3.5 weeks in and things getting worse


I’m not sure where to begin. I had my single incision vasectomy 3.5 weeks ago by a reputable surgeon who had done some friends of mine with generally positive results. Surgery itself went fine, a couple quick jolts and it was over. Sat at home for 3 days and went to work on Monday. By that Friday i was having a lot of prostate pressure and frequency to urinate. I was given antibiotics and that seemed to help that issue. However, as time goes on, my pain is increasing. I have the occasional dull ache on both testes which are tolerable. My main issue though is the incision site. The best way i can describe it is that it’s a cold burning or an itch that can’t be scratched and it is causing referred pain in my groin and bladder. It’s very painful and is getting increasingly hard to ignore. I’m only able to ignore it if there’s an ice pack on it. I’ve had many sleepless nights and was prescribed some sleeping pills but even those aren’t working now. I’ve spoken to a different urologist, whom i have a lot of respect for and he believes it’s inflammation running up the nerve routes and should die down in time. I was taking Aleve without much relieve and recently switched to Meloxicam with no better effect.
As I have read many of the posts here I realize that I have made a huge mistake. I thought I was doing the “manly” thing because my wife has issues with all forms of birth control. She never pushed me into it as I was actually the one who really wanted this. I have two daughters and our last one had colic. She cried 20 hours a day for 7-12 months and there was no way we could have coped with a third child like that. I’m not sure what I’m looking for here. I just needed to write this all down. I an truly sorry for anyone going through this. Eventhough it has only been a few weeks for me, it has been trying for my wife and I. In a weird way, it has actually brought us closer as we have had some very honest conversations. I worry though that my issues will begin to frustrate her but as of right now she has been a strength for me. I am going to call the uro again tomorrow and see about some pain meds and setup FMLA since I can’t work without sleep as my job is in healthcare. Thanks for reading this, i know it’s long.


Just saw your post. I’m in healthcare as well and I understand how frustrating this can be. You’re still well within the window of hope and the odds are in your favor. There’s only so many things it can be. Most people experience congestive pain right out of the gate. Even though that typically clears up within a couple of weeks, I personally know of two friends that had congestive like pains for 3-4 that spontaneously went out one day. It is possible you have a granuloma and that is the pain you are experiencing. Lastly, there’s a possibility that a nerve was nicked or damaged either during entrance or upon exited your scrotum. Depending on his technique. It’s not uncommon to catch a nerve in a stitch. I would rest as much as possible. Long hot baths with epsom salt and lavender were huge for me early on. Just keep your head up and understand that there are plenty of guys with pain at 3-4 weeks and have a complete recovery within a month or two. It’s easy to let your head get away from you and your anxiety shoot up. I was on suicide watch for a few weeks early on. No one understands what you are going through more than we do.


@Kyvas Hi, Mate you are still early days rest, anti inflammatory’s, ice, pain killers that all you can do. Prostate issues and frequency urination are all common symptoms which will subside with time. I had these symptoms very bad and that gets better with time. I have lots of other issues you don’t have so give it time some take up to 6 months to get better. Do not keep taking doctors heavy drugs as they can play havoc on your stomach, mine has been fried from medicine.


I agree with the other two, take it easy, NSAIDS, ice. Unless there is some proof of infection don’t bother with the strong antibiotics they might offer.

Sorry to hear of your troubles. Don’t let you mind go too far into this. There are specialists out there. Where you living?


Thanks for the quick response guys. My mental status is what I’m struggling with the most. Its very hard to control anxiety. I’ve had my chest operated on twice and although that hurt like hell, at least that pain was explainable. I realize that it will probably work itself out with time but i was not prepared for a prolonged recovery. How do you guys cope mentally? I’m in Louisville, KY.
If there’s any consolation to this, I have already convinced 3 people not to have it done. Thanks again.


The mental thing is hard it gets all of us it wears you down in the end. See a counciler for help to cope its hard road. All the best brother.


6.5 weeks now with little improvement. I was having a ton of pain at work and had to take time off. I had to almost convince the uro because he couldn’t believe that someone would have so much pain they couldn’t work although he admits PVPS is real. I have switched to another uro whom i have a working relationship who believes i am having severe pelvic muscle spasms in response to the vasectomy. I have had a couple PT sessions and that is absolutely horrible but does seem to help. Anxiety/depression have set in but Lexapro seems to be working to help with the catastrophic thinking. I am still hopeful but obviously very worried.


I’m at 8.5 weeks now. Pain in testicles is minimal but present. However, I have lots of referred pain into rectum, pelvis and abdomen. I have lots of pressure and general discomfort. My entire nervous system feels off. I have been off work for 4 weeks, and will be off for at least another 2. I started on Gabapentin last week and it has definitely decreased the burning pains and seems to be helping me relax a little. I haven’t had to take narcotics because I can’t go to work on them so I hope that the Gaba works to quell the pain over the next couple of weeks so I can go back to work. Still going to PT and going to try some acupuncture this week. Hot baths seem to be the best thing right now. Still realize I’m in the window of recovery but Anxiety is high. Thanks for letting me write all this down even if there is no response, it is therapeutic.


Has anyone on this forum had severe perineal and rectal pain? Could it be referred pain from testicles? It feels like my rectum is going to explode and that my perineum is weak almost like it’s been worked out too much. The Gabapentin has gotten rid of the burning pains but this perineal and rectal pressure is killing me.


I used to have the perineal pain and rectal pain early on.

I honestly think it was from being in pain and tensing my pelvic floor. Felt like I was sitting on a tennis ball all the time and my perineum was burning/pins and needles.

I don’t get that anymore fortunately - I’m 8 months out and I think what’s worked best for me is pelvic floor stretches and hamstring stretches, at least twice daily, and if you can stand it, try to walk for at least 20 minutes a day. It’s not easy, but my pain levels are much lower on days when I walk and stretch.

