles. Then a few days later the tingling turned into pain, and it would alternate between the two. The pain would shoot down my legs and into my feet. Sometimes it felt like my entire leg was being squeezed, like the feeling of having a blood pressure cuff inflated. The leg pains would wake me up at night. I got a prescription for meloxicam from my urologist, and it didn’t really touch the pain. Finally he ordered an ultrasound - everything appeared normal.
My mental health by this point was devastated by all of this. I was full of guilt at the burden I placed on my wife because the pain kept me from being a normal parent to our kids. My older son kept asking when I would get better. I was constantly full of fear that I would never get better. I sucked to be around. It was the first thing I thought of when I woke up, and it would keep me from sleeping late into most nights. I ordered myself a blood test, because I felt exhausted all the time and wondered if my testosterone might be low. It turned out I had become prediabetic despite losing 20 pounds since the vasectomy and having no family history of diabetes. My testosterone was in the low 400s.
I was constantly online reading about PVPS, and so I learned that many people get their vasectomy reversed in an effort to resolve their symptoms. I had a consultation with Dr. Sheldon Marks at ICVR in Arizona, and he said there was a chance that reversal could help with the symptoms I described. After lots of going back and forth about it, I scheduled my reversal for the end of January. I spent an unbelievable amount of money flying to Arizona, booking a hotel and transportation, and on the procedure itself, which cost $10,500.
The procedure was under conscious sedation. Dr. Marks removed these inflamed, scarred segments of my vas, which both contained inflamed sperm granulomas.
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they were inside me
He said that when he cut the scarred section off of the vas, a “copious and impressive” amount of fluid came out, suggesting that there was a lot of epididymal pressure. It was reasonable that this and the inflammation on the vas could have been causing my pain, he explained. He said these results were extremely favorable and was very optimistic for my recovery.
I recovered for four days in a hotel, doing nothing but icing my balls for 30 minutes, then 10 minutes off. I did this through the entire first night, then all day, for the rest of the four days, until I flew home. I was placed on a 1 month tapering course of prednisone - 20mg, 10mg, and then 5mg - which is intended to keep the vas reconnection from swelling up, closing, and scarring. The prednisone made me feel very shaky, and I sometimes would have body twitches, especially while laying down. Prednisone also raises blood sugar (remember my new prediabetes?) so I ate a hotel chicken caesar salad for every meal.
I watched House of the Dragon, which I didn’t think was very good. I started Succession, which is good. When I flew back, I iced my balls in the sky over the site of the Trinity nuclear test. See photo:
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Now i am become death
At one point my ball icing bag leaked all over my ass and I had to do several walks of shame to the bathroom throughout the flight.
The recovery from the reversal was intense. I spent basically two entire weeks in bed, which I have to say, really fucking sucks. I could feel my body turning into mush. After 2 weeks, I was instructed to begin ejaculating once every 24-48 hours in order to keep fluid moving through the vas reconnection. In other words, I am clinically manded to ejaculate basically every day, forever. For me, I had no pain during or after ejaculation, which was a positive change.
At the 2 week mark, I still had a lot of discomfort, but I generally felt pretty good. By week three, I felt good enough to take my son to the movies. But by the time I was hobbling home, the pain was so bad I worried I had torn my reconnections open, and laying in bed later I almost went to the ER. But the pain did go back down to a manageable level after a few hours.
My postoperative instructions said that by 4 weeks, it would be safe to resume exercise. This was not the case for me. I was still feeling too much discomfort and was too sensitive. Around that time I had my first semen analysis - these are used to determine whether the connection has stayed open. My total count was 215 million. I understand this is on the relatively high end even for a person who hasn’t had a vasectomy and a reversal, which I suppose supports the theory that I was experiencing pain because of an uncontrolled buildup of sperm in my balls/epididymides. So technically, my reversal was a success. But I was still in a level of pain that was similar to my pre-reversal situation.
