Post Vasectomy Pain Forum

8 weeks out- Hemotoma- Pressure- High Testicle- Pain

Hello All,

New here. I am 8 weeks post Vas. I had a hematoma on my left testicle near incision that is almost gone. Since procedure I have felt pressure on that side. My testicle also seems to sit higher and it is hard to make it comfortable, no matter how I try to adjust. The pain use to be sharp and intermittent, but now its dull and just tender some times.

I have had entire days where I experience zero pain. Then it comes back. I have not started exercising yet, which is hard because I have a passion for cycling and mountain biking.

I did have 2 cycles of anti-biotics, an ultra sound (seemed to be clear) and so far my Urologist just tells me it can take time.

I am wondering if anyone has gone through something similar and how their long term outcome and timeline looked like?

Thank you all for reading.

You are twenty steps into a marathon. follow the guidelines, ice, take it easy. do NOT be in a hurry to resume activities that can be strenuous or cause pain.

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Thank you for the response DrMarks. I guess the question is. When will I know when it is time? My doctor is being very vague and not answering Last time he told me to try riding a little bit and see. But I just don’t feel I’m ready

This is probably the most common question I get from men with PVPS. The answer is totally weaselly end of no value so I apologize in advance. When each person should take the next step depends totally on that person and when they wake up in the morning one day and say enough is enough I’m ready to move to the next level. For some men it’s literally a few months after the vasectomy and for other patients I’ve done reversals on it’s as far out is seven years or more.
The biggest worry is if surgery got you into this mess then they’re concerned that surgery will just make things worse. If you seek out a doctor that really knows what they’re doing and performs a state of the art reversal and provides appropriate reversal after care then the majority of men have either total resolution of the pain or dramatic improvement enough that they don’t care and can get on with your lives. There are a small percent where the pain comes back months to years later. And there’s an even smaller percent that don’t really feel that it helped. Sometimes the pain that they experienced before the reversal is gone but now they experience a different pain. Again I always encourage men to seek out pelvic pain physical therapists because I’ve had wonderful results with patients that I referred and what’s nice is it’s noninvasive it doesn’t require medications and you’re not burning any bridges…
I have referred many men to Dr. Parekattil usually with very good results but as he will tell you sometimes not with good results. He’s a good doctor and in every interaction with me has been very honest and straightforward. Being totally transparent there are men that have gone to him for various procedures and then came to me for a reversal so I think as I mentioned earlier it goes both ways. I personally am not a fan of the nerve stripping techniques but I know some men have had wonderful outcomes. And I’m definitely not a fan of the orchiectomy Fir pain because of those men that I recall that ended up with a significant phantom pain and now what do we do? I hope these points are of help. Each person will know when it’s time to move to the next level and when it’s time to consider a reversal and that just depends on how much of your life has been destroyed by this pain and how long you’re willing to tolerate it before you move to surgery. I wish you the best.

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I suffered pain for over 20 years and hated everything about vasectomy. If so many men have issues why isnt or doesn’t the medical profession be more honest. If they told men the truth then I am sure that the more truthfully the informed decision was told to men the less vasectomy would happen. I have talked to a lot of men about all the issues and all the extra costs that are involved and they still believe the drs. That come back and say I wish that I listened.such a lot of ruined lives with vasectomy not to mention the divorce rate. Men beware is all I can say. Dont get a vasectomy. I know that we can’t have lots of kids as we can’t afford that. However it like changing one problem for a heap of others.and I am testimony to that one. I worked it out that the original cost of vasectomy and over $20000 that I spent with urologist I could have brought a lot of condoms and still had change

