3.5 weeks in and things getting worse


I had an appointment today with the PT I’ve been seeing for the past 5 weeks. She’s been very nice and does a really thorough internal massage which I believe is helping. Sadly though, no one in her practice that specializes in pelvic pain has ever seen a patient for post vasectomy pain. She didn’t deny it was causing my pain but seemed to have a hard time correlating. However, and the reason for this update, is that over the weekend she was at a continuing education conference in Texas and one of the sessions dealt with male pelvic pain. She told me that they spent a long time discussing PVPS and that the figure told to them was that 15 - 25% of men experience some sort of significant pain after vasectomy. She then did an extremely thorough exam of my scrotum, testicles, perineal area and rectum further confirming my right testicle and rectum are causing me a lot of my issues. Honestly, i wasn’t sure i was going to keep going but she seemed much more engaged today so I’m going to stick with it. Sorry, for all the long posts but it’s amazing the information I’m now being presented after already having the vasectomy. Really pisses me off I wasn’t presented this before and that I didn’t do enough of my own research. This forum provides a good vent and a good journal. Thanks guys!


The reason you aren’t being presented with that info before is if you were told that 33% of all men with a vasectomy have some kind of pain after having one, NO ONE would get one done.

If you were told that ED and other issues could be there afterwards, NO ONE would get one done.

They lie for money. Plain and simple.


This is just myself and my way of thinking i wont deal with female specialists with this pvps issue. I feel its to hard for them to understand. Even though one assistant who helped with 1 of many nerve blocks was good but said herself she had a hard time understanding all this pain from the simple snip.


We now know they sensory nerves are there it’s like chopping off a body part in a sense maybe mention that to her.


I am dealing with understanding pelvic floor female specialist and her internal/external treatments are helping me (together with stretching and elliptical machine exercises), pain did go down. To me seems useful to have PT sessions for at least 3 months to see if pelvic floor tense muscles are the main cause of pain (muscle spasms triggered by vas - surgery injury).


So I’m at 17 weeks and thought I’d update my status. I am still in pain, mostly in the scrotum/right testicle, but most of the referred pains have tempered down except in the rectum and occasionally in the lower abdomen. I am currently taking Elavil, Gabapentin and Meloxicam which I’m bummed about but they are helping to control the pain. I don’t want/can’t take narcotics so I’m glad these are helping. I don’t really have any side effects either which is a blessing. I’m definitely not where I want to be but I can function very well and I am only limited when it comes to increased activity. I met with the local uro that deals with PVPS yesterday who still believes time and patience are what I need right now. Dr B at the PUR clinic agreed with that during the consult I had with him a couple weeks ago. My current plan is to just try to ignore the pain and move on with my life. Next will be to try to lower my meds but I’m going to give them a solid 3 months before I start to wean off. I won’t consider surgery until the 1 year mark, or if things go south again. I have prepared myself for a long struggle and that has helped mentally. Going to try paleo and exercise to see if it helps. This whole experience has changed my life forever in many negative ways, but surprisingly also in positive ways too. I’m going to try and switch my focus on the positive things and hope that helps me a little too. Thanks for reading my posts and offering advice. This website is definitely a blessing.


Sorry to hear you’re not trending better. Hang in there and keep us updated. How is work for you?


@MikeO Thanks for the kind words. I would say I am trending better, but frustratingly I think it’s because of the meds. At 2 months post vas, I was in bad shape, and was frightened about my future. I’m still worried/scared/nervous, but the future doesn’t look so bleak anymore. I am now hopeful, where before I was not. Work is going very well. I have an extremely stressful job that involves a lot of movement. It also involves a lot of mental and cognitive function. The stress doesn’t help, but being able to focus on something makes the pain go into the background. I also find that talking to people and laughing as much possible is a great distraction.


@Kyvas hang in there!


I was still getting worse at the point you are. I continued to improve all the way until 18 months, so don’t lose hope. You’re still on the right side of the stats.