I’ve also stopped taking all meds (lyrica and nortryptiline) so I think my nerve issues have improved a bit, but they’re still there and flare up when I exert myself - which for me is life changing.

You may want to consider trying alpha lipoic acid - see my thread here: Alpha Lipoic Acid - Anyone else try it? I take 600mg on an empty stomach in the morning and it’s almost as effective as lyrica so far - yet I’ve only been taking it for 3 days now. It might be worth trying.

Hang in there man, you’ll eventually get a bit better. I’m not saying you’ll be cured, but eventually you’ll become accustomed to the pain and some of the worst pains will hopefully settle down.

I was in rough shape for a good 6 months, but now at 8 months, I’m mostly functional and don’t pop pills around the clock anymore - still in pain everyday with flareups, but definitely ahead of where I was.


Yes, I’m one year into my 3rd flare-up/bout of PVP since my vasectomy in 2005 (and reversal in 2006). My first bout is hard to recall, but I remember telling people I felt like I was sitting on an onion. No pain in the rectum, but definitely the perineum.

Same thing on this 3rd bout. Started off as a tender left epi, then grew to the whole scrotum, then to the perineum so badly that I no longer felt the scrotal pain. I’m almost certain it’s a tense pelvic floor. I did a about 4 months of pretty intense pelvic floor PT and have since been able to keep the perineal pains at bay. But, the scrotal pains returned, so I think the perineal pain was masking the scrotal pain.

Got to be related.


Two years out and still get consistent rectal pains. It’s. Not constant but I get the bad pressure as well as lightning shocks down into my rectum. My guess is pelvic splanchnic nerves are involved somehow. This would explain the abdominal pains as well as these nerves run a large portion of your digestive tract.


Where are you from Kyvas and what type of surgery did you have? One incision or two? Scalpal/non-scalpel? Clips/sutures/cautery? etc…

No two sets of men’s junk are exactly alike and no matter how many successful procedures a doctor performs doesn’t mean they will never hurt a guy.

The assymetry on the access points on my scrotum is proof to that. Vasectomy as performed by most urologists is imprecise to say the least. It’s done by feel mostly. The most critical step, isolating and yanking the vas out is done by feel.


Thanks for the responses guys. I feel pretty sure its a nerve issue combined with an anxiety level I never knew I could hit. So, I’m actively trying to relax through multiple modalities. The gaba has the pain to a somewhat tolerable level so I’m going to try and go back to work Monday which will help with keeping my mind occupied.


@MikeO. I had the single incision nsv, cautery, sutures and a single suture on the incision. I’m in Louisville, KY.


I met with my urologist today who’s been very helpful and very upfront with me that men do have issues but that he’s never seen my symptoms before ie rectal and perineal pain. Wanted to give you all a synopsis though. As the Gabapentin has taken away some of my pains, i’ve noticed that my right testicle has been hurting. During his exam there was definitely pressure and pain on the right side. (Side note, my right testicle never developed with puberty so it’s the size of a marble and i always figured it never did anything for me ie sperm, testosterone, etc.) He and I decided to do an inguinal cord block with lidocaine which definitely reduced the pain during exam. He is now going to refer me to his partner who does vasectomy reversals and microsurgical procedures to get his opinion as he thinks the pain may be referring to my other areas. The doc he is referring me to trained under Lipshultz and I’ve worked with him in the past and know he does good work so I’ll be interested to see what he says although that appointment isn’t for 2ish weeks. I asked the doc i saw today if he was thinking i needed a denervation, which i wont consider, and was surprised to hear him say he doesn’t recommend it because nerves grow back and can cause more pain. I’m also going to be starting Amitriptyline to just cover more bases. I’ve had pretty good success with the Gaba so far, except for some jitters, so hoping this will help too.


Just be careful with the Amitriptyline and Gabapentine. Those are both super bad drugs and can really mess you up.

As for the pain, it sounds like you have nerve pain given the block helped you. Me, it made me jump off the table when the Doc did it. They figure I have congestion pain.

The retail perineum pain, yep. I have that. I think it’s tied to the pressure I have. I also have pain when urinating. Cause everything is tied together muscle/nerve wise. It’s not like I can’t, it’s just tougher and again is like pressure.

With your comment about your body feeling off, as others have pointed out, Vasectomies cause auto-immune issues given your body is producing sperm but it’s just sitting there and your body has to kick into gear to absorb it.

At least you have a Uro who admits PVPS is real. That’s a tough thing to find.


Yeah, I’m aware of the side effect profile of these drugs but need to try something because i can’t work right now. I’m pretty positive it’s mostly nerve related, with some minor congestion, so I’m hoping these drugs will at least help tame some of the overreacting nerves. I’m going to see the local guy here and see his opinion and then probably contact some of the specialists on this board for my next steps. Still hopeful that some of this will go away with time as it seems to have with many on this forum. Right now I’ve got to focus on faith, hope and love.


In my case 3 days after vas pain started, prostate become boggy with high count of white blood cells. After few months prostate seemed to return to normal state but rectal, perineum, scrotal and leg pain remained. Actually I would not be surprised that my prostate is constantly bit irritated after vas. My pain is somewhat less now at month 13, doing PT (internal and external) for 6 months now, exercising almost every day, stretching, massage therapy, relaxation and meditation. If things don’t improve significantly I will schedule reversal at month 20. Give it enough time with exercise/stretching/PT before seeking more involved (surgical) solution. Anxiety and depression, well, is normal for us with this kind of condition - Xanax and Tramadol taken occasionally help me. Hang in there, you are not alone.


My prostate has played up badly since vas and urination problems.