Post Vasectomy Pain Forum

2 Months post-reversal checking in

Hey everyone, hope you guys are doing better or making some progress.

Today is 2 months post-reversal and I don’t feel any better unfortunately. If anything, I might be just a bit worse.

I’ve been trying to live my life as normal as I possibly can, and staying off of here to help get my mind off of this helps my mental state a little bit. I used to think that the guys who left this place got better and moved on, but I think a lot of guys just don’t get better and try not to dwell on how their lives have changed.

My wife said it perfectly - that I’m grieving for the life I used to have. That couldn’t be more accurate for pretty much all of us here.

I guess you could say my pain changed a little bit post-reversal, for example ejaculation feels better and I don’t have an uptick in pain afterwards, if anything, it’s a pain reliever to do it twice a day, but that’s not very practical.

I saw Dr. Jarvi a couple weeks ago and he wasn’t very hopeful about me getting improvement from the reversal. He says it’s 3 months post-reversal where the pain relief peaks, and if I was going to benefit from it, I would have by now.

That comment kind of struck me as strange, since a lot of guys here say 6 months, 12 months or even longer, but I don’t know what to think anymore.

We talked for a while about denervation, removal, nerve blocks etc. I asked why denervation success rates vs what we see on this forum don’t add up and he said something to the effect of 85% being ‘creative writing’ and that denervation is closer to 70% for improvement, but follow ups are short term only and the pain may return as nerves regrow etc. He also said he’s done denervation on both sides, it works on one side and does nothing on the other and they just don’t know why. His thinking is that reversals are way more successful and safer than denervation.

Which brings me to my next point, he offered the option of inguinal removal too and they have very high success rates with it, but of course there’s no going back and I’ll possibly need T therapy. I also have a lot of cord and abdominal pain and removal might not even help that. Just imagine having an empty sac and still being in pain. That scares the hell out of me. If it was guaranteed to fix me, I’d do it tomorrow, but it’s another roll of the dice.

So at the present time, he prescribed flomax to help relax my pelvic floor (which it does) but it has disturbing side effects (dry orgasm, peeing semen, ED) and he also wants me to restart nortriptyline to see if it helps.

I start pelvic floor PT in a couple weeks and I go back to see Jarvi in January for nerve blocks and see what’s what.

I’m leaning towards removing my bad side and denervation on the not as bad side. I know denervation is not popular here, but I talked to one of Dr. Jarvi’s patients last week who had the exact same thing done and he had a great result and is doing really well. Maybe it could work for me too. Who knows.

Thanks for listening everyone.


Have you had your first SA yet?

No SA was done actually, which I thought was kinda weird.

Dr. Jarvi asked if I wanted more kids and I said no, so I think he’s only interested in pain levels vs. fertility.

At least I didn’t have to beat the meat in a dr’s office :joy:

That’s just weird IMO. I would want to know every last detail about what did what, what happened, am I even fertile, etc.

No sense in assuming this and that. For all you know, it wasn’t even a success far as fertility.

I am stunned Dr Jarvi wasn’t interested in knowing himself :confused:

Yeah I was kinda shocked too, but I mean it was a reversal for pain and if all he’s concerned about is relieving pain, then what’s an SA gonna say?

I’m definitely a classic nerve pain guy, so I had my doubts about the reversal.

I’d like to know if I’m still sterile, shit at least I had that before the reversal.

I hear you man, but when you say things like, ejaculating doesn’t seem to bring on more pain, perhaps even twice a day, and never had an SA, I’m like, hmmm.

If you don’t know if you are, or not, it could be more pvps brain games. Been there.

At 2 months post-reversal I wasn’t any better, either. I noticed some improvement around 9 months, but have been on a plateau since. I’m planning for denervation in Jan.

I know the mind can wreak havoc on chronic pain and vice verse, but could you elaborate a bit more? I’m curious.

Are you more congestive pain or nerve pains or both?

There was a good recent example of reversal playing brain games with a guy here far as I’m concerned. Was feeling so much better, great recovery, etc, etc. When that guy found out it wasn’t a success far as fertility, all of a sudden not doing so well.

I actually went through this myself years ago before I had my second reversal. There wasn’t anyone around to that had been there, done that to even recognize what I was quick to point out not long ago.

Granted, I was not such the success story after my first reversal, but I definitely detected a similarity. I’m glad I participate here, and was able to help a brother out.

I see lots of brain games going on here with several members. I’m not suggesting anyone’s pvps is in their heads, but there is something to all of this for many.


Guys that are approaching their reversal dates that start trending better all of a sudden.

Guys like myself that get worse when I dwell on my pvps, especially the nerve damage spectrum of it.