So, I am at 6 months now post vas. Thought I would post my progress to just to keep the timeline going. The last 4-6 weeks have been going very well. I would say that I am definitely trending better. My mood has drastically improved and I’m able to tell that because everybody is telling me I seem to be back to my normal self. I still have daily pains. Mostly in my groin, rectum, and scrotum. For the most part, I am able to put them in the back of my mind… Stress and physical exhaustion usually make it worse, but I am able to quickly recognize these and rest or de-stress myself pretty quickly. I have cut the med doses in half and feel pretty confident I will be off most of the meds in a month. Saw a GP who has been super helpful and I’ve got a good titration plan setup. I don’t see the PT anymore but have kept up with biweekly massages. I’ve also seen a couple of chiros but they were of limited help. I have started to see a guy who dose Fascial Stretch Therapy and he has gotten all of my muscle spasms and tightness to drop dramatically. I was skeptical but it has been very beneficial. I also read the book Take Back Control (recommended by @SPEDRED I believe) and have been applying some of the principals the author recommends. I believe that has helped a lot by helping me to realize how much anger I carry and how to get rid of it, which in turn has helped with the pain. Anyway, I think I am going to try some of the kettlebell exercises recommended by @victor and see if they help. Thanks for all of the support. I feel like this nightmare will eventually end but this has sucked. I think about and pray for all of you often. Thanks for reading this and letting me put all of this down.


I hesitated posting this but feel I really need too. I’m writing this because I need to release some of my thoughts. Over the last week or so I’ve been feeling very depressed about all of this. I can honestly say that my pain is improving but it is constantly freaking there. I get moments of reprieve and really am enjoying life for the most part but when my thoughts turn to the pain I just feel the life being sucked out of me. My pain isn’t nearly as bad as it was 3 months ago, and I am improving, but the fact that it is still present is so depressing. My wife and support system is strong but I know they don’t want to constantly be bombarded with my issues, but it’s so hard not to break down and cry. I haven’t broken down in awhile but I think I need too. I’m not writing this looking for sympathy because I know some of you all have it quite a bit worse, but I just needed to write it down. Screw this “syndrome”. I am so angry too and its hard to release all of this and accept it all. Anyway, thanks everyone for this forum. It’s nice to know I am not alone and to be able to read that there are plenty of success stories on here. Good Luck everyone.


hi Jim. feel free to vent anytime. I think as men we are more likely to hold our anger/tears to ourselves. the depression from the pain and what feels like hopelessness at times is bloody tough going. I wish we could re-program our brains to stop feeding us pain signals. all the best.


Kyvas, I hear you and every guy here, I bet, has been in your place. I have those moments myself. My first bout started TWELVE years ago next month, October 2005. By some standards, I should be grateful. 9 of the past 12 years have been pain-free, but this current bout is at about 18 months with no end in sight. Getting through each day is a chore. Just something about scrotal pain that brings a guy to his knees.

I don’t have any answers for you, but I find that if I’m taking some proactive action I feel better about the future. If you’re in wait-and-see mode, maybe schedule an appointment with one of the PVPS-conversant uros, one who does reversals or denervation for pain, just so you have that avenue opened.

Cleveland isn’t too far away, but I believe the reversal/fertility uro Dr. Sabanegh is hard to get an appointment with. Might be worth a trip to see him if you can get in. I saw him during my 2008-09 relapse and against last winter. Great guy, very compassionate.


My god man you are not alone. That dark side of the force anger is so tempting to give in to. You have to manage it with exercise and general good health. But, YEAH, once you’ve had catastrophic pain it is hard to deal with it. It’s like PTSD. I really believe guys with catastrophic pain like us suffer from PTSD. When you get uncontrollable pain it changes your brain and nervous system. Do whatever you have to do get well.

I’ve sometimes thought that some of the novel therapies like tripping on halucinogens in a friendly environment might help us rewire our nervous system. It’s hard to break out of it.

Do what you have to do to stay healthy and relax.


Thanks everyone. It’s good to not be alone even if it’s part of a dysfunctional group. @MikeO i actually started some kettlebell training and it felt good to workout but the eventual muscle soreness combined with my baseline pain and a couple of stressful days at work finally broke me. However, I’m going to keep up the exercise and see how i feel once i get past the initial couple of weeks. Anger is a beast man. Some days i just want to stand up and yell at everyone because they can’t see the pain I’m in while they are acting normal and jovial. Anger is the easiest emotion to experience though so it’s not surprising i feel this way. I do wish i could experiment with some of the hallucinogens just to rewire. Most of them are none addicting and have been proven to allow the brain a chance to destroy old pathways and create new ones. That’s the current theory behind Ketamine, which is a hypnotic similar to LSD, and it seems to be working because these clinics are popping up everywhere and the studies are showing significant results. Thanks again fellas.


Weird question. When i massage my lower abdomen/waist, particularly on the left side, i can feel a stretching sensation in my rectum and throughout my pelvis. Anybody else get that? I’ve really been working on self massage and noticed that and thought I’d ask. It seems like this stretching sensation might be indicative of continued pelvic floor muscular dysfunction or hip flexor/psoas tightness.