A few days after my first semen analysis, my surgical site became infected. After a week of keflex, it didn’t clear up, and I had to be hospitalized for a course of antibiotics. It turned out my surgical site grew an antibiotic-resistant bacteria called pseudomonas aeruginosa. They did an ultrasound, and I had a new varicocele on the right side plus two small hydroceles, one on each side. When they released me, they gave me a 9 day course of levaquin 750mg. Having looked up quinolones, I was terrified of the side effects. The day I took my first dose, I swallowed the pill and immediately took a short walk, the logic being that it was a beautiful early spring day and that I should enjoy what potentially would be my last walk in a long time in the event that my tendons exploded or I had a quinolone-induced psychotic break.
I got through the course of levaquin and my infection resolved. I have some new tinnitus (right now it sounds like there is a cicada behind my head), but so far I have avoided the really extreme ‘floxing’ side effects I’ve read about. I did, however, develop new, very extreme urinary urgency and frequency symptoms the day of my first dose which continue to the moment I am writing this. I went to a new urologist who did urine and semen cultures, which came back negative, and he thinks I have non-bacterial prostatitis or pelvic pain syndrome. I am wondering if the cause of this is the tension I have carried in my body since the vasectomy, since those 20 minutes or so of clenching every muscle and sweating every drop of sweat onto the operating table. I don’t know.
I had an initial consultation with a pelvic floor physical therapist who, with her finger up my butt, told me that she would have expected her exam to reveal more tightness for someone with the symptoms I described. I was not very encouraged by this, as I was hoping that I would have some really obvious pelvic stuff that would be the unambiguous cause of my symptoms. But I will continue with the therapy in hopes that it will help.
Yesterday I had my second semen analysis, and my count was 115 million. I understand that sperm counts fluctuate wildly, so I take this to mean my connection is still open. With the level of discomfort that I still have, I was worried my connection had closed. But I guess it’s open, and I will just keep waiting to see if I get better. This brings me to today.
As of today, the pain in my balls is still there. I am intensely sensitive, if I touch them lightly they ache. If I stand for too long, it feels like someone is pulling them. This is especially true on the left side (the large varicocele side), which almost always feels like it is swollen and oversized. One of the many urologists I’ve seen suggested embolization before another surgery because I’ve already had so much stuff done down there, and there may have been damage to my deferential veins that might put my testes at risk if I get varicocele microsurgery. So if things don’t get better, another genital procedure may be in my future.
Both balls frequently feel heavy and cumbersome, and I rarely feel comfortable. I still can’t exercise. The only definitive improvement has been the leg tingling and pain - that hasn’t come back. I am grateful for this.
Before all of this, I was a runner. I would ride my bike with my older son. We would go on hikes, we would go camping. I will do these things again. If I have to get my balls cut off and take testosterone or pain pills or whatever, I will not deprive my children of life with a parent who thinks of them first instead of being constantly preoccupied by pain. There must be a way. So far, I don’t know if my reversal worked. I know that the timeline of my experience is extremely compressed compared to many men who get PVPS. When I see stories of people who dealt with it for 5 years, 10 years, 20 years, it strains my comprehension.
To you, person reading this, if you’re out there, I wouldn’t say that I have any advice for you. About two months into my post-vasectomy experience, I called my dad and asked if he’d had any pain after his vasectomy. “No, I went out drinking the night before, and I was back up on my feet the day after.” So I guess it’s not genetic. I had an experienced doctor. I followed the instructions. I don’t know why things went wrong for me. I hope I will get better.
Maybe don’t rush into a reversal as quickly as I did - I had mine at the 3 month mark, and I don’t know if I would have gotten better if I waited, but I probably wouldn’t have gotten worse.
Whether you’re getting a vasectomy or not, whether you already have, whether you’re getting a reversal: good luck to you.

Its been over 2 weeks since my snip. Feeling much better. I took notes each day to document my progress. Thus far it seems like im doing fine and have had no big issues. Ive been wearing a jockstrap all the time and feel like im mostly healed. Still a little sensitive but that gets better everyday just slowly. I hope my notes can kinda show how the recovery can be. My doc does around 300 snips a year so i felt pretty comfortable with his skill. He prescribed valium pain pills and antibiotics. My recommendation is to lay around as much as possible for as long as possible. Some days are better than others and you might have a very good day followed by a very bad day. Im back to exercising but havent done any lower body or cardio yet.
