Post Vasectomy Pain Forum

1 month out, burning pain

Hi all,

I had my vasectomy just over 4 weeks ago. The procedure went well, pretty much no pain during it other than the injections. I had the usual soreness and bruising which went away within a week.

At around the 1 week mark, I noticed a marble sized lump on my left side. It’s pretty high up, just the left of the base of my penis, and depending how I’m standing/sitting sometimes disappears into my thigh. This lump was slightly uncomfortable, but nothing unbearable. Over the next couple weeks some mild pain/soreness/warmth would come and go. The lump reduced in size to about pea sized.

Over the past week, the pain from this spot has gotten worse. I am pretty certain this is the vas cut site on my left side. It has not grown in size, but has been very hot/warm feeling. Sometimes I get pains down my thigh from it too. A warm bath makes it feel much better, but even that in the past few days doesn’t last long. It was so bad last night that I couldn’t sleep. Advil/Tylenol do pretty much nothing for it. When it wasn’t as bad as it is now, a couple Percocet before bed would let me get to sleep, but even that didn’t cut it last night.

Any ideas? I did go back for a follow-up just over a week ago, and my Uro said everthing is healing up fine, and sometimes you get lingering pain and it should go away within 4-6 weeks. I don’t think I could take 4-6 weeks of this burning.

No pain during erection or ejaculation at all, if that helps.

I realize a month is still within the healing period, but the fact that this symptom has been getting worse lately has be really worried.

Any ideas?

Thanks in advance.

I had the same type of lump on my right side. Yes it is the point of transection. If the doctor used fascial interposition as part of the closure it would add to the liklihood that’s it’s just inflammation. Your doctor is probably right - it can take up to 3 months for the body to heal from the vasectomy. So much for the whole you’ll never know a difference after a few days spin everyone gives.

What type of vas did you have? If it was open ended you could be developing a granuloma already. That could also be true with a traditional vas but would be less likely. That could cause pain.

I’m my case the lump I had that was similar to yours did disappear and resolve. After a while I couldn’t even find the location anymore. Instead I developed a granuloma on the other side.

Final tip - don’t allow it to go unchecked for too long. I switched uro’s after a year (had long term mild aches and the granuloma) and my second uro thought that my first uro should have treated me more aggressively early with high dose anti-inflammatories. If there’s inflammation around your nerves and it persists for too long it can create chronic nerve pain. My advice - start taking a NSAID (my uro prefers neproxin/aleve) in a high dose. 1 and 1/2 half aleve every 12 hours for 10 to 14 days. That’s similar to what I’m on now post vas reversal. If it’s not resolved in a couple weeks go back and be clear that you’re worried about the pain. My guess is that it will resolve. It may be TMI but I found that my usual position for sex aggravated the lump and we had to make some adjustments so that the irritation went down - which it did.

Thank you for the reply. To answer your question I had a closed no scalpel vasectomy.

Just an update with where I’m at. Today is the 6 week mark from my surgery. Things have definitely calmed down. The lump has reduced in size to match the right side, smaller than a pea. I went to my GP after a few sleepless nights had me a wreck and got a short term prescription for Ativan and Ambien, which has helped immensely. Calmed me down, and let me sleep. I haven’t needed the Ambien in a week.

Symptoms are improved, I think. Not really any persistent pain. What I’m currently left with is a burning coming from the left vas site after prolonged sitting, or any kind of activity. So after a day at work, it can range from “slightly uncomfortable” to “racing home to get into a hot bathtub”. I do wake up with slight tingles around my left thigh sometimes as well, but that does seem to be improving ever so slowly as well.

I’m still concerned there may be some nerve damage/entrapment going on. I know its getting better, slowly, but I’d hate to end up with permanent issues. I’ll probably give it another week or two, and if these symptoms persist, head to the Uro for another followup.

That slight burning in the inner thigh cost me my hip and my knee. Keep a close eye on it.

Hey all, another update. I’m now at about 7.5 weeks post Vas surgery.

The good news is the majority of the tingling/numbness outside my groin has subsided. It’s pretty rare that I feel any of that. I haven’t had much trouble sleeping and nothing has woken me up lately.

I can also be moderately active without issue. I was able to lift weights for the first time last week without any major problems. Weekends are actually pretty good, since I can keep active. I do get some lingering soreness from both sides after being too active, but nothing horrible, it’s more in line with what I’d describe as soreness from still healing.

