I've just realized I have PVPS


I have read some of your posts and I am sorry to say that I am part of the group. Unfortunately I am one of the few that went through a vasectomy with an outcome of such disappointment. The pain has really affected my life in an obvious negative way. Reading all of your posts has helped me tremendously and I thank you all for the insight. My Dr is less than helpful in the beginning stages of our realization of where I stand. His first reaction was to give me a steroid shot which was a mistake on my part for accepting. I suffered through three days of agonizing pain with no relief. He is now recommending an ultrasound and Pain Management. I am so curious to know if the ultrasound will give any insight to what went wrong with my vasectomy. If anybody has experience with the ultrasound and Pain Management , I would love to hear what I might expect.


Where are you from? How long ago did you get the vasectomy? Do you know which method was used? Who is the doc?


+1, how long ago was the vas? Were you told of any risks? Who did the vas?

We’re not trying to ‘punish’ your doc, but it’s important to note what you were told and that the doc has had a bad outcome.

You can get the ultrasound, it’s not a bad idea, but don’t be surprised if it shows nothing abnormal. All vasectomized men have swollen epi’s in an ultrasound, yet most have no pain, which is kind of amazing really.

What are your symptoms? Where are you located? You should really see a doc who knows a thing or two about PVPS, which is unfortunately not many docs.

@Ronnie, sorry you’re here. If it’s of any comfort, just know that you’re not alone in all this and there might be some treatments that help.


I had the Vas about 5 months ago and I was told of the risks. They said it was less than 1% chance this could happen. Now I know why I’m not a gambling man. The Dr.'s name is CASEY KI-CHI NG MD.
The symptoms are extreme sensitivity and continuous pain. Some days are worse than others. Located here in LA so if anyone has a good recommendation for LA doctors please let me know.
Not sure what method was used but I will find out.


Sucks to see another one here who was told the 1% BS. Forget your local doc-yes get an ultrasound but the odds of it really showing something that helps you are slim. Others will chime in with doc in the know but if your problems continue really the choices are reversal, live with it and hope, denervation. I have had two reversals and don’t regret either one. This forum is a lifeline for you…so sorry to have you here though


Telling patients 1% is actually much better than the .1% many are told. Dr. Casey Ki-Ching is actually quoting the low end of the AUA range. Of course if he’s keeping score then he has 99 more to perform pain-free to be able to keep saying that.

Maybe we ARE making a difference gentlemen…


Ultrasound probably isn’t going to show anything. I’ve had three, all were normal, and only gave my uro team another excuse to question my pain. I’m not saying it’s a complete waste, but don’t get over optomistic about the results and certainly don’t question yourself when it’s normal. Hope that helps. If there were a magic MRI or X-ray or test, we’d know about it.


Why two reversals? Do the reversals always work and does the pain disappear all together?

I truly hope I can go through an entire 24 hours without thinking about my pain, discomfort or simply what movements not to make. Walking or sitting without consideration could potentially lead to a terrible day.


Ronnie, I just had a steroid injection like you discribed and am having horrible pain from it. Was your injection into a granuloma, or somewhere else? You mentioned the pain lasting three days. Did anything you did make it better (or worse)? I didn’t realize that there would be lasting pain from the injection, just thought the initial pain of the needle would be it, but it got worse as the day went.

I am also 5 months post-vasectomy. I hate to hear you are still in pain as well. Welcome to the forum, where at least some people have an idea of what you are experiencing.


My inspection was into the spermatic cord. Nothing I did helped the pain. All movement made it worse. Couch and TV all weekend.


When Dr. Parekattil and Brahmbatt of PUR clinic do their cord blocks they are done under anesthesia and with a lot of local anesthetic too. They also load you up with pain medications while you are recovering just to try to get you to past the pain from the injection to the point where the steroids start to do their job. I had one block from them. I made the mistake of being stingy on the meds they gave me and ended up having a lot of pain one morning. Pain from a block or injection of steroids is going to happen. That’s normal. I would not expect it to last more than a couple of days. Make the guy write you a script for pain meds so you can be comfortable while the pain wears off.