Day 1- 1/12 10am appt scalpel method whole thing took 30 min. Took valium prior my doc recommended it and i would as well. Much easier and no nerves. Needle hurt some not unbearable. Felt very little after needle just some pulling. Went home lots of ice. Little swelling. Took prescription pain pills and antibiotics. I did not get off the couch. My wife was great and set me up with lots of snacks. Day 2- more general swelling and soreness. Not too bad. Lots of ice. Laid on couch all day. going pee was uncomfortable. Day 3- same as day 2 but switched from pain pills to tylenol because pain pills make me loopy and itchy. Couch again all day. Day 4- swelling and soreness. Felt better and moved around more. Switched to ibuprofen from Tylenol to knock out swelling. Which knocked it out pretty quickly. Finally took a shower felt much better afterwards. Night day 4 went back to my bed from the couch (prior to this slept on the couch because the dog sleeps in our bed and moves around alot and i didnt want to get bumped) Day 5- woke up felt much better. Took ibuprofen and did the dishes. Probably stood and moved around too much as my left side had a swollen knot on the body side not testicle side just above the scrotum. Right side was ok. Mostly just sensitive all around besides the knot. Took more ibuprofen and lots of ice and laid down. day 6- back to work. i have a desk job so i can sit most of the day. still sore but it seems like each day now is a little better. still taking ibuprofen to keep swelling down. tiny bruise on the left side right where there was a swollen knot yesterday. might have been a little bit of bleeding no further pain on left side. felt better moving around but was cautious whenever i moved. evening little sore but more uncomfortable than anything else. took ibuprofen during day and tylenol in evening cause i was concerned the little bruise would enlarge from the blood thinning effect of ibuprofen. hit 5000 steps which was probably too much was kind of uncomfortable all evening and laid around little bit of pain on left side same as yesterday. day 7- still sore and uncomfortable maybe a little more uncomfortable than day 6 but not bad as i can sit and kind of lay back in my office chair most of the day. took ibuprofen. as the day progressed i developed that kicked in the nuts feeling in lower abdomen when i walked and nuts were a little more sensitive and had a few weird little pull pains. not terrible just uncomfortable. some moments were just fine others more uncomfortable. Day 8 - 1/19 Made it a full week! i feel sensitive more than anything. still a little sore. its getting better. still wearing jockstrap all the time but taking it off for showers or bathroom isnt too uncomfortable anymore. ive had a few light twinges of pain in testicles and lower abdomen but nothing crazy. right testicle has been a little more sensitive than left. had my first ejaculation and no issues at all felt normal and no blood in semen i was kind of surprised how normal it all was. day 9 - i forgot to take ibuprofen in the morning and didnt really notice. still a little sensitive in the nuts but the soreness is probably 85% gone. i didnt think that ibuprofen would help with sensitive nuts so i didnt take anything. more light twinges not too bad but noticeable. day 10 - same as yesterday still sensitive and just a little sore it comes and goes. Had second ejaculation again normal. day 11 - woke up a little sore in the lower belly. still sensitive. not bad i think its getting a little better each day. i take ibuprofen sometimes just in case there is swelling i cant see. had third ejaculation. day 12 - woke up and felt pretty good. did a light arm workout no lower body or cardio. very lightly sensitive but walked around no problem. day 13 - same as yesterday lightly sensitive but feeling good. each day is a little better. day 14 - tried going with just briefs no jockstrap but nuts were a little sensitive and ended up putting on a jackstrap and any discomfort went away. each day is a little better. can walk around with jockstrap no issues. day 15 - made it 2 weeks! still have sensitive nuts but thats all really. im at probably 80% and each day gets a little better.

