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Pain Starting after 2 years


#1

So, I am 39 and had a close ended vasectomy in Jan 2016. Operation was more or less fine, some pretty major “tugging” pain on the left side, but no complications. Recovery was a little long, but normal.

So, in March of this year, I started feeling a discomfort in the left inguinal area. Basically, directly left of the top of the base of the penis. It would occasionally radiate down to my left testicle, but never felt like the pain was coming from the testicle. Pain was never more than a 2 or 3. By the time I was able to see a urologist about a month later, in mid-April, the pain was already subsiding and then went away completely. Urologist did not find anything unusual on physical examination.

But then in early July, about 3 months after the pain had gone away completely, it came back and has been present for over a month now. The same pain, a kind of burning, radiating pain in the pelvic area just to the left and above the penis. No pain in the testicle or epi. Nothing really seems to agitate/stimulate the pain. (e.g. urination, ejaculation, sneezing, exercising, etc.) It might get slightly agitated when squatting/bending or lifting heavy objects, but not consistently.

I went back to the urologist, but he again found nothing on physical exam, no inflammation, negative urine test, and an ultrasound showed nothing (hernia, etc.) It seems like the urologist is stumped and me too. He does not seem very keen to pin it on the vasectomy, but I feel like it couldn’t be anything else. But it seems so strange to have this kind of pain starting years afterward.

Has anyone else had this experience?


#2

Sorry to link to another post, I think reading this prior post is a decent place to start:

You may or may not have a vasectomy caused pain problem, but the best way to work that out is probably to look at the pain experienced urologists list linked in that prior post and book a consultation with one of them to get their opinion.

It may well be that there is no connection , but most urologists do not have any specific specialism in diagnosing and treating chronic scrotal pain, hopefully you will find that conservative treatment will be enough to get things to settle down and back to normal.


#3

Hi, yeah, I would like to determine if it is vas related or not. I also feel like a specialist would be the way to go for ruling these kinds of things out. The problem is that I am located in Finland, so meeting with specialists in the US/UK is probably not an option for me. I have done some digging, but it does not seem like there are many (if any?) real PVPS specialists here.


#4

If you can not find a local specialist you could possibly check flight prices to the UK on http://www.Skyscanner.com

The two UK specialists I know of are :

Duncan Harriss
http://www.yourvasectomyreversal.co.uk/testicular-pain/#.W3VfVFDTU0M

Mike Henley
http://www.vasreversal.co.uk/pain.html

A consultation is usually about £200.

You would need to fly into Birmingham airport, or East Midlands airport as they are based in Nottingham and Derby. Then take either a taxi or rent a car.

They are primarily private fertility vasectomy reversal practices, but have chronic testicular pain experience and should be to give you guidance on the cause of pain.

I know that is quite a large step however , and others on this site may know of a much closer option for you, I do not know anything at all about medicine in Finland.

I cannot find chronic pain treating clinics, but here is a paper on reversal in Scandinavia, though not around chronic pain, the papers authors may provide possible start contacts to diagnose or get information more locally:

https://www.tandfonline.com/doi/abs/10.1080/003655901750170542

The authors all are from the University of Helsinki
Hospital Urology Department.


#5

Sorry to read about your situation.

I did some reading years ago and learned that nerve damage (neuropathic) pain often surfaces years after a surgery. As a result, doctors are hesitant to blame the original surgery as the source due to the lapse of time. Heck, anything could happen. Your case is not as unusual as you’ll hear. Many of us had an uneventful vasectomy only to develop chronic pain months or years post-vas. My pain started 8 months post-vas.

The PUR Clinic in Orlando suggests something called Wallerian Degeneration of the nerves. I’m not here to promote their theory over others, but it does explain the lapse of time between initial assault on the nerves and the manifestation of pain. It also explains the intermittent symptoms. In my case, I had pain 10/2005 - 11/2006, again 11/2008 - 4/2009 and now 4/2016 - present. Notice that I had two periods of 2 years and 7 years of ZERO pain where I was able to get the irritated nerves to “turn off.”

