Vasectomy reversal and other strategies to mitigate postvasectomy pain syndrome

Variations in vasectomy techniques have failed to define a means of preventing postvasectomy pain syndrome. In addition, studies examining the pathophysiology of this condition have failed to elucidate a reproducible cause. Prevailing assumptions are focused upon epididymal congestion and obstruction.7 Potentially, up-and-coming techniques such as vasal occlusive gels, currently under development, offer novel alternatives to traditional vasectomy. Such an intra-vasal approach could involve the percutaneous puncture of the vasal lumen and instillation of a reversible, semi-permeable polymer gel. This intra-vasal option could theoretically decrease the negative side effects that result from direct scrotal manipulation. However, if the assumption of epididymal congestion holds true, it would stand to reason that any mechanism that retards the flow of sperm from the epididymis has the potential to result in postvasectomy pain. Thus, potentially the best correction for postvasectomy pain rests with the generation of a hypothetical male oral conceptive. Such a medication, by avoiding the need to have an occlusive process for vasectomy, could eliminate postvasectomy pain and its related sequelae.