TDLR - snipped today, no scalpel, no clamp and under general anaesthetic . Done privately in the UK for £2,741. Pain during 0/10. Discomfort during 0/10. Pain after (0/10). Discomfort after (3/10). Currently no regrets.
I just had the procedure today (Friday 05/01/24) so it is still fresh in my mind.
I made use of one therapy session to make sure I haven’t missed anything from a psychological perspective in my decision making (self-pay). I didn’t think I did, but as this is considered a permanent body alteration, I just wanted to be sure I had no blind spots.
The surgical notes reads:
“Vasa identified and clipped through skin, no scalpel technique incision in skin right and left, vasa identified and mobilised and a 2cm portion excised, ends tied with 2-0 Vicryl and diathermised, fascial interposition with 2-0 Vicryl, haemostasis and skin closed with 3-0 Rapide. 0.5%Chirocaine instilled into wounds 10ml”
Went private after referral in the NHS for two reasons: (1) the waiting time at two clinics I was referred to was 12 months at one and 24 months at another - I live in the South East of England, UK; (2) neither clinics offered sedations or general anaesthetic (GA). I have anxiety when it comes to medical procedures and don’t cope well with pain or discomfort. I wanted to be put to sleep.
1230 - arrived at hospital reception and admission to hospital with confirmation for the procedure I was having. Sat in waiting area.
1240- taken into my room by hospital porter. Shown what was in the room and how to operate certain things. At the same time, another member of staff arrives to take my food and drink order to consume after the surgery.
1250 - nurse comes to confirm medical history, complete some more paperwork, check the procedure I was having and confirm the last time I ate or drank due to the GA. Gives me hospital gown, dressing gown and slippers. I get dressed into them. Note, I was told to bring my own dressing gown. I don’t wear one so don’t own one. I wasn’t onto buy one just for this so was hoping the hospital will give me one considering how much I paid. They did.
1310 - anaesthetist attend to once again confirm the procedure I was electing to have and go through side effects, concerns I had and what was going to happen GA wise.
1325 - Consultant arrives to confirm the procedure I was electing to have (for the 4th time today). Goes through quickly what he went through in detail at the initial consultation around risk, the technique I have chosen and how he was going to compete it. Went through pains meds he would give to take home (paracetamol for mild pain, co-codamol and a laxative if I end up taking the latter due to moderate pain). Answered any last questions or concerns I had.
1340 - waiting around in the room with my wife. Had some nerves so went to use the toilet to see if it helped calm me down a bit. Big Bang Theory was on so watched that for a bit of a distraction.
1400 - nurse comes to collect and takes me to theatre.
1405 - enter the theatre prep room. At this stage getting some what more nervous because there were 5 people in that room all doing different things to prep. The urologist was not present at this point. I think the number of people took me by surprise. At this point, I remove my boxer shorts. I was thinking this was my very last chance to call it quits and walk out. Like I said, I am not good with medical procedures.
I lay on the bed for what must be about 5 minutes whilst they all do things around me. The anaesthetist puts a line into my left hand. He injects the first liquid which is meant to do something, maybe a pain killer. I was told what it did but have forgotten in the midst of everything going on. He then said he was going to inject the second liquid in three seconds and that this would send me to sleep in under 10 seconds. He counted down to three. Injected it. I was in the middle of asking another question and the next thing I knew I was awake in the recovery room. That GA stuff is powerful. I’ve only had it three times in my life. Can’t fight it.
1515- about this time. I was awake in the recovery room with a nurse sat facing me monitoring my obs. No pain. Very slight discomfort in left testical and right lower abdominal area (internal). It was hardly noticeable but it was there. Pain scale 0/10. Discomfort scale (2/10). We chatted for half an hour or so. She said I was in theatre for 45 minutes and everything went as planned. Once she was happy, she called the porter and my original nurse to wheel me back to my room.
