Post Vasectomy Pain Forum

9 Months Post - Lots of Pain & Sperm Count Never Changed

Sorry, it is a quite long. I started making a journal of my experience a little over a month post vasectomy.
The following is a detailed description of my no-scalpel vasectomy experience with [first urologist] on Thursday, December 27, 2018 and post vasectomy pain over the next months.

TH 12/27/2018

  • Scheduled for consultation and procedure for same visit.
  • Consultation was a DVD video. Informed there would be some swelling, bruising and little to no pain post-op.
  • After the video was over, [first urologist] came in for a Q & A.
  • [first urologist] informed me that this day was his last day of the year before going on vacation.
  • I asked about underwear post-op. Was told to wear whatever was comfortable. I asked if boxers were fine and he said yes. I found out later that should have worn compression underwear and/or jock-strap to compress any possible bleeding.
  • I was not warned about complications such as excessive bleeding, hematoma, pain lasting longer than a month, inflammation, or erectile dysfunction. Nowhere in our discussion or in the documentation was the possibility of PVPS (post vasectomy pain syndrome) ever mentioned.
  • Early into the procedure, after my single shot local anesthesia but before the vas deferens was cut, I told the doctor I could still feel everything he was doing and that it was very painful. He acted surprised but told me that it was okay because he would be done in a few minutes. It was the worst pain I have experienced and I could feel every step. I was vocal about this but he never offered to administer additional local.
  • I think it is important to mention that he did talk quite a bit about how he was starting an out of town vacation the following day. This is pertinent as it possibly speaks to the fact that he could have been distracted by his upcoming trip while performing the procedure.
  • In addition to his excitement over his vacation, he repeatedly and arrogantly bragged about how long he has been doing this procedure and how there have never been any complications in his many years of performing vasectomies.
  • After the procedure was complete, I was at about an 8 on the pain scale and could hardly walk. I was instructed to take over the counter Tylenol. No prescription was written.
  • At home, scrotum completely stretched, very large, and dark purple. Penis was also dark purple.
  • I powered through because the doctor’s consultation made it seem as this was a normal reaction and that I was just in the higher range of the average of patients that have pain.

MO 12/31/2018

  • I was getting worse, unable to return to work, and it was now past the 3 day period that [first urologist] informed me of. I called his office but they were not open and the answering service answered. I asked for the on call doctor. They looked it up and with surprise in their voice, told me that there appears to be no on call doctor. They suggested I try the emergency room.
  • Because of long wait times I decided to call a nearby urgent care. I was told that I would not be allowed to be seen and that I could only be seen by a doctor from the Urology office. They recommended that I do not go to the emergency room as they would charge me for the visit, give me Tylenol, and send me on my way unless my life was at risk.
  • I contacted my Primary Care Physician and was told the same thing as the urgent care.
  • I called the Urology office again and spoke to different person at the answering service. That person also confirmed there was not an on call doctor. I was told to call back Wednesday, January 2.

WE 01/02/2019

  • I called the Urology office first thing in the morning and was told I could see [second urologist] at 8:30 am as [first urologist] was not in the office.
  • [second urologist] performed an exam of my scrotum. He said that it might be a hematoma that has hardened and had I called the previous Friday, they could have drained it. [first urologist] had told me to wait 3 days for symptoms to go away before calling in.
  • [second urologist] ordered a STAT ultrasound.
  • After the ultrasound, [second urologist] called and confirmed it was in fact a solid hematoma.
  • [second urologist] prescribed an anti-inflamatory (meloxicam 15 mg) but no pain medication despite the fact that I had verbally and physically expressed how much pain I was in.

FR 01/04/2019

  • As the pain had not subsided, I called the Urology office at 12:41 pm to leave a message with [first urologist] in regards to prescribing something for the pain. I was told he was there and that he should return my message shortly.
  • At 3:47 pm, I had not received a call back so I called again. The answering service picked up and informed me that the office must have wanted to close early. I asked to speak with the on call doctor. They said they would call me back.
  • After 15 minutes, the answering service called back with a doctor on the line but I did not get his name. He told me that he could not prescribe anything to me as I was not his patient. He told me to call back Monday, January 7.

MO 01/07/2019

  • I returned to work even though my pain had not changed and my mobility was very limited.
  • I called the Urology office first thing in the morning and again asked to leave a message for him.
  • At 10:35 am, [first urologist] called me back. He attempted to prescribe codeine for me even though my chart shows that codeine is the one medication I am allergic to. He ended up prescribing Toradol 10 mg, but I discovered that I could not take any anti-inflammatory medicine with it.

WE 01/09/2019

  • After 2 days on Toradol (taken as directed), I received zero relief from this medication. I decided to stop this medicine and go back to Tylenol and the prescribed anti-inflammatory even though I notice no change.
  • I decided then to go back to my PCP for my condition.

