Erectile Dysfunction Following a Vasectomy " Jason a 42-year-old executive with three children"

Case study ( 1325 views as of August 21, 2017 )

Jason is a 42-year-old executive with three children. Although both busy with their careers, Jason and his wife had a good sexual life, and he had no erectile or ejaculatory difficulties. He recently underwent an uncomplicated vasectomy, and when he resumed sexual activity, he was disappointed that his erection was not as firm and that the orgasm he experienced was not as strong. He blamed it on a diminished penile sensation since the vasectomy, and dismissed it as temporary.

Unfortunately, this issue continued and several months later, Jason visits his family doctor. His physician reassures him it is not the vasectomy per se, and tells Jason this should resolve itself as his psychological outlook improves. However, Jason requests a referral to a urologist for a vasectomy reversal.

The urologist repeats what the family doctor had said, and feels that Jason should see a sexual medicine specialist or a psychologist as there is no organic or medical cause for his sexual changes and does not want to do a reversal without further assessment.

Jason sees the sexual medicine physician who re-explains anatomy and introduces the idea of how the mind-body connection can affect sexual function and sexual signals to the pelvis, and what the vasectomy meant to him in terms of manhood and stages of life. A 3-month trial of daily PDE5i is introduced to improve nocturnal, spontaneous and sexual erectile function and improve pelvic vasocongestion. Jason also sees a sexual therapist for three visits. Over time his erectile function and orgasmic quality improves substantially, although not to what he feels are pre-vasectomy levels.

Jason could benefit from continuing discussions with his family doctor and urologist to monitor his physiological symptoms. He could also continue seeing the sexual medicine specialist and perhaps the sexual therapist to work on any psychological component to his condition.

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Conversation based on: Erectile Dysfunction Following a Vasectomy " Jason a 42-year-old executive with three children"

Erectile Dysfunction Following a Vasectomy " Jason a 42-year-old executive with three children"

  • I wonder if erectile dysfunction following a vasectomy could be a short term thing due to the changes in hormones. And would eventually return to normal ?
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    • @Michelle Kaarto that's a good question. I know that making the choice to have a vasectomy is very hard for many men. Maybe he's struggling to come to terms with what it means
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    • I don't believe that erectile dysfunction is a typical side effect after having a vasectomy. When we had our consult with the urologist, we were warned of the usual signs of infection to watch for, and were told of the slight change if bleeding in the scrotum that could happen following the procedure. I would wonder if Jason's symptoms of erectile dysfunction have a stronger psychological contributor.
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  • What does Jason's overall health look like? He is young, but if he has other risk factors for erectile dysfunction, perhaps it is not just due to his vasectomy treatment and ensuing psychological impact from the procedure. If he is overweight, diabetic, or has high blood pressure, these factors can all contribute to erectile dysfunction.
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    • Smoking can also contribute to erectile dysfunction. Is he a smoker ?
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  • Explaining the procedure and how things will be afterwards would benefit men a great deal. In their minds they feel nothing should change and everything should be the same as it was prior to the process. In this case, Jason feels things are different and it is affecting him psychologically. Giving more details and information prior to the procedure may help eliminate some of the feelings Jason is having.
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    • I think that because it's a "simple procedure" the emotional aspect of a vasectomy is often overlooked when couple's do have the discussion
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    • I also wonder about the benefit of treating a vasectomy as more of a procedure affecting both a man and his partner. I know my husband and I had conversations over a few years before his procedure and it really was a joint decision for us.
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  • I wonder if there would be a benefit to including a psychological component with a vasectomy? It seems as though many men consider this procedure as a threat to their manhood, and perhaps more discussion around post-vasectomy sex may help better prepare some men. My husband recently had a vasectomy and while the physician was very thorough, it would only take an extra few minutes during the consultation appointment to address this concern. I went with my husband to his vasectomy appointment, and it helped us to both be there to hear the information and also ask any questions we had.
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    • I agree that there are a lot of emotions involved with a vasectomy. Having some counselling post op would help men deal with the feelings related to their vasectomy
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