The main problem is the burning after sitting, which still happens. Most weekdays, it’s pretty bad by the end of the day on my left side vas knot from sitting at work. When symptoms are low, both knots feel about the same size, around pea sized or less. But when the left side gets aggravated from sitting, it gets noticeably larger and inflamed, at least doubles in size. While the knot is hard feeling, when it swells up it feels softer.

I’ve switching to a standing desk at work, and alternate standing/sitting every 20-30 minutes which keeps the symptoms at bay longer, and I go for a walk at lunch, but I still end most days with the left side knot burning pretty bad.

I did go to my Uro for another follow up last week and got more or less the same story, everything feels and looks normal and I just need to give it more time. One theory we came up with is that the stitches on the end of the vas haven’t fully dissolved yet, and may be getting irritated. I did notice that my external stitches took much longer than most people say to dissolve, close to 3 weeks. He said the internal stitches are double the thickness as the external were, so I’m hoping that’s all it is.

Hmmm, when I got reversed I could still see the sutures on the excised ends. What type of sutures do doctors normally use for vasectomy?

Standing desk… it irritates me that (at the very least) we end up modifying our lives in the effort to alleviate pain that we were never supposed to have in the first place.

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Another update, at exactly 2 months from surgery now. I’m kind of using this as a journal to keep track of events.

Not much has changed since my last update. Weekends are pretty good unless I have a flare up from sitting for too long. Activity in general doesn’t cause many issues, it’s primarily sitting. I normally wake up feeling fine, then what I do in the day will determine how I feel.

I do still get ocassional tingles/numbness at the cut site, and in my toes on the same side, but its not that bad.

I came across this post

Which mimics my symptoms almost identically. I do get the same inflamation of the area when it flares up. I feel like I have a granuloma that somehow increases in size and causes the issues after sitting.

I saw a future update from that same member who eventually had it cut out.

I’m thinking at this point I give it another month to get to the 3 month point, and if symptoms don’t change, I’ll find another Uro for a second opinion. I know additional surgery this early is never a good idea, but I also don’t like the idea of a granuloma knocking around in there causing issues any longer than necessary.

Nerves are funny things. I’m on my 3rd flare-up of (apparently) nerve pain since my vasectomy in 2005. I’m improving, so I’m disinclined to let anyone touch my sack unless the trend changes.

If you’re dealing with an aggravated nerve, from my experience, I’d suggest holding off as long as you think you’re improving or at least level. Any invasive procedure, be it injection or be it surgery, runs the risk of doing more damage. I had Dr. P.'s mega block of the spermatic cord done 3 weeks ago. There were a couple days where I was worse than when I went in, and that was a frightening couple of days.

Best wishes for continued improvement. As a marker for you, my first bout of PVP started 7-1/2 months after my vasectomy (early March 2005 vas, late October pain) and I had a reversal the following June. No regrets on the reversal, as I’ve had a 2-year and a 7-year period pain free between flare-ups, but just wanted to encourage you to be patient. Easy to say, hard to do, I know first hand.

pnetts,

A couple weeks after I wrote this message, I had a setback. I decided I was really starting to feel good again, so I tried running a bit after some other exercise and I think I irritated the nerves once again. I think the muscles in my hip either spasmed/swelled due to lack of use and compressed the nerve again in my hip, or the nerve got irritated and caused the muscles to spasm. Either way…bad idea on my part. It’s taken about a month for me to get almost back to where I was pre-run in my hip flexibility and such (not quite there yet). I had the inner thigh pain again and could feel that the muscle in my inner thigh was super clenched, but that has mostly gone away. Now I just have a bit of hip tightness and/or weakness that is annoying, but I have also been doing some stretches in that area. It feels like a good massage would help…

I think originally I had 2 problems. I think I had an inflamed granuloma and also nerve/muscle issues. I no longer get any pain at the surgical site, so that is a blessing and having the granuloma cut out was good for ME in that regard. Based on discussion with the doctor that did my surgery, the granuloma had attached to the spermatic cord, causing the cord to pull up and rub nerves (is this really true? I don’t have the answer to that, because I was knocked out during the surgery). I would definitely seek a consult with someone in your area that is a PVP expert and do it sooner rather than later. With nerves, once they are activated/irritated they take a while to shut down and they are then hypersensitive. I would try to get those under control as quickly as possible.

