What is a Vas Deferens?

and what does it have to do with dysejaculation?

Not every man considers ejaculation to be a pleasant experience. For some men, ejaculation can hurt. Dysejaculation is one of the possible long-term complications of inguinal hernia surgery.

As a non-doctor, I did not realize that the vas deferens was a muscular organ that contracted during ejaculation. From information intended for consumers of medical care, written by providers of medical care, I had somehow gotten the idea that the vas deferens was little more than a simple tube, and that it carried sperm from the epididymis to the seminal vesicles (also not true), and that some other mechanism, that didn't involve the vas deferens, was involved in ejaculation. What I learned, after quite a bit of looking around for more detailed information than that usually provided by providers of medical care, to consumers of medical care — is that (1) the sperm produced by the testicles, after being transferred from the testicles to the epididymis to the vas deferens, and after traveling up the vas deferens toward the general area of the bladder, is actually stored in an ampulla, one at each end of each vas deferens, not in the seminal vesicles as I had erroneously thought, and that the seminal vessicles are actually nearby glands, that contribute to seminal fluid, along with secretions from the prostate (2) the amupulla is a part of the vas deferens, a widened area at the end, and (3) the vas deferens is a muscular organ rather than a mere tube, as I had erroneously thought, and it is a muscular organ that contracts as part of the process of ejaculation. Furthermore, surgically reducing a hernia — the first part of the 2 parts of a hernia operation — requires surgery very close to the vas deferens, and it doesn't seem to be all that difficult to damage the vas deferens in the process. Bummer. And finally — a chronically infected and inflamed vas deferens can make ejaculation impossible — without excruciating pain. Little thing, big pain.

None of the web sites I had found, that purported to inform people about everything they needed to know about hernia surgery, mentioned this possibly long-term, painful complication of hernia surgery. The web sites indeed mentioned a significant number of possible complications, including nasty ones such as testicular atrophy, and hematomas, and also, as briefly as possible, touched on "inguinodynia" and "dysejaculation" — but not one mentioned the possible complication of excruciating pain every time you ejaculate, if you ever do ejaculate — instead of trying to avoid it, possibly for the rest of your life.

Here is a nice page that explains a bit of the anatomy and physiology of the vas deferens, and here is what the page says in regard to the nervous control of this muscular organ, control by the parasympathetic, sympathetic nervous system:

  1. Parasympathetic produces emission. Slow peristaltic waves along the vas deferens move spermatozoa from the epididymis to the ampulla, where the sperm is stored before ejaculation.

  2. Sympathetic produces strong contraction of the smooth muscle of the vas deferens producing ejaculation.

  3. Sensory Afferents travels through the pelvic plexus and along the pelvic splanchnic nerves to sacral levels S2-S4. As a result, pain of deferentitis or from prolonged engorgement of the ampulla is referred to the perineum.

The perineum, in case you don't already know, and in case you might be feeling a bit lazy about looking it up — is the area between the scrotum or vulva, and the anus. That's where it may hurt, if there is a chronic inflammation of your vas deferens, even though the vas deferens itself is elsewhere, higher up.

Check out Dr. Feliciano's whole site, starting at his home page here.

There is a quote that, several times, I have heard, attributed to Albert Schweitzer: "Pain is a more terrible lord of mankind than even death itself." I believe that this is true. Also attributed to Dr. Schweitzer, is the following remark about pain, that it is "the most terrible of all the lords of mankind." Yet how many times have I heard other doctors, in reference to pain, say "it's not gonna kill ya" — as if this was good news. It's not good news. We have, I think, some evidence for the fact that pain can be worse than death, in the fact that interrogators are more likely to threaten to cause pain to people, to get information from people against their will, and less likely to threaten to kill the person they want information from. I don't think this is simply because they can't get information from a dead person. I think it is because people are naturally more afraid of pain than death.

I mentioned to one hernia surgery specialist that I consulted, before having my hernias repaired, that I was concerned about the the acute pain and discomfort of surgery, but that I was more concerned about the long term results of any surgery that I might want to have, and about the possibility of having chronic pain consequent to surgery, and I mentioned that I felt that the likelyhood of chronic pain should influence my choice of what kind of surgery to have. His brusqe reply: "we don't do hernia surgery to prevent pain; we do hernia surgery to prevent incarceration, strangulation, gangrene, and death." Despite knowing this surgeon's reputation as a skilled surgeon, and despite my personal belief that he was a skilled surgeon — I felt I would be in better hands if I had someone else do my surgery — perhaps even someone with less surgical skills, but better patient-care skills, more overall living skills, and really — just some more plain, ordinary sense.