Post Vasectomy Pain Forum

Another Personal Journey

I have put off creating this for too long. I have visited this site off and on over the past year, and sometimes it has helped and other times it seemed like it was the biggest source of my anxiety.

I want to first say I am sorry for everyone that finds themselves in the position they need to even search for a site like this hoping to find answers to such an isolating situation, and then thanks to everyone who posts their story along with the medical decisions they make and the updates that follow. The information can be really helpful.

So, how I got here. I was 32 years old, My oldest son had just turned 5 and my youngest daughter was about to turn 1. My wife had what I would consider a difficult delivery with our daughter and we had decided we were happy with a boy and a girl.

I did what many responsible adults do when considering contraceptive methods and went to a consult for a vasectomy November 2017. I was given the pamphlet and the Dr. discussed complications such as Hematomas, sperm granuloma, and infections. I asked about type of underwear to wear, and he said whatever is comfortable, but most people opt for some type of brief. I asked about pain afterwards and he said to expect to be sore for a couple of days, but had never had anyone have any extended pain past a few days. I questioned him again about it, and he said he had never had any of his patients have any problems and he had actually “fixed” 2 guys that had some minor issues.

I walked away from that consultation and did not call back to schedule the procedure. I had one of the best years of my life. Work was going well for me, my wife had just finished her PhD, and we were finally spending more quality time together after we put the kids to bed, which lead to more intimacy. I am glad I had this year.

November 2018, I start thinking about contraceptive measures again. I didn’t want my wife on birth control for the next 15+ years because she had been on it for so long already, and it did effect her. In this past year, I had several friends go through with a vasectomy and they all seemed to be very happy with the results. I schedule another consult and get the same pamphlet from the same Dr. I saw a year ago with the same story.

I call back and schedule the procedure for December 21, 2018. This was the day everything went to hell for me. I could not have possibly imagined what I would be in store for. Hindsight is 2020.

The Vasectomy: Was a no scalpel procedure, shots hurt like hell, took him about 10-15 minutes to do the damage. Cut and clipped no cauterization or sutures that I was aware of. When he was finished, he said I could go ahead and get up and get dressed or keep laying for a few minutes if I felt faint. I went ahead and got up and noticed my sack felt like I was carrying a bowling ball. I even commented " I feel like I am carrying a bowling ball down here, is that normal?" He said, It may feel heavy from the anesthetics. I asked “Did everything look and go Ok” he said “Oh yea”. Then he was out of the room. I put my standard boxer briefs on (No strap) and met my wife in the lobby and she drove me home.

Within hours of being home, I developed a reactive hydrocele (did not know this at the time). I was in excruciating pain as the swelling got as large as a grapefruit. I had no clue what was normal or not, but I told my wife something couldn’t possibly be right. I texted a few friends that had the procedure and they said the same thing. December 24, 2018 we go back to see the on call urologist. He said it could be a hematoma, and give it more time. December 28, 2018 I had made zero improvement and gotten worse so we went to a walk in clinic that friday night and they ordered an ultrasound the next day at the hospital. Went to the hospital the next day and had the ultrasound done. I still remember the walk up the steps to get to the room, absolutely miserable. Ultrasound showed a hydrocele. Lucky me.

First week of January 2019, I see the surgeon that did the procedure. He seemed very empathetic about what had happened and assured me he was going to get me right. He said he had never seen anything like this happen to anyone ever before. I told him that even though the right side was swollen due to the hydrocele and was painful and uncomfortable, I had what seemed like more pain on my left side just above the testicle where a small bump was at. I asked him what that was and what could be causing that pain, he shrugged and said he wasn’t sure. I asked if it could be the clips or the vas that was cut, and he said again he just wasn’t sure. I asked what do we do now. He said to give the hydrocele some time as it may reabsorb. Wonderful.

I ordered several different types of jock straps until I found one that could fit everything in. The only problem was my left side hurt like hell just above the testicle and I thought maybe the strap was digging into too much or the hydrocele was putting pressure on it. I didn’t know what was going on, just that it hurt.