What my doctor told me was if you do have a granuloma or something that is pressing, rubbing on the nerve, then you need to take care of the issue at hand. I was going to get a nerve block, prior to the surgery and he advised against that at the time, because even with the block, if the granuloma is causing the rubbing on the nerve, you’re not actually taking care of the problem at hand, you’re just masking it. He felt that removing the granuloma would get rid of my pain. It hasn’t happened exactly like that…but it has decreased my pain some and I think now has limited me to nerve pain. I was scared to death to have a second surgery…but I’m glad I did at this point.

Who knows though, everybody’s body is so different. Our experiences can define our expectations of life. I never thought I would have this type of thing happen to me and I have always been healthy. Now that I have to deal with this pain and the cause being a decision that I made, I have had a much harder time accepting that I can no longer do the things I once could. My mindset has went back and forth so many times and tried to place blame on myself, the doctor, my wife. In the end though, it doesn’t matter. I was dealt this hand and I have to deal with it. I am not in the same position as a majority of those on this board. I have hope that over time the rest of my issues will resolve. But I have resigned myself to the fact that they might not resolve and I am at a crossroads, either I can choose to piss and moan about it (which I still do sometimes) or I can go on with things and make the best of it., which is much easier said than done.

Pnetts, one piece of advice that I would give you, is don’t mess with the granuloma too much. I think that was an issue for me. I may have been irritating it, because of my obsessive nature. I would have to check it all the time and hope it got smaller. I probably caused some of the inflamed pain/damage myself. So, if you do mess with it a lot, I would stop. If you want to check it, then check it once every few days or once a week. See if that helps any…

Sorry for my post if it offends anyone, but I thought I would share what little knowledge I have on the situation.

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Thanks for the reply and the update. It really means a lot.

Everything you’ve said regarding the granuloma/rubbing on nerves, etc makes sense to me and still lines up with my symptoms. Something giving me hope, as I’ve mentioned I think, is most of the discomfort has become localized to my left vas cut site where I think I have the granuloma. Not too much thigh issues, just the occasional foot tingling, and when that happens it’s pretty minor.

Your last point about not messing with it is something I actually thought of yesterday. Like you, I was constantly messing with it, trying to tell if it was smaller or bigger, etc. I’m going to leave it alone as much as possible, I’m sure constantly poking and prodding doesn’t help anything.

Burning is a little better at work today as I learn how best to sit without aggrivating it.(bolt upright, legs spread) Unfortunately this position puts pressure on my lower back which has always been bad, so now I end up with back pain at the end of the day. Ugh.

I lifted weights again last night and may have overdone it, I’m getting some sharp pain from the bad side today occasionally when walking. This is the first time I’ve had this type of pain. I need to not be stubborn and let it heal and stop moving around so much.

Something that’s really been bugging me is I have a week long trip to Scotland planned in a month. The idea of a long flight and lots of driving around does not sound pleasant. Really bumming me out as I was looking forward to this trip.

Anyway, thanks again for the replies all. I’ll keep you posted.

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Hi all, another update. I’m now at the 3 month point.

Symptoms have been s l o w l y improving, I think. Some days better than others. I still get burning from the left side vas after sitting, but it takes longer to come on, and when it does, at its worst, it’s nowhere near as bad as it used to be. I also still sometimes get pins and needles feeling around the scrotum, and my left toes.

Just got back from 9 days in Scotland. The good news is I was able to mostly enjoy the trip. The 6.5hr flight there I was actually almost completely fine, and we did tons of driving, and as long as we stopped and stretched every 1-2 hours, I was in decent shape. Not normal, but well enough to manage. Lots of walking too with minimal discomfort. On days with more driving, 4-5 hours, I was definitely hurting by the end of it, the worst was one day coming back and getting stuck in traffic, working the clutch with my left leg repeatedly sucked. But overall much better than I thought.

So most mornings, I wake up feeling mostly normal. Then I sometimes get a “coolness” coming from the left vas, which can progress and sometimes feel like a burning that can radiate, or comes and goes. It all seems to depend on how I sit and for how long.

I’m still hopeful that since I’m seeing progress, as slow as it may be, I’ll eventually get back to normal without additional surgery. My lumps are pretty much non existent, I can just feel the cut vas ends now if I feel around.

Haven’t been back to the uro yet, I do have my 100 day SA coming up in a week though. Not sure if I want to bother with another appointment with him to tell me the same thing, or schedule a second opinion with another doc. There’s a local guy on the list here I may call.