Sadly you are totally correct. When I used to consult men before a vasectomy I used to do my best to try to talk them out of it and go through all of the worst-case scenarios including PVPS and spontaneous reversal. I would warn them there is a rare but definite risk for life destroying pain that may or may not be treatable with medications, therapies or even surgery. Though nobody can tell you why it occurs it’s my understanding that it may be a genetic predisposition to a response to the trauma of the surgery. This is why when I talk to people I emphasize that they use minimal cautery, and perform the reversal hi enough up away from the testicle, exercising a small segment, interposing a layer of tissue between the two ends which are gently sealed with cautery. I do not use sutures nor metal clips which I think also contribute to the inflammation. But again, most urologists perform many thousands upon thousands been never have a patient with this, while there are others that have several patients so i wonder what they do or dont do. And because it’s a relatively rare there truly are only a few doctors that understand and manage PVPS well. In addition to Dr Parekatill in Florida, Dr Jim Hotaling up in Salt lake City, Utah has had good results. I just stick to doing reversals.

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Doctors need to tell the partners also. When doctors tell the wife “This is basically a slam dunk, in-out, ten-minute, no-risk proposition. If he won’t do it, the only reason I can think of is that he doesn’t care about your safety” they are coercing the man by putting him in a position where the couple has a false view of the safety. With that false estimate of the risks, a man really would have to be pretty selfish not to get the vasectomy.

If doctors said “Well, I’ll be frank with you. The thing you’re really going to care about, the outcome that is going to gut you if it happens, is that the man you married may go away permanently after this operation. He may be in pain for the rest of his life. He may be cranky and distant from now on. He may no longer enjoy sex. There is a non-trivial possibility that this will destroy your relationship.” … Well I simply cannot imagine them being that straight with the partner. But I collect stories from men and women and the women sound just as bitter as the men that they were deceived into thinking nothing serious could go wrong.

For me the worst part of this isn’t that I have pain every day. My relationship with my wife has been seriously damaged because I’m just such a different person now. My whole pelvis feels injured and absolutely un-interested in sex. And my wife is bound up with this. I can’t drive by the hospital where I had my operation done without having negative emotions. It isn’t rational. I don’t blame the building. How can I feel the same spontaneous affection for the person who asked me to get this surgery? It isn’t rational to blame her, but my feelings simply are not the same as they once were.

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Ethan, the blame belongs squarely with the medical community, especially the urological association, excluding those who try to help like Dr. Marks, Dr. Parekatill, and several at the Cleveland Clinic who’ve helped me. My journey began in 2005, and I’ve been one of the fortunate ones who’s been able to achieve remission 3 times for about 12 of the last 15-1/2 years.

You’ve done a lot of research. There’s mountains of evidence confirming that vasectomy is a risky venture. No one would fly on an airplane with the same proven risks as vasectomy, yet it continues, because men are lied to and the truth is ignored by physicians.

I’ve shown my GP (new to me post-vas) the evidence. He’s become an opponent and counsels his patients against it. I’ve spoken with a few men he’s referred to me (with my permission). A small victory, but that’s the ground war we have to fight.

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I can relate to that to Ethan. Bad news all around

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Hi Dr. Marks,

I just wanted to ask whether it is possible that some guys who go in for a vasectomy are getting a free GF or IL neurectomy as a bonus.

This is a frame from a popular youtube video about vasectomy:

image

What precautions to urologists take do make sure that the scalpel is not cutting through the GF or IL nerves as it goes through the cremaster here?

I think it’s inevitable that some of us end up with damaged nerves, it’s just a matter of the severity and impact.

Several forum members have been diagnosed with core weakness and core dysfunction for the first time post-vasectomy. It’s relatively easy to see the connection between vasectomy and pain, either congestive or neuropathic, but it’s taken me 15 years to get an inter-disciplinary team to admit THE POSSIBILITY that my vasectomy led to a damaged GF which led to a weak/dysfunctional core which led to premature erosion of my L5/S1 facet joints and spinal fusion. I’ll never be able to prove it with certainty, but I’ve had enough PTs, orthos, and neurosurgeons look at me and not come up with any other explanation for my lumbar ailments starting 4 months after my vasectomy.