February 2019: After 5 weeks something had to give, so I scheduled an appointment and had the damn thing aspirated. That was a world of fun. Got to get those awesome numbing shots that hurt like hell again and having a 30 CC syringe jammed into your scrotum repeatedly and drawing fluid out. At least at the end of this procedure I had a bit of slack in my scrotum. Everything was still large, but this provided some relief.

March 2019: I went another 4 weeks and had a follow up with the surgeon. He seemed very happy that the fluid had not returned fully (even though I was still carrying around a tennis ball). He said to give it some more time and hopefully the rest would reabsorb. Scheduled a follow up Early September 2018. Great.

From March to August I patiently wait, hoping things would go back to normal. I try to live a normal life and for the most part I succeed. I was always uncomfortable, but I tried to not let the situation affect me. The back/top of my balls seemed to constantly be sore, and my left scrotum just above my testicle and outer thigh tingled/burned all the time along with my inner thigh and my perineum area hurt when sitting.

I get a call back from the urologist in August saying they had to push my appointment out a few weeks. Fine.

Sometime in September everything goes to hell. Not sure what caused it. I end up “tweaking” my lower left back or it had a spasm and it hurt like hell. A week or so later the burning in my left scrotum got so bad I couldn’t sleep for more than a few hours at night. I called the urologist and say I need to be seen sooner. They tell me my Urologist was out on extended leave for medical reasons. Wonderful. So, I had to reschedule with a different Urologist and the earliest I could be seen is Ocotober 7, 2018.

I see urologist #2 and give him the backstory. He orders an ultrasound to see if anything had changed in the area. Ultrasound comes back showing a Hydrocele on the right side and a 3mm epididymal cyst on the left side. I asked what could be causing the pain on the left side. He said he wasn’t sure. He recommends a Hydrocelectomy to fix the right side. After discussing this with my wife, I schedule the surgery hoping maybe relieving the pressure of the hydrocele it would resolve the pain on the left (if it was agitating a nerve or due to the size, as I thought the hydrocele had been increasing in size over the past few weeks)

Ocotober 24, 2018: The Hydrocelectomy, Ouch. They knock me out, cut an incision in the middle of my scrotum, pull the right testicle out, drain the fluid, and in my case radically excised my tunica vaginalis. Stitch me up and leave a drain tube. I wake up with a feeling like my testicles had been kicked 1,000 times. I go home within an hour of waking up, at least they put me in a strap. I am pretty miserable for 4 days with the drain tube causing the worst of the discomfort. After those 4 days, I go back and the surgeon removes the tube. That was a relief.

It seemed like everything was going to be ok the first week after surgery, but then the dreaded burning pain in my left side came back and spread again with vengeance. I had always felt pressure in my lower abdomen/inguinal canal since the vasectomy, but I thought maybe it was from the weight of the hydrocele. Now it turned into some sharp, burning pain. It was at this point I started to fear the worst. My mental state, which had been pretty good the past year started to deteriorate rapidly. I won’t go into any details, but suffice it to say it was bad. None of my previous issues seemed resolved and I now had new pain.

I called the urologist office and saw the surgeon 2 weeks after the procedure. He reassured me what I was feeling was normal and would resolve.

I am now almost 10 weeks post op and still have some issues.

I have burning pain in my inner thighs, outer thighs, scrotum, and perineum areas when sitting for longer than 15 minutes. Makes driving very uncomfortable. I can get a sharp pain in my left inguinal? right at the bast of the penis just to the left side. When I put pressure the sharp pain intensifies. Getting up from sitting the back of my balls hurt like hell, almost like someone is trying to rip them off, but once I start moving the pain eases up. Same thing happens when I go from moving to sitting, it hurts like hell, but then eases up. The back/top of my balls ache constantly. Just above the left testicle hurts and gets worse whenever the testicle is forced upward with a jock strap or briefs or sitting, it feels like something is just putting constant pressure on it, I have to wear loose boxers to keep this pain from intensifying to an unbearable level. The incision still hurts to the touch, but hopefully that will improve. Also, my lower left back and hip will burn at 2 locations.

