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Pelvic Floor/Bulbospongiosus Pain


#1

I had a rough night with pain in the bottom/back of my testicles last night. Felt like congestion pain for sure, which is weird, because I had a reversal, but anyways, I started feeling around/massaging while I was laying in bed last night and it’s hard to say, but I think the pain generator was coming from just above and behind my scrotum, particularly where the bulbospongiosus muscle is.

From what I’ve read this can refer pain to the tip of the penis, testicles, lower back, etc. which are all symptoms that I have.

To be honest, this pain is one of the worst that I have and it’s making sitting miserable as hell.

Yes, I will be going for pelvic PT in a couple weeks, so hopefully this helps, but my question now is, does anyone else have this type of pain and are there any stretches or massages I can do in the meantime? It’s making me miserable and I feel the worst that I’ve felt in months to be honest.

Thanks fellas.


#2

Hang in there man. Yeah I have pain like that too.


#3

describes me as well. love to know the answer


#4

Your spermatic cord lies along side of the base of your penis. It passes right by there on the way to the inguinal ring. When you get a reversal they have to dig around a little in that area to free up vas. My original vas incision so close to the base of my penis that it was practically on top of it.

Above are my theories on it based on observations of my anatomy and the scars I had post vas and reversal.

I think if you’re lucky you don’t end up disturbing the nerves too bad and things feel normal. I have a lot of pain, tingling, stinging etc. in that area sometimes. It sucks totally.

There is a lot of talk about how a vasectomy too low can cause problems. I think the opposite is equally true and maybe moreso.


#5

Thanks @MikeO, to be honest, I really don’t think it’s cord pain and here’s why:

I started massaging around the area last night and was poking and prodding at my testicles and it didn’t really elicit any pain, until I pulled my scrotum forward and started rubbing the muscle pictured above that I felt where the pain was coming from. That muscle was rock hard and probably in spasm or something and rubbing it did give some relief. Not much, but enough that I could get to sleep.

According to wikipedia that muscle is innervated by the pudendal nerve, so I suppose it’s possible if I had some form of pudendal nerve damage that the muscle would spasm or cause pain. Man I sure hope that’s not the case.

The pain that I feel in that muscle is purely like a tight/cramping muscle pain. I don’t have any stabbing or burning feelings there, so hopefully it’s just a pelvic floor issue that physio can help with, but who knows.

I will say this though, sitting down typing this with that muscle pain, it sure feels like scrotal pain since it radiates downwards. I mean, I still have scrotal pain and cord pain, yada yada, but this particular pain that I’ve been getting seems like big time pelvic floor dysfunction.

I’m not trying to sound like a denier or anything, but pelvic floor issues can cause scrotal pain too, and pelvic PT is hopefully going to be a big piece towards my healing puzzle. Hopefully.


#6

I get burning/weird pain in this area at times as well, even after my reversal. For me, I noticed that I would get pain in this area after I did something that pissed off my testicles/epis, even if they didn’t hurt. It wasn’t uncommon for the onset to be delayed 5-15 minutes. Slightly bump my nuts? Fire shitshow starts in about 10 minutes. The severity of the agrivation determined the length and severity of pain. If I ice the boys though it goes away… my nuts/epis rarely hurt, but they are the source of this kind of pain for me. I focused on basic leg stretches in the perineum area directly between me legs after my vas and it helped with the burning quite a bit.


#7

When did you get a reversal?


#8

Just less then a week ago. I have not tried stretching yet, of course. I’m breaking the rules by being on here lol. If I don’t ice for a few hours I get the TERRIBLE burning sensation all around my rectum, perineum and area you discussed in the original post. Yet I have no nut pain. Congestion is much better following the surgery but I’m pretty sure I’m stuck with the rest of this mess… still early though.


#9

Well congratulations on the reversal and good luck man. I hope it works out well for you.

Definitely take it easy for a while and just do what your body allows. You’ll know if you do too much and need to back off.

If the reversal doesn’t help with the perineal, rectal pain, then I would seriously look into pelvic PT.

My biggest regret (other than the VAS duh!) is not going for pelvic PT first.

Pelvic PT is another conservative measure that won’t really make anyone worse and I think it’s an important step for a lot of us. Unless of course you’re someone who strictly has pure congestion pain with no other symptoms.


#10

Please share the exercises.

Yeah, I don’t have nut or epi pain. I have groin/pelvic floor, sit bone type burning pain.


#11

Does the pain radiate down your hamstrings at all?


#12

Thanks. I have no regrets about the reversal. After seeing what they pulled out of me I’m not surprised at the pain I was in. I have about 3 weeks of couch time ahead of me.

