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Steroid (cortisone) injection theory


#1

I’ve been watching the show, Autopsy, the Last Hours, and in the Bruce Lee episode, the Dr. tries to figure out what killed Bruce Lee. He concludes that the many steroid injections that Bruce had to help his slipped disc ultimately lead to his death because too many cortisone shots damages kidney function. So too many shots over 3 years finally damaged his adrenal glands and kidney to the point that his body couldn’t function.

But a single shot near the damaged area where vasectomy pain occurs could potentially help the problem. If I understand correctly, a cortisone shot breaks up scar tissue, and radically reduces swelling.

So have any if you actually had a cortisone shot into the area of PVPS, and what was the effect? I’m not talking about steroid pills, but focusing on the injection of cortisone. In another thread, a book is referenced that talked about the pain being a result of entrapped nerves. It would seem that cortisone could help break up the scar tissue that is contributing.


#2

Tried several steroid injecrions in cords and inguinal area worked for a bit. 1week or so. But even injections have the side effects like tablets.i was given big doses and the usuall cant sleep for 3days and extreme hunger, took a fortnight to go back to normal.


#3

Thank you for the reply. So you didn’t get any long-term benefit?


#4

@PVPain no long term at all. All the best with your journey hope you find some answers. So far i have found no answers.


#5

Looking back I wish I had NOT had a nerve block with steroids. The immediate result of my block was a huge water weight gain and severe agitation. I don’t know how much was injected into me but it must have been a lot. I would fear the effect of concentrated steroids injected into healthy soft tissues. What effect might it have on healthy tissue?


#6

Cortisone shots are essentially synonymous with the “nerve blocks” of the ilioinguinal and genitofemoral nerves done by Pain Management specialists. They don’t actually inject into the scrotum, but above the scrotum in the groin. They haven’t helped me.

To MikeO’s point, he and I both had Dr. Parekatill’s “mega” cord block where he blocks the entire spermatic cord with analgesics and steroids. I actually had a positive experience with mine. I had some immediate benefit from the analgesic, then worse pain, then decreased pain 4-5 days later once the steroid kicked in. Lasted 2-3 months and gave me a 50% pain reduction that was much appreciated. Seems to have worn off a couple weeks ago, so I’m back to the drawing board.


#7

The pain doc I saw three times was pressuring me real high to get a block. With pain levels between a 2-4, now lately 3-6 I just don’t see the point in aggravating it.


#8

I’m glad I asked. It doesn’t appear that a steroid injection has helped people here, and steroid shots are hard on the body.


#9

I didn’t mean to lead you that way. I got very good relief from Dr. P.'s cord block (which uses steroids) and I intend to try another. No doubt, steroid shots are hard on the body, but seem to me to be less risky than surgery.

There also appear to be some diagnostic values to nerve and cord blocks.

As with anything, you have to weight the pros and cons compared with other alternatives.


#10

I see what you mean. I’ll ask my Dr. his opinion on this also. As everyone else here has figured out, I wouldn’t be taking my time to consider this if it weren’t for the original surgery.


#11

I would like to add that my block gave me complete relief on the right side which was not that bad to begin with but the result was very pleasant. On the left not so much but that’s because I think non the left my pain is damage to nerves outside of my spermatic cord.


#12

Do you mean it gave complete relief, then wore off? Was it pain killer plus cortisone?


#13

Oh, and if cortisone shots help break up scar tissue, and if nerve entrapment in scar tissue is a cause of pain, why wouldn’t the injection be right around the cut end of the vas?


#14

Thanks for the perspective on this guys.
I’m just about 48 hours since a steroid injection and if anything it’s a bit worse. Maybe just a bit sore still from the injection itself. Hoping the the ‘4-5 days’ to kick in’ theory is going to work for me.

Hoping a few of these injections can get me over the hump while the nerves settle down. I’m 7.5 months post vas and I’m just done with all of this.

JW


#15

Yes, the first couple of days after a nerve block can be tough. The needle aggravates the nerve(s) and the steroid is delayed acting.

If it’s of any solace, I jhad a “mega block” with Dr. Parekatill in Orlando in late June. Hurt first night badly, then was pain-free for 2 days, then lots of pain after anesthetic wore off for about a week, then pain-free (down 80-100%) for 5-6 weeks. Unfortunately, the steroid injections aren’t giving me durable relief but, supposedly, my continued positive response to them is an indicator that SCD would help.

You should calm down in a few days.


#16

Thx raising4girls!

Few questions and term clarification if you don’t mind:

How did you know you had a ‘mega block’? The same question essentially would be how would I know if I have/had one? My urologist is talking in generalities and was just saying that the steroid will ‘help’ while the nerves are ‘calming down’

I’m scheduled for another steroid injection in less than two weeks, but I’m wondering if that’s too much in a short amount of time. I mean…if it gets me 10-12 weeks of relief while the nerves are still settling then ok I suppose…
just don’t know what the exact issue is, but I suppose that is par for the course with most of us…

Has anyone here needed the doc to ‘excise’ the vas area to as he put it ‘clean up’ the original site? It sounds like the last resort before recommending a reversal In my case, the urologist I have now DID NOT DO MY VAS… I have a feeling he’s being more aggressive with me because of that fact

What does SCD stand for exactly?

Finally, these injections… what does insurance generally cover? Of course it depends on your insurance, but as far as they are concerned, I had a ‘successful’ vas… was deemed sterile about a month ago…so they might deem this ‘unnecessary’… who knows???

Happy Sunday BTW :slight_smile:


#17

Mega block is a non-medical term someone on this forum coined for Dr. Parekatill’s approach. He seems to be one of the few urologists nationwide treating PVPS with therapeutic spermatic cord blocks consisting of anesthetic and steroids (and botox if you go up the ladder). Whereas traditional pain management specialists typically inject the same concoction, they inject once and higher up in the groin targeting the GF or II nerve specifically. In my own experience, I’ve not found a pain management doctor to treat the entire spermatic cord in one procedure with multiple injections like Dr. P.; hence the phrase “mega block.”


#18

That’s sooner than I’ve heard anywhere else but that doesn’t mean it’s wrong. It might make MORE sense than waiting 1-2 months as is more common. I’d definitely give it a shot, pun intended, if given the opportunity.


#19

That was offered to me, like you, by the uro I saw once pain set in post-vasectomy, also not the guy who did my vasectomy. I decided that if I was having my scrotum opened up again, it would be to be put back together. I think others her may have gone the clean-up route and may chime in.


#20

SCD stands for spermatic cord denervation. It’s one of the surgical options available to us with scrotal pain. It has mixed reviews on this forum.

Oddly enough, my insurance has fully covered every nerve and cord block/injection I’ve had for the groin and for my lower back (another issue). By contrast, I’ve had all kinds of problems getting insurance to cover medications.