We are not unique. Nerve damage is a risk of any surgery. The difference is that vasectomy is presented as simple and virtually risk-free and, more importantly, it’s an elective surgery. Hernia surgeries are also known to cause groin and scrotal pain, but they are repair/restorative surgeries, so I have no anger toward those doing hernia surgeries. The patient has to balance the benefit of fixing the hernia with the risk of incurring nerve damage.

In the case of vasectomy, patients are being misled by urologists who continue to deny the risks. This group is changing the landscape. I’m pro-choice on vasectomy, but with better information provided to the patient.


#6

Well, that is disappointing to hear. Haha. It is pretty interesting how the nerve could “calm down” once it is agitated/exposed, whatever the right word is. I guess I can only hope that it is not vas related since it doesn’t seem like there are a lot of good options for dealing with it. However, as a pretty healthy guy with no prior history, it seems unlikely to me that it would have been caused by anything else. :-/


#7

I’ve had similar pain like simultaneously being stabbed in the groin and feeling like a balloon is being painfully expanded in the same location. I don’t know how such a thing would be possible, but that’s what it feels like: simultaneous stabbing and expanding.

I have some other pain that you didn’t describe, but where you are right now is a lot like how my own pain began: it started very mild and infrequent, but then intensity and frequency escalated. Describing the pain to my first urologist and to other GP’s, it’s easy to understand why they thought I was describing an inguinal hernia, but 2 MRI’s, 3 ultrasounds, and no less than 4 physical examinations revealed nothing. I mean, absolutely nothing: no bulges, no swelling, no inflammation, zip. Zero. Nada.

It was very frustrating for me because I was pretty damn sure the pain was vasectomy-related, but none of these examinations revealed anything at all. Because the pain came and went – i.e., it wasn’t constant – the doctors and my first urologist all believed that it was unrelated to the vasectomy. I understand that the most reasonable decision for most doctors in most circumstances is to not jump to conclusions and try for the easiest solutions first since quite often health complaints are less serious than they appear, but it got pretty tiring having to argue my case over and over again to each new doctor I met.

Best advice I can give is to keep a detailed journal about the frequency and intensity of the pain along with what seems to aggravate it. Keep notes about what you’re doing to treat it and whether the treatments are helpful, because this will help you make the most of the severely limited given to you to speak during an appointment: https://www.cbc.ca/news/health/doctor-patient-visits-1.4755498 I suppose this number could be different in different parts of the world, but on average you’ve got 11 seconds to tell the doctor your side of the story before he or she stops listening.


#8

This is a very common pain, many men experience this. FWIW, I had very good results with serrapeptase and natural anti inflammatories.


#9

Thanks for the reply guys. How long after the V did most of your all’s pain start?


#10

Pretty much year after vas


#11

Well, it is now nearly 2 months since I made this post and I am still dealing with the same pain. A few days where it was achy all day and very distracting. Some days it nearly goes away, but I can never forget that it is there. :frowning:

I have been to ultrasound, CT-scan, physical examinations and nothing, zip, nadda. So, now I have been referred to the pain management doctor. This tells me they have given up on it, really. The urologist I was seeing has admitted that he now thinks it is a result of scarring pinching a nerve from the vasectomy 2 years ago. This is interesting because originally he wasn’t willing to entertain that idea.

I have started thinking about reversal, but I am unsure whether that is the way to go. I really don’t know if my pain levels are bad enough to consider it or if it would even help since my pain does not seem to be congestive in nature? (perhaps it is and this is only referred pain, idk) I am pretty depressed at the moment since I am unsure how to move forward with this.

I have been taking some vit B and serrapeptase as some have recommended. I also started papaya seed with the thought that at least I can use it as an elimination test. (e.g. if I get better after using it, then perhaps it is congestion related after all and that would better guide decision making). I have only been using it for about a week now, so still in the early stages. I have also started doing daily pelvic floor stretches and I really love them. They relax me and definitely seem to calm the pain/discomfort (or maybe it is the meditative nature of doing them that also helps).