I have had my testosterone tested twice. I have an appointment on the 2nd to review the second results. I will update that information in a few days.

I know this seems like a lot of information, and thanks to anyone who happens to read through all this and I will gladly take any advice or suggestions anyone can offer.

I will keep any updates on my situation in this post. If anyone has any questions about hydroceles or the hydrocelectomy procedure, please don’t hesitate to ask.

I would like to give a special thanks to my wife, she has been such a rock for me at times. She really is one of the most amazing people on this planet. I don’t know how people go through anything like this alone.

Thanks again and Here’s to hoping 2020 is a better year than 2019.

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Thanks for your story. I had my snip out of state and by myself. Man was I lucky. I didn’t even have to ice back at the hotel. No complications until I got back home and soreness on the left side wouldn’t go away.

Update for my testosterone tests. Of course, like most here I did not check my testosterone prior to my vasectomy because prior to my vasectomy I had no symptoms of low T.

First Test 11-21-19 Testosterone: 323 ng/dL No Free Testosterone listed.

Second Test 12-17-19Testosterone: 328 ng/dL Free Testosterone 13.7 pg/mL

Testosterone is on the low side of normal with a range listed as 264-916 ng/dL

I also had my PSA tested on the second test, but not the first.

Prostate Specific Ag, Serum: 1.0 ng/mL
PSA, Free 0.32 ng/mL

I guess the PSA tests look ok,? If anyone would like to comment if they look normal please do.

Your first doc sound a lot like mine and I had mine done just 6 days after you had yours.

Hey Slayer, did you ever get the pathology report back from your surgeon that did the vasectomy. They are supposed to test to make sure it was the Vas Deferens that were cut and not something else.

I am sorry you are having to go through this. Are you able to describe specifically the type of pain you are having and the location of the pain? Also, how big did your hematoma initally get and the where was it located. Is it still the size of a marble now or completely reabsorbed?

I’m wondering the same thing. There is another member on this site that had a vein sected on at least one side, instead of the vas deferens. He has a ~similar story to @SlayersCouncil - hematoma, etc…

That member quit posting a ~couple years ago, and if I remember correctly, I assume he likely stopped posting after posting a blurb suggesting he filed a lawsuit against the urologist that performed his vasectomy.

Sorry this wasn’t posted in your dedicated thread @SlayersCouncil. This is where the discussion ended up for the time being.

My story, in full, is in another thread: 9 Months Post - Lots of Pain & Sperm Count Never Changed

I have seen multiple doctors and not one of them ever suggested a pathology report (I had never even thought of it until you mentioned it). I had asked all of them if there was a way to see if both, either, or even neither vas were actually cut. I had read articles online how imaging could actually trace the vas to see if it was intact. Every single one of them acted as if I was off my nut (no pun intended) and that no imaging or test could see that. They all told me that the only way to find out what happened inside me was to cut me open and go digging around in there. I am very much against ever getting cut open again unless it is a life threatening emergency (this is not the first time i’ve had a botched surgery from an overly cocky doctor). I did get the 3rd urologist to order a CT scan with and without contrast but neither he nor my current 2 doctors are able to read it (or so they claim). I and the imaging center provided all of them the imaging and the technician’s report. I have zero background in any medical field yet I can clearly see a difference between my images and ones I have seen online of healthy, unsnipped scrotums.

I could never get the original doctor to see me again after my procedure. I had an appointment with one of the other docs at his practice and a short discussion with him on the phone more than a week after the procedure despite multiple attempts to contact him. After that, I never heard a peep from them until it was time to get a semen analysis, which I had already done with a different doctor. That one time I spoke to him on the phone, he had a very skeptical, unsympathetic tone about the whole situation. This whole ordeal has made me very distrusting of doctors as a whole and has me viewing nearly all of them as self-centered, greedy megalomaniacs that are only in it for the money. I know not all of them are like that but I really do think the majority of them are.

