Post-TRT: Searching for Surgical Alternatives

TL;DR TRT didn’t resolve any of my symptoms, I felt awful on it, and it was probably going to give me CVD. Doctors deny vasectomy could have caused hypogonadism. Doctors and/or co-sufferers, do you know any surgeons who look seriously at diagnosing vasectomy-induced hypogonadism and surgically reversing it? Details below.

Relevant pre-TRT and peri-TRT information.

Long story short, I got on TRT without issue. Unfortunately, it resolved nothing and made several things worse. ED, lethargy, did not improve; from the 3rd week in I developed new-onset hypertension clocking in at 150/120 on average (up from 115/60); tachycardia (110 BPM up from 65); and significant chest pains. These side effects persisted even when they lowered my dose to 130, 110, and 90. I cycled off utilizing an 8-week HCG protocol, completed in July, and my lab values are now almost identical to where they were at previously. BP, RHR likewise, and no more chest pains.

Since that time, I’ve been on the doctor merry-go-round all over again. The (somewhat) truncated version is this: Up until mid-2017, I had zero symptoms of hypogonadism whatsoever. Health was great. Then I had a bladeless vasectomy in mid-2017. 18 months later, January 2019, I had the cascade of 3 of my 4 current symptoms: testicular atrophy and pain; erectile dysfunction; and overwhelming fatigue, all persisting to the present. I’ve browbeaten doctors into ordering blood tests when they assert (without examination) that my T is fine and my testicles are “normal;” I managed to wrangle an MRI confirming bilateral hydrocele and some type of cyst; I’ve eliminated poor bloodflow as an ED cause via a penile Doppler; I’ve had a CAC score which eliminated early-onset CVD as a cause.

Pre, during, and post-TRT, I’ve been to 6 different urologists. Every single one asserts that vasectomy cannot cause ED, hypogonadism, or low E2, and that in fact nowhere in medical history has that occurred. Which, frankly, I find to be incredibly unlikely. When I ask if vasectomy reversal could change anything, they refuse to speculate, because “vasectomy didn’t cause it in the first place.”

I’m at my wits’ end. My quality of life is zero. Doctors who frequent this forum; those similarly afflicted; anybody else in-the-know - is there any surgeon who works in this and is interested in doing a differential diagnosis? And if so, please point me their way.