I will likely continue with these conservative measures for a while and see how that goes I felt like I should post here because of my original post and the helpful info I received so far.


#12

Pain Management specialists frequently treat men with ilioinguinal/iliohypogastric and genitofemoral nerve pain whether from vasectomy, hernia, and other causes. I would definitely see someone in pain management. A few well-placed steroid injections might calm things down.

Where are you located?


#13

@raising4girls - Yeah, you are right and maybe I shouldn’t be so negative about the pain doc. It actually isn’t a pain doc, but a physiatrist. He does accupuncture, manual manipulation, injections, nerve pain, etc. I should think of it positively and perhaps it can help.

I am located in Finland, so finding PVPS specialist is more or less not possible.


#14

Injections are useful, especially in diagnostics to see which nerve might’ve been impacted. Every pain doc I’ve seen seems to want to start with the II/IH, but I’ve never had an issue with it (despite having had a hernia repair 40 years ago). I have more of a favorable response (pain reduction) from injections to the GF and to the entire cord.


#15

Heh. Well, I saw the doctor. He thinks it might be some kind of ligament pull and wants to send me to MRI. When I asked about it being from vasectomy, he replied, “I don’t think so, I mean it is such a small incision and operation conducted much lower than where you’re having pain.” …sigh…

I mean, I hope he’s right, no doubt, but it seems the ignorance of this condition is very widespread.


#16

It’s worth looking into, of course, if just to rule out more common ailments that refer pain to the scrotum.

See if you can find Dr. Parekatill’s document about Wallerian Degeneration of the nerves in the scrotum after vasectomy. It explains why pain my return years after the initial assault.

I had my vasectomy in 2005, had it cleaned up and reversed in 2006, and lived about 10 years pain-free until this relapse. It can happen at any time. So, in my current case, it wasn’t the vasectomy directly, but the vasectomy created an injury, weakness, etc. that made me vulnerable to another injury that I incurred in 2016.


#17

Seems to me you had some short lived relapses during them 10 years, I definitely recall several of them prior to this last one. Nothing like you’ve experienced during this last relapse which seems to be going on 2~ years. A lot of blocks, other procedures, poking and prodding during these last two years as well, relevant, or irrelevant.


#18

Just one relapse 2008-09 for about 6 months. Who knows.


#19

Yeah. The thing is, I have no pain in my scrotum or testicles at all. They are just fine and no aching, etc. It is just a “burning” pain that happens about 1-2 inches up and to the left of the base of my penis. It can radiate outward now and then, but that is where the pain seems to be originating.


#20

It’s not strange at all. My experience was a gradual worsening of symptoms. Even before I suspected it was my vasectomy I started having problems sitting and sleeping and had what felt like a non-stop prostate/uti for years. The pain I had was alongside/at the base of my penis on the left. I had a bilateral incision vasectomy. The left incision was really high in my scrotum almost closer to my inguinal area practically on the shaft of my penis. That’s where I had the worst pain and by the time I got reversed it was excruciating and life altering. It got to the point where I could not take long trips or see movies or sit through my kids musicals/plays and I afraid to to go to bed because the pain caused by erections was excruciating and I knew it was coming. I also started getting numbness and sensations like my left testicle was tied up with fishing string in the morning by the time I got reversed. I’m at work right now on lunch break and I’m okay. There is not a lot of information about post vasectomy pain out there but one thing you will find almost universally in any definition of it is that it can start immediately or any time after a vasectomy so what you are experiencing is not uncommon.
Among men who end up with problems a later onset is not rare/uncommon.

We get a lot of guys here, a lot of them, that are in acute pain post vasectomy. Those guys we tell to relax work with their doctor and they will almost certainly be okay in a few months. Then there are guys like me and apparently you that don’t show up on these forums for years after vasectomy. I didn’t join a forum until 3 1/2 years after my vasectomy and waited another year and a half after that to take action to address the problem. I had already tried cutout cushions, standing desks, acupuncture, therapy, all kinds of weird supplements, anticonvulsants, anti-depressants, anti-inflammatories, antibiotics, mindfulness etc. etc.