No problem. My story is a bit complicated and I’m not sure how much or if it applies to the average guy (victim) on the forum. In retrospect, I sometimes wonder if the vasectomy played a part at all. I’m guessing it did, but it didn’t manifest itself like the majority here.
March, 2005 - Vasectomy, closed-end w/scalpel. Normal recovery. Back to regular activity in 3 weeks.
October, 2005 - Developed massive groin pain following last bike ride of the year. Radiated into scrotum but was regional. Remember distinctly three statements: (1) felt like a steel brush was being pushed into my inguinal canals, esp. left, and around the scrotum; (2) felt like I was sitting on a tennis ball; and, (3) felt like a hand was reach up through my anus and grabbing/squeezing my scrotum from behind. Note that scrotal pain itself was overshadowed by other pains.
Visited original urologist who was useless and dismissive. Saw another who admitted PVP existed. Sent me to Pain Mgt. who prescribed gabapentin. Same pattern as everyone here.
Feb, 2006 - Found that another uro in Cleveland had published a lot on PVPS and saw him. Great man. Suggested injections and, if they failed, reversal. Did notice I had granulomas on both vas tips. Found elevated PSA, too.
June, 2006 - Reversal.
Nov, 2006 - Pain-free for about 2 years. Continued normal activity included more than simple recreational but not competitive bicycling Spring thru Fall.
Nov, 2008 - Relapse of pain. Biggest problem was sitting. Six months of gabapentin and Celebrex.
May, 2009 - Pain-free for about 7 years.
April, 2016 - Pain started again after first bike ride of the year (see pattern here). Most notable symptom was sharp, stinging pain top of testicle but soon became regional.
Aug, 2016 - Ilioinguinal block - no result
Notably moved to perineum. Learned about pudendal pain from Pain Mgt. Never heard of pudendal nerve until now.
Nov, 2016 - Jan 2017 - Two pudendal blocks plus pelvic PT. Really helped with perineal pain, but started feeling scrotal pain AGAIN.
Apr 2017 - Spermatic cord block with Dr. P. in Orlando.
Pudendal and cord blocks knocked pain down 50-75% thru mid-July 2016. Even got back into bicycling (big mistake but, hey, it was summer). All pain (scrotal and perineal) came back
Aug 2017 - GF nerve block with pain mgt. Scrotal pain disappeared.
Oct 2017 - Pulsed RF ablation of GF nerve. Procedure is essentially the same as a nerve block other than the needle is solid and delivers pulsed of heat designed to “scramble” the pain signal on the nerve. Scrotal pain still gone.
Yesterday - Pulsed RF ablation of left and right pudendal nerves. Again, very similar to pudendal nerve blocks. Lay on stomach, insert needles in your buttocks, and wait for the machine to run its course. Other than occasional pinch, didn’t feel anything during the procedure.
Results from ablation take 2-4 weeks to develop, so I won’t know for a few weeks whether this worked.
Hope that helps. As you can see, my situation is a bit different than a lot of guys here. It’s been intermittent but long-term, and it didn’t start immediately following the vasectomy itself.
Some docs are sure the vasectomy caused this, some believe it’s from bicycling, some say both, some believe it could be referred from my lower back. As background, I had lumbar spinal fusion in December, 2012 during one of my remissions from groin pain. Looking at the nerves in the pelvis, I don’t think I’ll ever know for sure, and I’m not sure it matters at this point.