1545 - back in room with wife waiting. Pain scale 0/10. Discomfort scale (3/10). I get transferred over from theatre bed to my room bed. Hooked up to obs machine again and cannula taken out. Asked if I wanted my food now but declined. Still feeling a bit foggy brained from the GA. Said they need to observe for a least another hour and know that I have passed urine before I can be released. Gives me a hospital jockstrap. Once she leaves, I put on the hospital jockstrap, followed by my sports boxer briefs, followed by a sports jockstrap I bought for this procedure. Felt very supported.
1630 - consultant urologist arrives to check on me and answer any questions. I asked about slight discomfort in left testicle more so than the right and I was told was completely normal. I asked about the internal discomfort in lower abs area. Again, told this was normal because the vasa runs deeper up inside the body, behind the bladder the into the prostate. The surgery involved tugging on vasa which is why discomfort can be felt on those area now. I asked if I should have my semen checked annually once I get the all clear in 4 months time. I was told it would be a waste of my time and money. The technique he used, once all clear, the odds are less than 1 in 3000. I was told categorically, this does not mean if I had sex 3,000 times from now on, there will be one pregnancy. He said these odds are about failure per procedure. However, it was up to me if I wanted peace of mind.
1635 - food arrives - Tuna baguette, fruit salad, a drink and a croissant.
1645 - two nurses arrive to do final obs. Then ask me to go pass urine. They stood outside with the toilet door kept slightly ajar, I assume to check. I pissed for ages. They comments after if I was ever going to stop.
1655 - we leave the hospital.
More in the comments together with cost break down.

Got mine done yesterday, no scalpel method. I live in Ontario, and I got referred to a local clinic. Had to wait a few months for a time slot.
Preparation: No need to fast, but don't have a heavy meal beforehand. You need to shave your testicles, plus the underside and sides of your penis about a day before with a disposable razor. Trim the big hairs with scissors, then shave in the shower, gentle, short strokes, lots of foam/gel. You can leave the pubes above your penis intact if you wish. Wear supportive underwear: briefs or boxer-briefs, not pure boxers, as they allow for too much motion. You'll need someone to drive you to and from the clinic if you plan to have valium.
At the clinic: The doctor gave me a quick interview before the procedure to check I understand what I'm doing. I'm in my 30s and don't have children, and have never wanted them. Some clinics may refuse men if they're under 30 - this one did, though obviously this didn't affect me personally. I took a valium, and I was asked to apply a sticker with a lidocaine patch onto my scrotum. Had to wait for about 20 minutes for everything to take effect. You'll feel a warming sensation from the lidocaine, not painful.
Procedure: The procedure itself only takes about 15 minutes. You lie on your back and the doctor will locate your vasa by hand, make a small incision, make a few injections. I'll be honest, I was looking right at the ceiling and not at what was going on. It was mildly uncomfortable, and the injection made me wince a tad, but it was not particularly painful - I've had dental procedures that were far worse.
Immediately afterwards: The doctor gave me some antibiotic cream, some gauze, a jockstrap and an ice pack. The ice pack goes between the strap and your underwear to keep things cool, and he recommended reapplying the pack for a few minutes every hour, as well as changing the gauze twice a day for two days. He also gave me some Advil to take if needed. Afterwards, I felt woozy from the Valium, and had a nap in the car as my GF drove us home.
Days afterwards: It's been nearly a day since I had it done. I can walk and climb stairs, though slower and more carefully than normal. Doctor recommends resting for two days afterwards, no running, cycling or any major physical activity. No sexual activity for at least a week. My sex drive has not been noticeably affected, but I wouldn't masturbate for a week afterwards to be on the safe side. Besides, it still aches down there (not painful, but noticeable) so I don't really want to do it anyway.
Weeks afterwards: You are not sterile immediately after your vasectomy, so you do need to continue using birth control. The doctor recommends submitting a semen sample 3 months afterwards to confirm your sterility.

Hello, people I’m writing this guide, as an ultimate guide to possibly help certain people heal from the chronic epididymitis or testicular pain. I will list all resources and possible solutions as a whole from everything I read from people online.