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@SlayersCouncil If I were you, I would go down there and request the pathology report. I got access to mine when my scrotum became the size of a grapefruit. The receptionist should be able to print you a copy from their records.

If you got it, you would at least know if they removed a portion of the Vas for both sides or something else…

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Update: At my last urologist check up for the hydrocelectomy I told my urologist about all my symptoms. He seemed concerned and said he wanted to get me better, but upon physical exam I looked “ok”. He said my issues could be musculoskeletal.

He referred me to the orthopedic center where I am and then referred me to the urology center at a high ranking academic hospital in the state.

My Ortho appointment was today and my next urology appointment at the hospital will be February 27.

At my appointment today I gave the PA the full story starting with how I arrived in front of him, starting with the vasectomy, and told him all my pain issues.

He had X-rays taken of my back and did a full physical exam. Reviewing the X-rays he said I had arthritis in my lower/lumbar region that was causing all my issues. I asked him if he has seen this before, and he said he sees a couple guys a week with pain in their scrotum from their back. I asked if he knew if they had vasectomies or not and he said some do.

I didn’t ask what the average age was for people he has seen for this, but this seems crazy for me to have arthritis in my lower back at 34 causing pain in my scrotum. Maybe I’m wrong here.

He gave me a steroid pack and meloxicam and said to sign up for physical therapy twice a week for 4 weeks to see if I improve. I have a follow up with him February 11. If I haven’t made any improvement then we can set up a MRI.

Update: Got an MRI done February 18th. Met with the PA yesterday. He said the MRI showed degeneration of discs and mild bulges at the L4-L5 and L5-S1 sections. This paired with the arthritis in the facet joints is creating a narrowing of space that is causing irritation to the nerve and would potentially be causing the burning pain I am feeling in my thighs, groin and scrotum on the left side. He seemed very confident as he has had lots of personal experience with his own back pain that required 4 injections and 4 surgeries to correct.

He recommended I get a epidural steroid cortisone shot in my back? I have that lined up for March 4th, but I may cancel to give myself more time to figure this shit out. I still have a appointment Feb 27th with another Urologist at a researching hospital.

I have to admit, I am having a hard time accepting that all the pain in my scrotum is coming from my back. I have dealt with what I would consider minor back pain for a while, but never before my vasectomy have i felt burning or any type of pain in my scrotum.

My symptoms have not changed much in the past month. The intensity has gotten a bit better, but they are still constant.

I know there have been a couple of guys here that have had back problems, has anyone had burning pain in their scrotum that went away after a steroid shot in the back?

Have you tried physical or massage therapy? It’s been very helpful for me overall. An x-ray showed compression on my low back disks an hip joint. Hanging upside down from a chinup bar works great when I get low back issues. Electrical stimulation by a chiropractor was helpful too.

Ultimately I blame nerve irritation due to the vasectomy and congestion. It’s causing muscle spasm and in turn musculoskeletal pain. I had no low back or hip issues prior.

@Lee1985 - your situation and pattern sounds remarkably similar to mine that started in 2005. I had my vas in March (I was 40) and started developing lower back problems in July, also at L5/S1. Got treatment and the lower back pains went away, but in October, the MASSIVE scrotal and groin pains started. I’ll spare you the whole story, but I suffered in massive pain 'til I had a reversal in June 2006. After about 5-6 months, the pain went away and I was pain-free in the scrotum and groin) 'til April 2016 other than a 6-month relapse late 2008-09.

I continued to have off-and-on lower back problems during this period. In May 2011, I got off a roller coaster than the back pain began running down the leg. No treatments worked. The facet joints were shot, the disc had mostly disintegrated, and the vertebrae compressed on the nerve root. I had L5/S1 fusion in December 2012.

It wasn’t until I got back on this forum that others here and a PT educated me on the possibility that the vasectomy had caused GF nerve damage which, in turn, caused core weakness and dysfunction. The lumbar spine compensated for the dysfunctional core by shifting and taking on more load. That led to premature erosion of the facet joints.

