Post Vasectomy Pain Forum

Botox Ablation Journal


Hey guys,

I was in Orlando for a kids swim meet so I scheduled Botox ablation with Dr. P. I did it on Thirsday. I felt great that day but last night started having soreness in the abdominal/groin region when on the can. I’ll keep everyone apprised of my observations with it. It’s just injections and I was here so I thought I’d give it a whirl.


Lot of pain last night. Dropped off a lot this morning. We’re trudging around Disneys Animal Kingdom today. It’s not bad at all. I think it was a good decision for me to try.

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Could be rough after a day at Disney. Let us know. I’m curious why Dr. P. seems to try Cryo and Botox as options after denervation. You seem to be the first I’ve heard where he went Botox first. For my money, I’m willing to try any procedure with just a needle before a scalpel.


He had offered last time I spoke with him so I booked it. I have a spasticity issue so maybe when I mentioned that he offered. He was quick to point out it tends to wear off. Perhaps he would rather try to cure a guy with something more permanent than endless botox. I’m good right now.

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keep us posted @MikeO


Hoping you get some relief with this @MikeO hope you ‘survive’ disney!:joy:



Yeah right?

We met a couple families we all have the same observation. When you travel to Orlando for “vacation” you’re often up at the crack of dawn on your feet all day in the hot sun and trekking in and out of the park. Personally I prefer getting up a little later drinking a cup of coffee on the porch followed by sitting in a chair and staring at the waves. With none of that stuff happening at a particularly fast pace.

I’m on my way to work in hellish traffic at the moment. Standing in an hour long line for the Avatar ride is looking pretty good right now.

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Yes i remember magic kingdom on a sunny day with 3 kids under 6 is close to what i imagine a japanese POW camp to be like! Wonderful way to spend a huge chunk of your hard earned cash!! Good way to test if your PVPS has improved.

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Ha ha. I’m sitting at work feeling pretty good right now FYI. I’ll keep you all posted of course.

My pain levels are pretty good right now.


I wanted to explain the pain I had after the ablation/block in better detail. I was actually in great shape the second half of Thursday after the block. The day of the procedure went like this. I woke up at around 6:30 and helped my wife get my kid off to her swim meet. I then showered and took a Lyft from our hotel at 7:30AM to Clermont from Orlando ($21) where I was admitted at 8:30AM. They are doing a lot of work on that hospital and my driver dropped me on the wrong side of the hospital which was kind of annoying so I had to go out to the road and walk all the way around but I made my way to the right place. After I was admitted and stripped down in the pre/post op area at one point Dr. P came in and we chatted and he made me point to my trouble spots and he marked me up with a sharpie. After about an 2 hour waut I was wheeled into the OR and knocked out with anesthesia. I came to and said some overly familiar things to one of the nurses. The anesthesia quickly wore off and I was ready to go. I met with Dr. P again. He gave me pain med scripts and some antibiotics. One thing I noticed was the pain meds, while the same as my last block, contained a script for less Norco. It turns out 2 weeks ago the governor signed bill that makes it impossible for doctors to give more than a weeks supply to anyone not dying of cancer. Pretty pathetic that people who actually have chronic pain and might need something like that can’t get it due to junkies. Kind of made me mad. I have not filled that script however. I had a nurse service drive me back to Orlando because YOU CANNOT DO THIS UNLESS YOU HAVE SOMEONE WAITING WHILE YOU ARE IN THE OR AND WAITING TO PICK YOU UP. The woman was great and her service let me book her less than 24 hours before the surgery. She drove me back to Orlando. She was an older woman and was a hoot. She could not believe my story and was very sympathetic. “I never knew that could happen …”… It’s funny but one of the hospital nurses said the same thing. She had no idea until PUR and Dr. P with his patients from all over the world that a vasectomy could mess a man up so bad. She said she used to get mad seeing women get tubal ligation when the mans procedure is so much easier until she saw the stream of messed up guys that go there to be treated at PUR… Fast forward to when I got back to Orlando. I was not supposed to drink alcohol the rest of the day but I did have a beer at lunch with my wife at 2:30 or so. I felt fine at lunch. The whole area felt kind of weird at first. I got botox up in the cord scrotum area where I was accessed for my vas. I also pointed to the crease between my leg and scrotum and my pelvic floor around the sit bone. Aside from some general burning feeling like I had gotten a bunch of bee stings the first sign of significant pain came the next morning when I went to move and felt something that felt like pressure in my abdomen above my spermatic cord. When I sat on the toilet it was actually kind of painful and disconcerting. It was more of a pressure type of pain and soreness than a sharp pain. It was worse that night. Felt like swelling. I could not find an open Pharmacy within walking distance though, thus the unfilled scripts. That pressure pain reached it’s peak Saturday night after a day by the pool at Disney’s Animal Kingdom lodge. I had about 5 or 6 beers by the pool that day and swam a little with my daughter. I was a mess before bed. Again, when sitting on the can I had a lot of pressure pain in the low abdomen groin. However, yesterday before we hit the parks after a night of sleep it felt pretty good. Today at work has been great too. I feel really good right now and am hopeful this will help me. One thing I also observed is that I think I had a bit of a reaction from the steroid component Dr. P prescribes. I think it was Deca Duroblin. I have to say the next day after the procedure my body felt great. Joint pain was low and I felt really good but I did feel kind of wired, which I think was the Deca, and did not sleep well at all for 2 days. I had a klonopin left over from 3 years ago that I took to help me sleep and it worked.