I’m at 9 months post vasectomy and figured I would provide a followup just to keep the timeline going. I’m continuing to have a very slow improvement although I’m still in pain on a daily basis. It usually runs around a 2/10 but is very livable at the current moment. The part I’m having the most frustration about is the cyclical aspect of the pain. Most days are good and I’m doing well, but then, bam, I’m back at a 4/10 for a couple of days. Super frustrating. However, I’m only taking Elavil at night and an occasional NSAID, usually for other reasons, so I’m happy with where I’m at most days. At this point, barring a dramatic decrease, I’m not going to pursue any surgery. I’m too worried about making things worse, so I’m going to continue with the conservative treatments. I went to a different Pelvic floor PT whose been focusing more on the hips and external pelvis and I do think its helping.

Beyond that, I continue to stretch constantly and have actually begun weightlifting again which is going well. I’ve also realized how my mental state really affects my pain, so I try and stay relaxed and non stressed, which is surprisingly hard because i carry so much anger and frustration about this situation. I look forward to the days when I can get past the emotion.

To add insult to injury, I calculated how much money PVPS has cost me and I’m out $30K this year when you include lost salary, OT and medical bills. Knowing this has only made me more frustrated, but I guess it’s still cheaper than another kid. I’m lucky I’ve got a pretty good STD plan or it could have been a lot worse.

Anyway, overall I’m happy with the way things are going but still frustrated at long I’ve taken to heal and how much this has consumed my life.


Well, I’m 1 year post vasectomy. It’s been a rough year. I’d like to say things have improved but I think over the last month or so, that things have worsened a bit. My left epi is pissed off pretty much constantly and I’ve felt some of the anxiety and depression, that I experienced earlier on, coming back. I still get some pretty intense left abdominal muscle tightness. I believe its my internal oblique that will not relax even after PT and trigger point releases. Thankfully, a lot of my rectal and perineal pain have greatly diminished and don’t bother me often.

I visited my PCP a couple weeks ago and started on Cymbalta. Still too early to tell if it’s doing anything. He also referred me to a pain management doc. I’m not looking forward to going down that route but I will see what they can advise. My local PVPS guy wants me to try another round of high dose NSAIDs, so I started that last week.

Not feeling really confident that things will improve on their own. I told my wife, that I might have to do something surgically, but the earliest that I could do anything would be the fall. She would be on board if that decision has to be made. I’m terrified of making it worse because i can function normally for the most part, but I’m not sure I can live forever with this pain.

Maybe by some miracle things will spontaneously resolve over the next 6 months or so. I can only hope. Take care.


I thought I would post an update. I visited with a Pain Management last week who spent 40 minutes with me. He was very familiar with PVPS and sees about 6 men a year for it. He feels that since PVPS is hard to define, he treats it like a form of Chronic regional pain syndrome and he treats it similarly. He went through his progression of treatments including medication adjustments, nerve blocks and then stimulators. I agreed that blocks are warranted but told him I am not having nearly enough pain to justify stimulator placement. He explained, though, that he believes reversal is just as extreme of a treatment as a stimulator so both pathways should be considered. He also said that the psychological component to pain is greatly exaggerated in patients that present with pelvic pain versus other types of pain and because of this he believes I should see a pain psychologist. I agreed to the blocks and to see the psychologist. He also added a muscle relaxant to see if my abdominal muscles will relax. He also said he add a good friend with PVPS that had nerve blocks which provided a 30-40% pain reduction, but ultimately opted for a reversal and it was a success.

Yesterday, I saw my local PVPS and was surprised by his thoughts. He believes that since I’ve given it more than a year, and that i have exhausted pretty much all conservative measurements that a reversal is warranted. He quoted me at a 70% success rate. I think I’m leaning towards having the reversal, however, because of current life circumstances I can’t schedule one until the fall. He was okay with that and we both said maybe more time will help. One can hope.

In the meantime, he did agree that I should see a psychologist for a variety of reasons. One being to prepare myself that the connections could scar over and might cause some anguish about pain return. He also agreed that nerve blocks might help so I am going to book those. He also referred me to a scrotal pain expert in Tennessee to get a second opinion if surgery is the right move, which I agreed too.

I’ve also started accupuncture again with a guy who works with testicular cancer patients. He said it would take 5-7 sessions to see results, but if I don’t see them by session 8, than accupuncture will probably not be of benefit. It’s worth a try I guess.

I’m actually feeling good that treatment options have progressed, but I’m terrified that I could make it worse. I think I’m going to begin to prepare myself mentally for the reversal, but follow through with some of the above ideas. Anyway, sorry for the long post, but it’s beneficial to write it down.