I still have some he gave me last month that I haven’t used. I really try to avoid them because I had a bad experience with OxyContin just after the vasectomy. That isn’t what he doctor prescribed me, but a friend gave it to me because the Tylenol with codeine wasn’t cutting it. Withdraws were awful. I took one Vicodin last night to try and get some sleep, but it didn’t give much help. Today is less intensity of the pain as long as I am not active, so I am sure it will be gone soon, hopefully after tomorrow.


Mike, question, once the initial pain of your injection wore off, were you free of pain or was it just less than what you started with?


I had no real change. I remember the experience being unpleasant because it was a big rigamarole to fly down and get it done. The steroids made me kind of antsy too. I’m the very short term I was fine, then in the short term In was worse then I returned to baseline.


I felt the same way. Hope, pain, let down and right back to where I started from. So disappointing!!


So, I just saw a pain management doctor per my urologists recommendation, obviously because he doesn’t know what to do with me. Pain doctor gave me two options. 1)Gabapentin 1st and then nortriptyline
2) vasectomy reversal
Can you guys tell me more about the meds in option one? Does it help? Side effects? Is it worth it or a waste of time?


@Ronnie I took high does of Lyrica (it’s a GABA drug, very similar to gabapentin) with low doses of nortriptyline in my early PVPS days.

I started with the lyrica and had pretty tremendous brain fog and memory loss for a while, which did settle down after about a month.

Nortriptyline was added later on (30mg per day) and it did help with the pain a bit. I had wild dreams if I took it too close to bed and it kind of made me wired.

Lyrica and/or gabapentin are not good drugs to be on long-term (even though docs and the FDA say they’re perfectly safe)

This study tends to say otherwise:

A lot of people who take lyrica or gaba for a long time report memory loss, dizziness, coordination problems, etc.

I also quit lyrica cold turkey and went through some nasty withdrawal/flu like symptoms for a couple of days and didn’t feel ‘right’ for about a week. I was literally craving lyrica pills. It was weird.

Anyways, I’m not saying don’t try them. They do help some people, but just don’t be on them long-term.

Another thing to consider that I’ve found worked better for my neuropathic pain was alpha lipoic acid 600MG 1x day. It’s not just some BS supplement, there is research that it helps those with diabetic neuropathy, and in Germany and Holland it’s used as first line treatment for neuropathic pain. It’s not a cure for me, that’s for sure, but it helps take the edge off.

Anyways, I’d at least try the meds before going for a reversal, and see where you’re at after a month of taking them.


Actually yes, I think something is changing in the vasectomy world. I’m seeing a lot more vasectomy websites up here in Canada quoting the AUA guidelines, but they almost always have an asterisk beside the 1-2% and it says ‘to conform to AUA guidelines.’ Although being in Canada they should probably quote the CUA guidelines of 1-14% FFS.

So it’s on paper for patients to see and also to protect the doctors in a lawsuit, but I have to wonder - just what do these docs say when to their patients when they ask about that figure? It wouldn’t surprise me one bit if they said something like “oh yeah it’s overblown” or 'I’ve never seen it!" or “those are the guys who didn’t follow the post-op directions.”

The problem is, those conversations would indeed be off the record and pretty much impossible to use in a lawsuit, especially since they have 1-2% in writing.


@Ronnie, your situation sounds very similar to mine. My urologist didn’t know what to do with me so he referred me to a pain management specialist who was equally clueless.

The way you described the pain is almost exactly how I would have described my symptoms. Rather than drugging myself up for the rest of my life, I went the reversal route. After 4 1/2 months, I’m getting close to pain free.

I’m on the east coast, so I can’t suggest where to go for help. I found a Dr that has only been doing reversals for over a decade. He was good or maybe I just got lucky.

Hopefully this helps.


@Ronnie sorry to hear you are going through this too. I will second what sad-to-be-here said, though I haven’t had a reversal yet. I think we are in a similar situation. I know there is a Dr. Werthman, in Santa Monica. He has experience treating PVPS and can probably help you. I’m thinking I may fly to ICVR in tuscon for a reversal with Dr. marks. He has done a LOT of them and has treated a lot of patients with PVPS.

In my opinion, if you have congestion like I do, pain management is bullshit. that’s treating the symptom, not addressing the cause of it. That could be a long battle, I feel like it isn’t likely to ‘cure’ you. If vasectomy caused this and we are sensitive to being vasectomized, just un-do the mistake. that said I think it could be critical to get the best possible surgeon to un-do it.