My next goal will be pelvic PT. I’m certain something is wrong in there. 95% of my problems are left sided. When I get the burning/discomfort I get terrible muscle weakness on that side only… what a mess.


#13

Uh… basic leg stretches. I don’t know their names. I’ll see if I can look them up and get back to the post with it.


#14

@vasregret

As of right now, no. Pre-reversal if things got really out of hand the order was this:

(95% left sided)
Burning around/in rectum -> prostate burning -> burning left of perineum -> burning tip and base of penis -> left hip -> left leg -> and in one extreme case, bottom of left foot.

During my vas surgery, even when numbed up, the left side hurt so bad. I contribute that to what I am stuck with now.


#15

I thought I was the only one. I’ve had burning in the bottom of my right foot/heel off and on since the vas, and my right thigh, right side of the shaft of my penis and base, and of course my right nut is the bad side.

I get pain on the left too, but yeah, the right is where I felt a shooter/tingling so up into my stomach during the vas, so I can only guess I have some sort of nerve damage on that side. Which nerve? Who the hell knows.


#16

IMG_5453

Poor quality picture. Sorry.

I did 1, 4, 6 careful not to squish stuff, and 10 except I did 10 standing with both legs straight and leaning as far forward as I could. I also did this standing sideways and leaning towards my elevated leg. My descriptions are terrible, sorry. Perhaps when I’m more healed up I’ll demonstrate. Basically my goal was to stretch the middle of my perenium in 3 directions, forward, back and away from the center of my body. Would push to a, “comfortable limit” and hold for 15-20 seconds while sorta bouncing into it gently to give a little extra stretch. I used to be a pretty flexible guy. Not anymore.

If I come across a better picture I’ll post it.


#17

Who did your vasectomy and who did your reversal?

The pictures of what came out of me also made it obvious to me why I was in pain. It was disgusting. Clumps of black sutures on angry purple daggers of cauterized/strangled vas deferens.

I would imagine there was some obnoxious fascial interposition thrown in. I think that entire mess of inflamed scar tissue and clumps of sutures was constantly being twisted, pinched and pulled when I got erections and when I sat.


#18

@vasregret i was told by a pelvic floor PT that you cant stretch those muscles because they don’t run along a joint. However, they are fairly superficial and small so they can easily be massaged. She did say to do similar stretches as @john1 because stretching other things can release tension on those small muscles but there’s no way to specifically stretch them. Fyi, you can’t stretch the rectal muscles for the same reason and that those have to be manipulated internally.


#19

For personal reasons I will not discuss where I had my vas at this time.

My reversal was done by Dr. Peter Burrows at ICVR. No regrets. I am breaking the rules by being here but I can’t just abandon others when my experiences may help improve someone’s life.

I lost nearly 3cm of vas on each side… had three clips on each side, spaced out over 2.5cm. Mangled, bruised, scar tissue going everywhere. Absolute mess, the stuff of nightmares. I don’t know if there was anything else - I did not ask.

In regards to the stretching: it did not 100% fix me nor was it quick. I did it twice a day for about 4 days before I started getting results, including improvement in areas I could not stretch. If it helps though - do not stop doing it just because you feel better. By the time I was ready for reversal most of my pelvic burning was minimal, if at all, and I believe the stretching was the primary reason.


#20

@vasregret - I think you and I need to combine forces on research. I’m becoming more and more certain that I have a pudendal nerve problem (damage, entrapment, whatever). It lines up with my symptoms better than a more traditional PVPS diagnosis and it lines up better with my main form of exercise April-October, bicycling.

Seems like the pudendal itself is buried pretty deep and protected, but many of its branches were out in the open and susceptible to injury, including injury during vasectomy. I didn’t know until recently that the posterior scrotal nerves are branches off the pudendal; I had previously thought that the GF and II/IH were the only nerves in the scrotum.

I’ve also noticed that walking and stretching of the groin and pelvic region helps (a) eliminate what I suspect is referred pain from tension and (b) concentrate the pain right back to where my PT says the pudendal exits the Alcock’s canal.

PN is not a diagnosis either of us want to here. I hate projecting my/our situation onto others, but I can’t help but wonder if many more guys with post-vasectomy scrotal pain are experiencing pain from the pudendal branches. I think this is a plausible argument for the high failure rate of SCD. I believe SCD addresses only the GF and II/IH. If true, and the SCD was performed properly, then I think it’s logical that the pain generator was something else. Perhaps the posterior scrotal nerves branching from the pudendal???