Regrettably I have decided to create an account here to begin interacting with some of you in the hopes that I will get some good ideas for treatment as well as have others to talk to about this. Here is some background, apologize for the length. I am in the Columbus OH area FYI.
I had my vasectomy at the end of December of 2016. It was done by Dr. Riemenschneider at Riverside Urology. It was a "no scalpel" vas for whatever that is worth. The procedure seemed to go relatively fine to my knowledge.
My "pain" first started at the beginning of April. I began to notice some tenderness and increased sensitivity on my right testicle/side of that area. On April 10th I went to the first appointment I could get which was at Premiere Urology with Dr. Brown. He (within about 1 minute) diagnosed this as "Epiditimytis" and prescribed me 500 mg of Naproxen twice a day. I also had an ultrasound done which was negative for anything that they were looking for (I assume Cancer?). I took the Naproxen for roughly 3 weeks around which time the issue seemed to go away for the most part, so I started taking the Naproxen less frequently and eventually altogether.
The pain/discomfort came back probably around May 6th again, at which point I started taking the remaining Naproxen again and scheduled an appointment with my PCP (Jacob Wolf) as well as Dr. Brown. My PCP really didn't seem familiar with PVPS on any level and prescribed me an anti-biotic, despite my suggestion that this was not an infection or related to an STD.
I met with Dr. Brown again at some point in the middle of May. He (again very quickly) decided that if the Naproxen wasn't working, the next (and only) step he could suggest was that I see a Pain Management specialist, and referred me to Dr. Gladstone McDowell at Integrated Pain Solutions. I am still on the Naproxen by the way.
I met with Dr. McDowell on June 12th. He (again....very quickly) prescribed Gabapentin for me starting with 300mg per night for 2 nights, and then 600mg per night after that. My follow up appointment with him is scheduled for July 3rd. I then have a penciled in time for some kind of nerve block injection for July 7th should the Gabepentin not work.
The Gabapentin seemed to have a positive effect for the first 3-4 days with most pain and discomfort fairly reduced if not totally gone. However the symptoms returned on June 17th and still persist. I spoke with the PA there today and he is suggesting that I up my dosage to 900mg every night and 600mg every morning for a total of 1500mg within 24 hrs. We'll see how much this helps the situation.
My "pain" is not sharp, however it is typical testicular discomfort. Think of getting hit in the balls, however that feeling never really goes away. The pain/discomfort seems to be centered on my right testicle side, not as much of a groin issue or anything like that. My right testicle is much higher and pulled up close to my groin than the left one. This seems to be a change from before the Vas. Depending on the day it frequently does keep me from doing most things I used to do like running, biking, sex, and activity in general. I have done a few warm baths, do an ice pack from time to time, etc, but those are temporary band-aids. Ultimately I want this issue dealt with. I realize that it has not been extremely long since I started experiencing symptoms, but I don't want to wait a long time before dealing with them.
In hindsight I should not have had a Vasectomy. I believed that it was an incredibly routine, safe, common, and side-effect free procedure. I now know that PVPS apparently is not that rare and believe that this issue is not widely discussed in the public space (yet).
Dr. Brown did indicate that if my issue is related to Epiditimytis, which I believe would indicate congestion of sperm?, then a reversal may alleviate the backup/inflammation. Obviously things are not that simple, but I do not intend to just accept this pain/discomfort as it is affecting my daily life and very much dominates my thoughts and how I live my life.
Yesterday I spoke on the phone with Dr. Shane Russell. He seemed to think my pain sounds more nerve related and less congestion related, indicating a reversal would not be effective. He also suggested that Neurolysis may be an option and recommended Dr. Shoskes at the Cleveland Clinic.
That's my story so far. Thanks for reading, I hope that I can update this with positive news in the future.