On a serious note, I think the reversal vs. denervation vs. epididymectomy debate exposes the importance of trying to pinpoint the pain generator. I know that my back surgery was successful because 3 surgeons independently concluded my facet joints at L5/S1 were shot and simply removing the disc or bone fragments would be insufficient.
I've had a reversal already and my only SA in the last year showed 10MM. All 3 uros and my GP assume that's enough at my age of 52 to assume I'm patent. I DO think I have nerve pain, but want more concrete evidence that I'm not congested on one side. If I am congested, I think I'd opt for a re-do reversal vas-to-epi rather than epi removal.
I DID have a positive reaction to Dr. P's nerve block (at least 50% pain reduction for 3 months), so by their logic, I'm a good candidate for denervation. Again, I want more evidence.
Sometimes I think I should just get it over with and have my left nut removed. Cut right to the chase, pun intended.
With respect to epi removal, what happens to the sperm produced by the testicle now with no outlet. Does it spill out in the open? That seems like a problem waiting to happen.
I've spoken personally to one guy who had an epi removed. He said it helped, but he was almost immobile from pain pre-surgery. He's still in a lot of pain, just not debilitating pain.