TH 01/17/2019

  • I see my PCP, Dr. Shelley Ferrill, and she prescribed valium to help me sleep and provided a referral to a pain specialist.
  • I make an appointment with a pain specialist.
  • The earliest the pain specialist can see me is Monday, January 28, 2019.
  • I give their office permission to request my medical records from my PCP and [first urologist]’s office.

FR 01/25/2019

  • I called the pain doctor to verify my appointment and find that it had been cancelled due to [first urologist]’s office not sending the full medical records from my brief time as their patient.
  • They tell me they had called [first urologist]’s office a number of times to receive the missing information (most importantly the ultrasound results), but that they never sent them anything else.
  • I called [first urologist]’s office and specifically asked that they fax the information over to the pain specialist. They finally send the missing information.
  • I reschedule my appointment with the pain specialist, but now the earliest they can see me was to be Monday, February 11, 2019.
  • Because of [first urologist]’s office I had to wait an additional 2 weeks before I could be prescribed anything for my pain.

MO 02/11/2019

  • The pain doctor prescribes tramodal. I immediately stop the valium.
  • Over the course of a few days, the tramodal either provided little relief or none at all.
  • I made another appointment to see the pain doctor.

WE 02/27/2019

  • It has been exactly 2 months now.
  • I visit the pain doctor and he switches me to hydrocodone.
  • He suspects that the pain may be caused by blocked blood flow due to the hematoma and that would explain why I am experiencing pain on both sides of the scrotum even though the hematoma is located on one.
  • My scrotum (both sides) pain level varies from 5 to 6 on the pain scale.
  • Though smaller, I still have a large hematoma in my scrotum.
  • I have not produced a full erection since and any arousal is very painful.
  • I also suffer from slight incontinence. It is not enough urine each time to soak through to my pants but my underwear does get damp and leaves a noticeable smell.

FR 03/01/2019

  • I have a 9:00 am appointment with a new Urologist ([third urologist]) that is not affiliated with [first urologist] or anyone at his practice. He does however say that he knows of [first urologist]; and, before even starting the exam, defends and makes excuses for [first urologist].
  • [third urologist] performs a full examination and orders new ultrasound.
  • He instructs me to keep wearing constrictive underwear and take nightly soaks in a hot bath for 30 minutes each time. These things should help to bring the hematoma size down.
  • He urges me to try and ejaculate at home. That weekend I try and, though still painful, I am successful.

TH 03/07/2019

  • At 10 am, I have a new ultrasound performed at a 2nd imaging place.

TU 03/12/2019

  • At 9:45 am I have an appointment with the pain specialist.
  • He is able to review the new ultrasound results.
  • The results tell him that my blood flow is normal so that is not the cause of my pain.
  • He has concerns that the pain I am experiencing could turn into Long Term Pain even after the hematoma has gone away.

FR 03/15/2019

  • At 10:40 am, I again see my new urologist, [third urologist].
  • We review the ultrasound and, though it has shrunk (mostly thanks to the hot bath advice), it is still a considerable size considering how much time has passed.
  • He believes it is time to have a semen analysis and refers me to a lab.

SA 03/23/2019

  • At 8:30 am, I submit a sperm sample at lab. Prior to that I had followed all pre-appointment directions, which included ejaculating 3 days before the appointment and abstaining from any sexual activity from that point until the sample is taken.

FR 04/12/2019

  • At 11:00 am, I have my follow up appointment with [third urologist] to review my semen analysis.
  • The results read as if I never had the vasectomy at all.
  • [third urologist] asked that I get a second semen analysis, this time at different lab.

FR 04/26/2019

  • At 1:30 pm, I submit a sperm sample on site at the 2nd lab.

TH 05/02/2019

  • I was able to access my lab results via the lab’s patient portal. The results showed higher motility than my previous analysis.

WE 05/08/2019

  • At 11:30 am, [first urologist]’s office calls and leaves a message. The purpose of the message was to inform me that I still need to perform my semen analysis. This is the first time [first urologist]’s office has made any effort to contact me since Monday, January 7, 2019 at 10:35 am.

FR 05/10/2019

  • At 10:30 am, I arrive at another follow up appointment with [third urologist].
  • I still have hematoma that feels slightly larger than a marble.
  • He confirms what I saw the previous week when I saw my semen analysis results.
  • Since I am still fertile, he suggested trying the procedure again but this time at the hospital, in an operating room with full anesthesia. This, of course, would be a much larger expense. My wife and I had talked about this previously and decided it would not be a good idea to go this route.
  • I asked if there was any way – invasive or non-invasive – that we could find out exactly what was going on below the surface. I was curious to know if there was a possibility that [first urologist] had not cut one or both vas deferens and instead cut something else or if the vas deferens had simply reconnected on its own in this time period. [third urologist] told me that there is no way to find that out unless it was written in the chart. I thought that was an odd answer that seemed to blindly defend [first urologist]. His answer gave me doubt that he was 100% honest about that.
  • [third urologist] also could not give an explanation as to why I was experiencing pain on both sides of the scrotum even though the only sign of trauma was on my left where the hematoma is.
  • [third urologist] had me make a follow-up appointment for 3 months out.
  • Leaving the office, I felt defeated and very depressed. Everything that I had gone through and endured was for nothing at all. And I have no idea how long I will continue to be in pain. This has drastically affected my everyday life in a severely negative way. I cannot climb more than a few steps at a time and more than 10 minutes of walking inflames the area making it hurt more. I am unable to go to the gym or even do light exercising. I have lost muscle mass and my clothes are getting tighter. I have had to miss many important events with my family because of this. I am going on a cruise at the end of May that we have had planned since last year, and I am not going to be able to fully enjoy it or do all the things I had hoped to do. I have missed multiple hours of work due to recovery and doctor’s appointments causing me to have to use my sick and vacation hours or work extra hours away from home to make up the time.
  • I am still taking multiple over-the-counter painkillers daily to decrease my pain.