Today I feel good. That part of my body is not perfect but my pain is hardly noticeable. If I can get a spell of a few months out of the procedure it will have been worth it to me.


is the intention that this could potentially give someone long term relief? Or is it more diagnostic like a nerve block?


The intention is for longer term relief yes. I suppose it’s diagnostic as well in that a positive response may inform the doctor about the mature of the pain.


@MikeO why did he give you antiboitics?? Also is botox for inflamation??


Good news @MikeO long may it continue!


Any update @MikeO ? You and I seem too have a similar area and type of discomfort. Anything non-surgical is appealing. I’m relocating to TX and may try to find someone to try this if I can’t see Dr. P (he did my reversal).


Sorry I have not updated sooner. I don’t really have anything dramatic to report. I still have a very similar pain profile. The Botox did not cause more issues but it has not yet dramatically improved the particular discomfort I feel. I have had one bad flare up of IBS which I think was due to taking an iron pill.

Apparently it can take a while for Botox to fully kick in and then it lasts a few months or so and then things go back to normal. I am about 3.5 weeks post at this point. I’ll keep you guys posted if there are any new or noteworthy developments.

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@MikeO. My urologist just offered me the botox spermatic cord block a few weeks before scheduled SCD. My question. In the long run, was botox helpful for you? There is zero literature supporting this but it seems less invasive that surgical SCD.


@Roy, @MikeO, I’m very much interested to hear that, too. How does it work? How long does it last? How destructive is it? How often can it be repeated? And last but not least, what are other non-surgical alternatives (RF ablation, …). @raising4girls had a number of these treatments.
I was offered Botox injections for the pudendal nerve and for the GF in the inguinal canal by one doc (a radiologist) and RF ablation or one of its variants by another pain mgt doc (who doesn’t think Botox would help)…


Not sure what’s helping me as I had cord blocks with steroid and botox June 2018 and October 2018 with Dr. P. along with a GF block (steroid only) December 2018 via radiologist. All in all, my pain level has been down at least 50% and often 100% for the past 5-6 months.

I’m a fan of trying anything with a needle rather than a scalpel.


Duly noted and thank you.

I contacted Dr. Terlecki at Wake Forest who ran the NIH study out of Wake Forest in 2014. Botox blocks (different from the “scrotox”) helped some people but ultimately never recruited enough subjects -because few wanted to risk being in the placebo arm. I don’t know if insurance will cover much of this, but my biggest concern is could this negatively impact in some way a future SCD surgery.

Of course the home run would be that the block cools things off long enough so that surgery isn’t necessary at all.

While the mechanism for analgesia with Botox remains fuzzy at best, my guess is that the cremasteric muscle in the spermatic cord is angry and that muscle is chock full of nerve fibers. Blockade of the neuromuscular junctions within the SC may relax that muscle.