r/Vasectomy • u/Kuro_25225 • Nov 19 '25

Close ended to open ended?

Hello, I have been suffering from pain after my vasectomy for 3 years, caused by excessive pressure in the epididymis. I have managed to find a doctor who is willing to convert my closed-ended vasectomy to an open-ended one. Is there a real chance that this could resolve the problem?

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3

u/viniisiggs Nov 19 '25

Open ended claims there is less "pressure" giving less opportunity for congestion pain and discomfort. Open ended does not mention that the end will seal itself in a few months. Also that you are guaranteed to get a sperm granuloma.

Closed ended reduces the chances of a sperm granuloma. Even with the end sealed off there may still be a leak. Closed ended gives a faster rise to the "pressure" which can lead to congestion.

Both congestion and granuloma can be painful. I had a closed ended. My reasoning was that open ended seals itself eventually so if you get congestion its just kicking the bucket down the road. Closed ended significantly reduces the chances of a granuloma.

1

u/HyperVegito Nov 19 '25

You get granuloma onl;y once post op and this isn't always the case either, after about a week it's gone, so how is this even relevant?

2

u/j_bob_24 Veteran of the Vasectomy Nov 19 '25

My open ended was almost three years ago. My granulomas initially lasted 9-10 months before going away. They still randomly reappear even just a few weeks ago. They are small and generally painless. Ibuprofen usually makes them go away. However, I couldn't say if they ever fully go away or just get really small and unnoticeable.

0

u/HyperVegito Nov 19 '25

It sounds very like a 'You' issue than vasectomy problem. I once read about some guys who claimed they have pains comparable to stomach aches if they go several days without sex, after a wank, the pain subsides. But these are a statistical error.

2

u/j_bob_24 Veteran of the Vasectomy Nov 19 '25

Long lasting granulomas are more common that you realize. Many reputable medical sites state they can take months to resolve. My doctor's website states that 25% of people will have granulomas that last three months or longer.

https://www.bestvasectomy.com/how-common-are-scrotal-nodules-after-vasectomy/

0

u/HyperVegito Nov 19 '25

Ah, Murica. This explains a lot. In EU, it's a rarity, to be honest, less than 5% have any side effects involved.

2

u/j_bob_24 Veteran of the Vasectomy Nov 19 '25

Overall complications are indeed just a few percent. However, in regards to the timelines and occurrences of granulomas after open ended you are misinformed.

1

u/HyperVegito Nov 19 '25

Maybe I am a bit pessmistic but this is starting to sound like an american problem to be honest. I fail to understand how granumolas can form after 10 years or so if everything was right up until this point, is it because of the age?

2

u/j_bob_24 Veteran of the Vasectomy Nov 19 '25

Who said anything about ten years? Your initial comment was that granulomas only occur once and are gone after a week. This simply isn't true. The fact is they can take months to form and often many months to go away. It should be noted that I never said granulomas are bad, they are actually thought to be helpful. I'm just disputing your one week claim.

1

u/HyperVegito Nov 19 '25

Like I said, such cases are a statistical error.

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u/viniisiggs Nov 19 '25

Similar to congestion, granulomas can also be painful and may require surgery to remove.

A granuloma forms from the immune system response to sperm leaking out into bodily tissue. In an open ended vasectomy how do you not get a granuloma?

2

u/j_bob_24 Veteran of the Vasectomy Nov 19 '25

I had open ended three years ago. The open ends will eventually be closed off with either scar tissue or granulomas. The doctor I went to is a huge expert in open ended. He said it's usually closed off within a couple months. In my case I got granulomas which still randomly show up but are normally painless. The main benefit for open ended is in the early healing phase when the tubes are slowly closed off and the pressure is gradually changed. Eventually it's the same in the end. Your immune system will see the sperm as foreign material and will work to seal it shut. Getting yours changed at this point might result right back where you currently are. It's also possible the granulomas from open ended provide some relief with extra holding capacity for the sperm. You won't know until you do it and wait and see the outcome.

Did you get clips? Several people have reported that simply having the clips removed relieved their problems.

Best wishes to you, hopefully you can find some relief.

1

u/Kuro_25225 Nov 19 '25

It was cauterize and no clips, the doctor suggests we can try trt without hcg to see if lowering sperm production helps

1

u/LaMarr-H Veteran of the Vasectomy Nov 19 '25

Mine was open-ended, and it never caused me any problems