Proven fact? No, and I do have to admit that lumbar problems run in my family, but why at 40 right after a vas instead of 65 like my father?

Remember this…the nerves that innervate the scrotum do not originate at L5/S1. They come from L1/T12, upper lumbar and lower thoracic.

Best of luck. If you’d like to chat some time and compare notes, PM me and we can exchange phone numbers.

@WtfMyNuts Hey, Yea, I have been doing physical therapy the past 6 weeks or so. Hasn’t made any improvement in my pain. have not tried hanging upside down, but the PT place is now trying a traction? machine (pulls you to stretch the spine)

@raising4girls Hey thanks for the input. I will shoot you a DM and trade numbers with you. I appreciate your willingness to go through all this with me. I am just trying to figure out whats going on, and none of the Doctor’s I have seen have been able to agree on whats causing it. The Ortho docs say the pain in the scrotum is caused by Arthritis in the facet joints along with mild bulge in the discs at L4-L5 and L5-S1. I had an appointment at a Urology clinic ranked 35th in the US and they said it isn’t coming from my back, but I have PVPS and try to not think about this as “finding a cure” but “managing the pain”. What a fucking downer that was. They said I had hyperactive nerves or damaged nerves. I asked if I had permanent nerve damage and they don’t know. They literally don’t know shit about all this. I am going back in 30 days to see another Dr. there who has written some articles about PVPS. Maybe he can tell me more about whats going on. I have canceled my Epidural Steroid Injection until I can get a better feel of what the hell is going on.

They gave me Amitriptyline 10MG and 25 MG, and said to mess around with the doses to see if i can get anything to work. Great advice…didn’t they go to school for half their life for this shit, and then tell me to figure out my own doses. I wonder if I take the 57 pills I got left at one time if that would solve the fucking problem.

The “good” news is if the medicine doesn’t work I can reach into the bag and pull another medication out to try, and if that doesn’t work they will do a nerve block and if that works, I might be a good candidate for a spermatic cord denervation. I think I am just going to just rule that out for a long while or as long as I can stand it. I’ll go the reversal route and removal route before that i think.

They did note that I had a cord granuloma on the left side, which does hurt more than the right side. I can feel the granuloma when sitting and it can have a sharp pain to it at times and constant dull ache at the location. They said they don’t do anything for those.

  1. Anyone here have any experience with granulomas? Did it hurt? Did it go away?
  2. Anyone try Amitriptyline, did it help? ( I am going to use the search bar for this keyword, but if anyone is around that has tried it, please let me know how it went)
  3. Anyone tried a nerve block to calm the nerves down? Did it help? Could this make me worse off? Anyone have any success with just a nerve block to calm the nerves down for a few days?

Thanks

Yes to all of the above.

Granulomas post-vas at the vas tips. Reversal surgeon even offered to remove them and leave me vasectomized. I figured at that point if I was to be opened up again, it’d be to be put back together.

Amitriptyline helped a bit during my last bout, better than gabapentin. Those are the two most often prescribed non-opidoids for PVPS.

Had one nerve block pre-reversal. It helped, but not enough. Had several nerve blocks on this third bout. They definitely helped though, as you asked, they did tend to cause more pain for the first couple of days 'til the steroid kicked in.

@raising4girls Thanks for the response. I know I asked a bunch of different questions inside of questions, and thank you for taking the time to answer these, but just to clarify a couple things.

  1. I am assuming the granulomas hurt the entire time post -vas and never stopped hurting?
  2. After the granulomas were removed did your pain stop?

I am going to send you a DM if that is ok. Would you have time to talk this weekend?

Thanks

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Urologists seem always to blame a spine issue.

The fact is that nearly all men have some degenerative changes in our spines as we age. This is just one of many articles on the topic:
Incidence of Spine DD in Japan
Two problems:

  1. The discs weren’t causing us problems before vasectomy
  2. This could lead to unnecessary spine procedures, even surgery.

You are wise to proceed with caution.

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