Anyway, that’s where I’m at. Absolutely better than before, but still not normal.

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Was wondering how your progress is coming along. I’ll take it as a positive that you haven’t posted on here in almost 3 months. Your symptoms sound similar to mine, as did the guy who’s post you copied and pasted into this thread. I’m at 7 weeks. Hoping for slow continued improvement and some good news to look forward to. Thanks for any reply.

Apologies for not updating in a while, like many others I’ve been trying to stay off here since reading about others pain too much doesn’t help.

I’m just past 6 months from my vas surgery. I did have my 100 day SA and confirmed sterile for what that’s worth.

I think I can say my primary complaint of burning continues to get better, I rarely have those types of flare ups, but I still daily have other nerve type issues. Mainly coolness/numbness/tingling that moves around. Sometimes down the back of my leg, sometimes its in the hip, and often makes it down the back of my calf and into my foot. It seems to radiate from the left vas site, but since it’s not specifically “pain” it can be hard to tell.

I do consider myself lucky that I have pretty much no testicular pain at this point, outside of the rare pains which aren’t even worth mentioning.

I’m wondering if these symptoms are secondary and I’d benefit from some kind of PT. I’m not even sure who I’d see about that. Maybe a neurologist to start? The weird thing is on days where I can be more active, usually weekends, I can go pretty much all day feeling nearly normal. It’s mostly work days where I can’t be as active when it gets worse, even though I have standing desk and alternate standing and sitting no more than every 30 minutes.

I can lift weights and exercise now without issue.

So that’s where I’m at as of today. I’d definitely say I’m still improving slowly. Just other weird issues coming and going. Nothing that I’d describe as severe, but still a daily occurance.

@pnetts37
What did you do for the burning pain? My husband is 6 weeks out and his groin is “on fire”. I don’t know how severe your pain was/is but he says about a 7 or 8/10. I’m just trying to figure out ways to help him.

@Worriedwife1 He needs to see a physician about the groin burning. I had that early on. I took NSAIDS, Elavil and Gabapentin for it. I also did pelvic floor PT and massages weekly. The burning went away after 3-5months following this routine. I still have tightness and mild pain in the groin but nothing like the fire i was experiencing. His issue could be inflammation, nerve damage (which seems unlikely due to the bilateral aspect of it) but it’s possible, muscle spasms, and so on. See Dr Jarvi as soon as possible. Go to a GP in the mean time. Bring printed research articles about PVPS in case they doubt you and him. Good luck.

@Worriedwife1 Certainly seek medical help, as others have suggested. I’ll just toss out that not long after my vas I had 9/10 burning pain 24/7 and nothing would help at all. My entire pelvic region was inflamed. By chance I discovered that a dose of Benadryl at bedtime almost eliminated the fire the next day. Pelvic stretchs helped greatly as well.

Seems silly and may not help at all but it’s cheap. Just don’t overdo it. The side effects got pretty nasty for me after a week or so of continued use. If you try it and get good results let me know. Just curious…

@Kyvas I’m pretty sure it’s nerves. It’s mostly unilateral on his left side. I seems like it’s along his cord up to his hip area. His top part of his abdomen did have burning but he said the burning is subsiding but it is the stabbing pains he is dealing with. He isn’t getting any better and was only offered naproxen by our GP. We are waiting to see Dr Jarvi in 2 weeks.

@Worriedwife1 - I had really bad prostatitis like symptoms after my vas for about a month or two, which eventually settled down, and the absolute worst of my nerve pains got a bit better with time.

I’m not healed by any means, but it’s possible his could settle down.

Does he have issues urinating? I had burning and tingling across my groin after the vas for quite a while and I couldn’t wear a belt because the belt buckle would cause excruciating pain.

Another NSAID you could ask for is Toradol. It helped me tremendously in my early days, but it’s super hard on your gut and you can’t take it long term.

@vasregret He hasn’t complained about urinating to me (although I’m sure there are things he isn’t telling me because I’m freaking out with what is happening). He doesn’t have issues with sex, ejaculatjon, feeling in his penis. He never did. It doesn’t seem like congestion either although he did complain here and there that his whole groin was achy but that was after a full work day.

His main pain seems to run up the left cord with most of the stabbing feeling where the thigh meets the pelvis. He said that he actually tightens his belt because it puts pressure on his abdomen which feels better. If it’s not his belt, he lays his hand in a knuckle form and pushes into his abdomen to put pressure there.