Guys like myself that get worse if I think about my own pvps to much. If I think about where I hurt exactly, etc. If I’m feeling around to much, etc.

Guys that take a supplement that trend better in a matter of days.

Guys that never even had a vasectomy start reading these forums, and it makes them hurt.

Guys that are semi recovered and trending better in their own lives trend for the worse by reading this forum, etc.

Theres actually books I see recommend here that hit on this stuff.

Once again, I’m definitely not suggesting anyone’s pvps is in their heads, but when the mind gets wrapped up on their condition, pain’s, etc, they tend to trend worse.

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There’s a new member on this website that has been emailing privately. His pain doesnt seem that bad but he’s unbelievably anxious. Rightfully so. However, i basically advised him that needs to get off the website and try to live his life. I advised him to do this because his pain is low, he takes no meds, is way to early to think of options surgically and it’s clear his mind is making things worse. I made sure he knew i was not discounting his pain, but there’s a clear mind - body connection that is fueling his issue. I did tell him to check back in with us as time goes on, but sometimes you have to find ways to overcome mentally.

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The first time I spoke with Dr Marks he said his reversal for pain doesn’t even involve patency. He simply cleans the ends and tack them together.

While i see the benefit of “cleaning up” the ends, I also cringe at the thought of going through with reversal and not truly getting reversed. I would rather strive for patency and fertility in hopes of benefiting from less congestion, less systemic sperm ingestion, and better overall testicular health. When they do the so called quick and dirty reversal for pain, they’re guessing at the source of pain and you’re footing the bill. Not sure I like that.

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Interesting post @Choohooo, and I totally agree with you on the second paragraph.

I find it interesting that these top tier pvps docs tell us all something different as per our consultations. I could elaborate.

Wow really? Those were the words he used?

What extra steps do you think he takes for patency? Just checking samples for sperm? Would you even want a vasoepididymostomy for pain?

Do you really think I would’ve went through with a redo reversal if I had been told what he told @choohooo?

Meh, he doesn’t do that. I have pictures of beign reconnected and you can see the ink dots and the sutures as he is closing things up. No way he just tacks things together. For pain he probably doesn’t do vas to epi connection even if there is not much fluid but I doubt he just tacks stuff together. Mine was for pain for sure and I ended up completely open.

Yea, I agree. I’m not thinking Dr Marks used the words “just tacks things together” either. Prob just choo writing on the fly.

I posted pictures of my repairs here, and asked others to do so themselves. Nobody did.

Odd that I am one of the only guys, if not the only guy that has posted pics of my vas risks paperwork, vas informed consent paperwork, embolization records, other records, etc, etc here.

Mate your post got the best of me. Firstly i find it madness to be prescribe Flomax because your trying to keeps things open man. That shit does all wierd shit lowers sperm production dry eject, etc etc you know it man. Also what your wife said correct100% that is me. Also we do whatver we can to get by but also correct living off this forum is not good and that was me. man you sound better than myself so thats a good thing. So time may sort you out, all the best buddy.

In my recent consultation with Marks he said he would do a VE connection for pain if there was no fluid in the vas during the procedure, instead of VV. I asked about it, said I heard some docs always to VV for pain regardless. He said that was stupid, we should react to what we see case-by-case, not do the same operation regardless of observations during the procedure. that tells me he does believe patency is important for some pain patients, otherwise why do the more complicated VE connection? In contrast, Dr. Hsiao in Oakland said he would connect VV regardless, and doesn’t look for fluid/sperm during the procedure, nor follow up with SA after. So I don’t think he really believes congestion is the cause of PVPS. He was more of a proponent of re-doing the vas or converting to open ended, but the way he talked about it I got the impression he thinks PVPS comes from the vas site. His explanation of epidydimal pain didn’t really make sense to me, I think it could be pressure-related. Different docs, different opinions.

For myself I want to know after reversal if the connection was successful or not. If I am still in pain afterwards and still sterile, maybe the problem wasn’t addressed. IF you believe congestion pressure is a real thing, then it helps to know if the connection is open or not. If I have a reversal and end up still in pain and still sterile, maybe I still need a successful reversal. One situation I think would be hard is if you have sperm in ejaculate but still pain on one side, it would be hard to know if BOTH sides are open or just one.

When I spoke with Jarvi about VV vs VE he told me plain and simple, he’s never seen of, nor heard of a PVPS guy who’s been helped by a VE connection.

There’s a guy here whose VE connection made him worse.

Dr. P says the same thing about VE connections.

I get what everyone is saying about keeping the pipes open, but there’s so much more to PVPS than backpressure.