Two Weeks Post Mega-Block from Dr. P


Like a lot of therapies, I have to say I got some mild benefit from the cord block. The only new med I’m still taking is Mobic. I’m also still taking 25mg of amitriptyline. Whether from the cord block or the Mobic, since I am a bit better, I’m convinced that I’ve been needing a combo of nerve-pain drug with anti-inflammatory. My pain management doc and Cleveland Clinic uro nixed the anti-inflammatory, and I’m a little pissed at them now.

My current state is this. If inactive, like sitting at work, pain level is 0-1. DURING activity such as exercise, long walks, coaching softball, or getting up and walking around the office or a client’s factory does not hurt, but I hurt afterward. Can go up to a 4-5 pain level, but now no longer stays there 24/7. Rest brings the pain down quickly. Icing at night before bed seems to help next day.

I’ve also noticed that I am pain-free the day after taking a Viagra. Every time. Dr. P. said he was already thinking of having my try Cialis, so he prescribed a “home brew” that his pharmacy makes. It’s generic tadalafil and oxytocin (muscle relaxer) and it’s about half the price of namebrand Cialis. That alone makes seeing Dr. P. a worthwhile exercise if it helps. I get delivery in the next 3-5 days.

So, while I’m not where I want to be, I’m in a much better place in this, my 3rd bout since 2005, with PVP. Probably 50-60% better. Dr. P. suggested taking another 4-6 months before discussing anything like denervation since I’ve healed twice before.


Hi. how is the spec isl mix working?


Great question.

I was doing pretty well, consistently, through a couple of weeks ago. I had even been bicycling 3-4 times a week about 15-20 miles without raising a normally low pain level (1-3). Then I simultaneously ran out of Dr. P’s special brew of tadalifil/oxytocin and amitryptiline. So I switched over to gabapentin and basic cialis without the oxytocin. Within a week, I started hurting again.

I’ve got some more of Dr. P’s meds on order and hope they’re delivered tomorrow. I switched back to amitryptiline but had to restart at 12.5mg (half tablet) for a few days. I took my first 25mg full tablet last night and today was my best day in about 2 weeks.

So, good learning experience. I realize I’m not healed, but I’m learning what mix makes life tolerable and what doesn’t work. My other conjecture is that the effect of Dr. P’s mega block is wearing off. Not sure.

Either way, I’m planning to try another cord block with Dr. P. in the fall and if I get a similar positive result seriously consider denervation.

I know a lot of people are opposed to denervation, but I’ve got a different story/background. My vas was in March 2005 and pain didn’t start 'til October after, of course, bicycling. I had a reversal about 8 months later and the pain disappeared about 4-5 months after the reversal. I mean totally disappeared. It came back in late 2008 and lasted for about 6-7 months, then disappeared for 7 years. And I wasn’t being gentle. I bicycled 2,000 miles per year during those 7 years and was pain-free the entire time. This 3rd bout started in April 2016 after (a) wearing overly tight pants all day and (b) stupidly going for my first bike ride of the year that same day.

A lot of the guys on the forum have had non-stop pain from the moment of their vasectomy. Mine has been much more intermittent and, even in the bouts of pain, somewhat manageable. Dr. P and my uro at the Cleveland Clinic both see me as a good candidate for denervation. I’m trying to avoid it, but am not as opposed as so many on the forum because my case is different.

Sorry if that’s long-winded. I just started rambling.

Feel free to write back and ask any questions. I’ve been through a lot and have consulted many of the PVP uros…Dr. Witt in Atlanta, Dr. Marks in AZ, Dr. P. and Drs. Thomas and Shoskes here in Cleveland.



thanks for your detailed response Scott.

keep us posted on nerve block and if you do the denervation. my guess is there must be some good success stories but they don’t post on a pvps forum. my guess/hope is that as time goes by all the doctors that do the surgery and their equipment improve all the time. hopefully when I have mine done they have perfected it lol.

I’m due to go docs this week. I’ve only ever tried amitriptyline for pain and didn’t seem to work. going to ask for celebrex (but not sure UK doc will prescribe).

All the best



Some newer news. Pain Mgt. at the Cleveland Clinic is suggesting a GF block and, if it yields short and/or long-term pain reduction then do pulsed RF ablation of the GF nerve. I like this idea a bit better than neuolysis, at least at first blush. I would also do a 2nd spermatic cord block, likely Dr. P’s mega block, before any surgery.

So, right now, I have the GF black scheduled for 12 days from now. If I get no relief, then I won’t, of course, pursue RF ablation. I tentatively have scheduled a cord block with Dr. P. inOctober. That is my Plan B for now.



@Raising4girls (I am @Raising3girls, lol),

Thanks for sharing this with us. I believe I have damage to my GF nerve and am interested in seeing if this helps you. I have scar tissue up high at the base of my penis in the scrotum. It’s a long almost vertical scar and it creates that classic type nerve pins and needles shooting pain when I palpate and roll the skin there and when I sit it gets pinched/bunched up. Where is the Cleveland Clinic location you are going to?


MikeO - I’m seeing a guy named Dr. Grimm. He’s at the Strongsville and Medina CCF locations. He came at recommendation of my general urologist, not a PVP urologist. In 2005-06, I saw Dr. Mekhail at the main campus for Pain Mgt. I will see him if Grimm runs out of ideas.


In order to function at work I have to ice during the work day. I also go to car for lunch and ice. If I ever leave home I never leave without a cooler full of ice packs. I must ice 25% to as much as 50% of the time I’m awake. Who else is like this?

Before reversal I could sometimes use heat packs “hot hands” to quell the pain away, which would stay nice and hot for the entire work day. But ever since my reversal the “hot hands” aggravate the nerves too much.

Anyone try “hot hands” I recommend trying. You can buy from Amazon, be sure to buy the smaller size ones which hold inside compression shorts pretty well.


I think “hot hands” are the things my daughter used as a Color Guard member (flag spinner) in the marching band. Right now, sometimes heat helps (as in my heated car seats) and sometimes ice helps though I use ice only when I feel inflamed.

Sorry to hear the reversal hasn’t worked out for you as well as you probably hoped. I was fortunate to have 9 glorious years without pain post-reversal other than a 6-month relapse in between. Never thought I’d be back at this shit again, but it seems like I did something to aggravate the nerves pretty badly.



What type of pain do you have? Can you describe it and where it originates from? i.e. burning, aching, stabbing, tingling, throbbing in the cords, epis, under the scrotum, on the scrotum, high lowe etc. etc.


My pain is higher up in the scrotum on both sides. That’s the only location. I believe the pain is coming from the spermatic cords. Since the reversal I’ve had tingling, throbs, shooting pain, severe pain, epid… the works. For the last six weeks it has mostly settled into a duller pain. it gets a little sensitive, is just there and will slowly intensify if I don’t ice. Ice quells this type of pain. The pain may be trending back to how it was pre-reversal.


Sorry to ask but how long lost reversal are you?


my reversal was 11 months ago, done by Dr. P.


I posted a thread about updating your profile on this board that might help people to know your story and what you are dealing with without having to ask. Thanks for letting me know. If you update your profile it will help everybody. Sorry to be a nag.