1: Get tested for STDs all including (HIV, Clamydia, Syphills, Trachomatis) if positive get antibiotics as soon as possible usually this will resolve issues. If negative still take antibiotics as it may be an unknown bacteria. Beware of antibiotics such as Levaquin flox strong antibiotic, may have side effects and many don’t have side effects. Just be aware meds are working if pain goes away after two days or 3 day use that means antibiotics are doing the work. Doctors will also do urine test and check uti (Note Antibiotics usually are prescribed due to anti inflammatory)
2: If all fails no antibiotics worked or made you feel better get an ultrasound this will rule out cancer or something serious. Most likely urologist will say you have chronic epidiymitis. The issue we are all suffering. But get an ultrasound to rule out
3: This one is a hard one to get but many say certain bacteria can only be found through semen culture exams. But most doctors refuse to do this test. So good luck getting it.
4: Analyze your own pain, if you have pain coming from your stomach or but area may be something else causing it. Like Prostate so you may want to have that checked because it could be a cause.
If all this fails try possible resolution below:

1. Don’t Masturbate or have sex for 2 months or 4 months recommended. This including edging or even stimulate or getting hard on. Trust the pain can return from this.

2: Masturbate I know I mentioned in 1: don’t masturbate but believe it or not for some people after masturbating without edging has gave them some relief, Doctor says sometimes build up bacteria or sperm may release from the pain. Very rare though so don’t get too excited.
3: Supplements now there are a lot of supplements that have anti inflammatory properties, Ones I found online Turmeric, ginger black pepper, these have been know to relive pain, a lot. there are many other as well out there that could help. some drink cranberry juice, black seed oil etc do your own research.
4: CBD and Hemp oil many have said this has helped relief and even some doctors suggested.
5: Castor Oil and anti fungal creams do your own research a lot people had success.
6: Pelvic Floor Exercises look them up on YouTube they are basically like stretching. Have helped many relieve pain sometime even goes away entirely. This has helped relieve pain.
7:Icing and Warm Baths , this helps sometimes especially icing. However warm baths can cause inflammation to get worse as well as ice so varies for most people.
8: Try not to think about pain much stressing over it may make it worse mentally. Got learn to ignore it.
9: ibuprofen, advil etc may help relieve the pain or help with healing however I would say it’s not the final solution after it wears off pain may comeback. There are also alternative medicines pills that doctor can recommend for anti inflammatory not just ibuprofen so ask your doctor.
10: clean hygiene especially if u have foreskin can cause bacteria.
11: Jockstrap apparently helps people heal better when wearing.
12: eat more healthy some say it has helped them avoiding spicy and caffeine.
13: Maintain clean Hygiene and know your allergys I read stories of people masterbating with their pockets pussys and didn’t sanitize, caused them bacteria. People using lubricants allegeric to even condoms.
14: don’t put harmful chemicals in your balls certain creams or baby wipes while you beat your meat may have bad reaction on the penis.
Final solution urologist recommends for years of pain. Denerve the testicles this is last solution Remove testicle Depending on what they find I would avoid this.
I’m pretty sure there is a lot more information out there but this is basics of this terrible condition of testicular pain. Look at all your options and research to finally get healed. I gathered this from online reading everywhere from Reddit and online. Unfortunately there really needs to be more research on this because it’s lacking bad. I personally have not healed entirely and I’m going on a month with this pain in my testicle. From reading different people story’s avoiding getting hit in the nuts, practice safe sex don’t be rough during sex you could really hurt your own nuts. Good luck fellow men I hope u heal.
Disclaimer: I am not a medical professional these are just opinions and research.

I am Scott Andrew I'm 42 I was diagnosed with PTSD and Oppositional defiant disorder when I was 11 after a man held me against a bathroom sink and sodomized me. When I was 15 a new movie theater opened right near my home and I went on the first day and I went to the manager and asked if I could work there. And he hired me on the spot. I was so happy and that manager abused me sexually for half a year. Pick me up from my bus stop and brought me to his parents house in Longmeadow Ma and he made me breakfast and then I got really tired and went to sleep. I woke up 14 hours later at his house in different clothing.