MO 05/27/2019

  • Second day of cruise vacation. Due to yesterday’s walking more than usual and handling heavy luggage, I wake up in a larger amount of pain than I have experienced in a couple months. I take Naproxen and am forced to stay in bed until lunch when the pain has become more manageable.

TU 06/11/2019

  • I have a standard prescription refill appointment with my primary care doctor for my depression management.
  • Since the cruise ended, my pain has been worse than before the cruise. I assume it is in part due to all the extra walking I did while on the ship and at ports of call.
  • Since before the cruise, I have had extra bouts of heartburn and acid reflux that I attributed to the Naproxen I have been taking. My doctor confirms that may be the cause and suggests I switch to over-the-counter, extended-release Acetaminophen.

WE 07/10/2019

  • I do research to find out if it is possible for today’s imaging technology to track the vas deferens and determine if it is still intact. Due to the fact that my sperm count is at a normal level that does not correspond with a vasectomy in which the vas deferens has grown back after being cut, I think that something(s) other than the vas deferens were cut. What I discover shows me that it is possible to track the vas deferens.

FR 08/02/2019

  • Urologist appointment with [third urologist] at 9:30am.
  • Nothing has improved since last visit. I can now detect a small, hard, slightly smaller than pea sized lump on or adjacent to the hematoma on my left side that is more painful to the touch than other areas. I tell the doctor and show him where it is, but he does not examine that area and instead feels the lower scrotum and tells me things seem fine.
  • I request imaging to track my vas deferens and examine (again) what might be the cause of my pain. I get the referral for a CT scan with and without contrast.
  • I really get nothing out of this appointment except the imaging referral which, I think could have been given over the phone and should not have required a visit and $50 co-pay.

MO 08/19/2019

  • I have my CT scan at 9am at a 3rd imaging place.
  • I verbalize to the technician that my goal for the scan is to track the vas deferens and to detect anything out of the ordinary – including the aforementioned lump.
  • Before I leave, I receive a CD containing my image files and a program in which to view them. There are no documented results on the disc. Those go to the doctor.
  • Examining the imaging at home, I am unable to locate the vas deferens or track it. This is no surprise as I do not know what to look for or accurately read the images. I do, however, see the small lump on my left side from two different angles. It shows as a small white dot on the screen.

FR 09/06/2019

  • I have my next appointment with [third urologist].
  • He tells me that the report was inconclusive, did not show any abnormalities, and could not determine the source of the pain. He did say that the scan detected a small renal stone still in my kidney that was nothing to be concerned about.
  • I asked him what he thought about the lump that is visible in my scan yet not mentioned in the report. He told me that he could not say as he only has the report but no imaging to look at.
  • He instead suggests I make another appointment for next month to see if my situation has changed at all in that time.
  • He also, suggested that I see a neurologist to see if that doctor could determine the source of my pain. He writes a referral and sends me on my way. I look up this Neurologist and only find negative reviews so I choose not to contact him.
  • I have just spent another $50 co-pay for nothing and now am extremely tempted to find yet another new urologist.

FR 09/27/2019

  • Did research online to find an urologist that deals with PVPS (post vasectomy pain syndrome) and discovered only one doctor in my area, Dr. Lipschultz in the Medical Center. I made an appointment for late October.

TH 10/03/2019

  • At approximately 7pm, I arrive home from a short 2 minute drive and feel excruciating pain in my entire pelvic region upon exiting the car. It is about 8 on the pain scale and I have a difficult time walking. Since it had been over 8 hours after taking my latest dose of Tylenol Arthritis (extended tablets) I decide to take a dose of fast acting, extra strength Tylenol. After an hour or so, the pain levels out at a 7.

FR 10/04/2019

  • I wake up in the morning with my pain level at a 6.

This is quite the story, and I’m sorry to hear this. I don’t have any input other than keep jumping through hoops until you get some more answers.

If I had an advice for you, it would be, go slow, especially in regard to letting these people do things to you with needle’s and knife’s. I don’t care what they, or anyone else tell you, everything carry’s serious risks of it’s own - everything.

Please keep sharing your story here as things continue to present themselves.

Feel free to ask questions, although I may not have an answer for you.

Good luck brother.