In October of 2008 I was diagnosed HIV positive after I was unconscious then raped by two men I didn't know. I sought treatment at a medical center called FenwayHealth in Boston Massachusetts. My first time there I was set up with a Doctor who's name is Jason Faulhaber and his specialty was Infectious diseases. I was still in shock about the whole thing and my boyfriend was with me in the room and he explained what it meant for me to have HIV and how it can be treated and made me feel safe. When that appointment ended and I was about to walk out of the room he stopped me and took out his Fenway business card and he wrote down his personal email address on it "[DrCuteBoy@gmail.com](mailto:DrCuteBoy@gmail.com)" and his cell phone number and told me if I needed him I could reach him any time.
I soon after began seeing him for medical treatment where he did a physical and prescribed me some medications and on the way out of the exam room at the conclusion of my appointment he hugged me and kissed me on the lips in an overly friendly way. The next appointment when I was leaving and he hugged me I continued leaving before he had a chance to kiss me. A little while later that day I received a text message saying he was upset he didn't get his kiss. And I realized who It was. I was an attractive friendly young guy and very used to men flirting with me who were interested and I knew how to be nice and deflect and this is what I did. I didn't mention it to my boyfriend because I didn't want him to get upset.
I was only seeing Dr. Faulhaber around once a month. On a few occasions when I had other medical concerns I'd text his personal phone and see if he could see me and then he'd make an appointment to come in. And we also would text and say hello and chat about what was going on with me and I'd talk about problems I had. I had mentioned to him that the psychotherapist I would see weekly wasn't raising my dosage of ADHD medication like I wanted her to. He said he could treat me for this and he sent my therapist a letter saying he would be assuming my treatment. She responded with an email to him and myself saying she felt it would be inappropriate because of my history with drug abuse and believed a therapist would be better to serve me.
5/11/2009 he raised my dosage of Adderall and said he would prescribe me them but he would only prescribe me them for two weeks at a time, not the usual 4. And for this I would have to see him every two weeks.
4/29/2008 my first appointment with Dr. Faulhaber he would have me unbutton my pants and lay on the table and do his exam, lift my shirt feel and press areas on my low on stomach and ask if that hurt. Then Id stand up and he would have me pull my pants and underwear down he would have me cough while he felt my testickles then I would turn and bend over on the table and he would grab a tube of lubricant and he would put his finger in my butt and feel around and often I noticed he'd do this but not be wearing gloves. I didn't question him about this because this was the only time in my life where I would see a doctor on a regular basis and I assumed this is what happened during a visit with a Dr. dealing with HIV. Once in a while he would put a log qtip in me and send it off to a lab. This would take place even when I was going there only for my refill for adderall. This went on for a long time and all the while we'd be texting here and there like friends and it wasn't a problem for me and it would be a flirty conversation and I was always nice because he was prescribing my adhd meds and I didn't want to mess my script up.
And I always have to give him a hug and kiss after every visit with him. He even asked me to make a copy of the porn I would download and put it on a hard drive so he could borrow it and copy it.
Once I was out with a friend at a club and ran into him and he was with his friends and I spoke with them for a little and he gave me a hug and kiss when I left in front of his friends. To which he told me they were Jealous of him. Our next appointment was only a day or two later when I was running late and missed my scheduled visit and he said over text he would let me come in around lunch time and I made it on time. During that visit when I got on the table I was wearing a jockstrap and he was excited by this and he pulled them down slightly at the waist. And I got an erection. That would happen every time I took my pants down. I'd usually apologize and be embarrassed because I couldn't control that. This time I was laying on the table and my shorts were down and my jockstrap was on and he put lube in his hand and began putting his finger inside my anus and my erect penis was pushing out of the side of the jockstrap. Dr. Faulhaber then grabbed my penis and he put his mouth on it and began giving me oral sex at the same time he was pushing his right index finger in my anus deeper and more forcefully. I laid there watching this happen in shock and confusion. I didn't know what else to do and when he could tell I was going to climax he stopped the oral sex and said "shush" as he started masterbaiting me with his gloved left hand to completion. Removing his finger from my anus at the same time I was ejaculating. Very quickly he turned around and grabbed a paper towel and cleaned the semen off my stomach and wiped my penis off, he had no expression on his face. It was like in a “clinical manner” is how i'd describe it, and he put my penis back in the pouch of my jockstrap then threw the paper towel in the trash along with the one glove he wore on the left and he washed his hands. While I got up in a hurried manner and pulled my shorts up and picked up my bag and put it over my shoulder and he printed out my scripts and handed them to me and I took them and went out the door without stopping to say goodbye or leaned in and kissed. I dropped my script at the pharmacy which was right there in the front of the waiting room and I walked down the stairs and just as I reached the exit door and before I could walk out I received a text message from Dr. Falhaber saying "Don't tell anyone about this" Which I immediately called a friend Tim Jordan and told him about it.
I have some of the phone conversations with Dr. Faulhaber saved.
This was the only time in the office or anywhere that anything sexual had taken place. I used to get bad anxiety before I'd go to see him. I would take a recreational drug to put me in a good mood in the waiting room so I could go in and not have to feel how he made me feel. One occasion I overdosed and was unconscious in the exam room. I woke up there hours later.
And another time I ran out of the building and ran into traffic and ran up a cab breaking its windshield.
And another time after seeing him I left screaming I was going to kill myself.
Finally in 2012 I needed to be seen for an emergency and went into the office and he wouldn't see me and I said out loud in front of 2 nurses and another doctor "He can suck my dick but I can't be seen for an emergency" I believe that's when the investigation began. But the official investigation said there were 4 people they interviewed 3 and said that couldn't locate me which is impossible. I had the same phone number and at the time was in and out of FenwayHealth almost weekly.
When out of the blue I was told I'd be seeing a new Dr FenwayHealth never told me why or what happened with Dr Faulhaber. They never asked me if I was harmed. And It's something that I would feel over and over for every visit to that place. It wasn't until Aug 2016 that I told my provider Julie Thompson who passed me to someone else named Jessica Gutchess and I spoke with her a little and everyone at FenwayHealth started treating me differently. And after one appointment in 2016 around October I was told the Medical Director of Fenway Health wanted to speak to me. I was brought to the office of Alex Gonzalez, MD and left with him alone. And he said some things but I wasn't getting at what he was saying. Until he said "I sort of feel responsible for this happening to you" And I asked what he meant by that. Alex Gonzalez then stated that he was the one who god Jason Faulhaber hired at FenwayHealth and he added they were roommates in college. And I felt like it was happening all over and this wasn't appropriate and I walked out of there and never went back, abandoning any treatment for HIV or anything else until Feb of 2023 - I don't trust doctors. I was vulnerable and I thought I was safe but I wasn’t. And I felt FenwayHealth shut me down and kept it hidden. They didn't notify the police or ask me if I wanted to. They acted like they didn't believe me and never mentioned Jason Faulhaber's sexual misconduct, in which he lost his license in MA but moved to Virginia and continued to practice. From Day 1 where I was most vulnerable he was looking at me as his next victim. I am one of his victims and have been suffering in my personal life to this day and nothing has been done about it. Not even an apology. My grandmother in 2014 urged me to see a lawyer. So I found one in Springfield and told my story to them and they said they would work on it. But they just let time go by and the clock ran out and then told me they couldn't do anything and that there was no way to sue FenwayHealth. --- But what I found out after digging into it online is that the law firm I hired has a family member who was on a board of FenwayHealth at the time. And had also been a donor to FenwayHealth. Oh Well.
I'll finish with some Fiona Apple.
"What you did to me made me see myself something different
Though I try to talk sense to myself but I just won't listen
Won't you go away? Turn yourself in, you're no good at confession
Before the image that you burned me in tries to teach you a lesson
What you did to me made me see myself somethin' awful
A voice once stentorian is now again meek and muffled
It took me such a long time to get back up the first time you did it
I spent all I had to get it back, and now it seems I've been out-bidded"