Post Vasectomy Pain Forum

Chronic Orchialgia almost 5 years later

Hi everyone,

I’m the wife of a man who has had idiopathic chronic orchialgia since June 2016. He did not have a vasectomy. He had been getting worse and worse over time and the latest bought of pain has lasted since Oct 2019. He is on long term disability from work and often bedridden.
He had Microdenervation of the Spermatic Chord surgery done in Sept 2020 after a nerve block was done and he had pain eliminated for almost 2 hours. He was reeeeaaallyyyy sloooowwly getting better until a month and a half ago he started to see a physiotherapist. It seems that whatever is going on in the pelvic floor is complicated and he is now hurting pretty badly again.

Has anyone here had chronic orchialgia and pelvic pain not related to vasectomy and found pain relief outside of MDSC? There is honestly no forum on the internet other than this one that even begins to slow understanding of his condition. I am desperate, on stress leave myself, and trying to take care of a 5-year-old that has no idea what her father is like without extreme pain. He is generally at an 8/10.

Any help would be so helpful. Thank you.

Welcome. There’s a good amount of information on this forum regarding pain management options that so many of us have tried. These include Tylenol, ice, ibuprofen, cannabis, prostate meds, nerve injections, spinal cord stimulators, and nerve meds like Lyrica. I gave up exercise a long time ago. One poster here had orchialgia not related to vas and tried orchiectomy without a very good result. There may be some others with different results.

Sorry to hear about your situation. You said he had seen a “physiotherapist.” Was this a pelvic floor therapist trained in dealing with pelvic pain patients?

Hey! Yes we have tried all of those except for spinal chord stimulators and injections. Not sure if the doctors here will go for it. He is taking Lyrica and Percocet. He took Gabapentin and another one like that which stopped working. The Percocet does a bit but makes him super loopy. Like I would say with the Percocet he is at about a 6/10 but still unable to work. Like a 6/10 while he is laying down. He had a bad concussion about 8 years ago so medications affect his head a lot.

No trained in pelvic pain. That may be why she made him worse.

I have had pelvic pain for 20 years. My pain did not affect my testicles until my vasectomy 3 years ago, but nonetheless I have had some form of pelvic pain and urinary symptoms for a long time. I can recommend two things that have helped me:

  1. Pelvic floor therapy with a therapist specially trained in dealing with pelvic pain. This would be different from the therapy that older women get for strengthening pelvic floor muscles. Instead, it is almost the opposite type of therapy, focusing on relaxing the pelvic floor, such as doing reverse-kegels. Hopefully you can find such a therapist somewhere near you.

  2. There is a program available for purchase online with videos called “Dynamic Contraction Technique.” It costs in the neighborhood of $400 but I have had probably more success with that than anything else. It uses a different technique than the pelvic floor therapy.

In your situation, if you have a good pelvic floor therapist that specializes in pain, you may want to start there. If his pain is due to tight pelvic floor muscles, having someone get in there and force those muscles to relax can make a big difference.

Thank you!! We are seeing a pelvic floor therapist the end of April (with COVID everything is a longer wait). I’ll look at that program you recommended. Are you able to work, if you mind me asking?

Yes; I consider myself lucky. Although I have had pelvic pain and urinary issues for 20 years (since I was 22), my issues are mostly minor and nagging, not debilitating. I did have some pretty rough spells on and off in the first 2 years after my vasectomy (which now seems stupid that I ever had it in the first place). But I am doing much better these days. Mostly just low-level aching off and on but at times little to no pain. Relaxation and certain resistance stretches really help in times of discomfort. In the meantime of waiting for therapy, if you search for “male pelvic pain” on Amazon, you will find a couple of useful books. It is nice that you are actively helping your husband. Many of us on this forum do not get much support or interest from our wives about this issue.

Oh Wow! for one minute I thought my wife was posting on behalf of myself, your husbands story is very similar to mine.
Which side is your husbands pain, left or right, or both?
Does his pain radiate down his leg or up into his abdomen?
Does your husband have a trigger point, wearing jeans etc?

I myself suffer from chronic orchialgia, and I too have not had a vasectomy. My pain started 15 years ago and has got worst as the years have gone by. I have seen several urologists and have had several ultrasound, MRI and CT scans which have all come back with no abnormalities, except small varicoceles and cysts in both testicles.

I’ve tried all the horrid medications just like you have mentioned, I’ve had nerve blocks which have not worked, I’ve had a varicocelectomy where they cut out the varicoceles, this still didn’t work. Then last November I had a right side orchiectomy, the painful testicle was removed, and guess what? it hasn’t worked, I am still in the same pain???

I have just been told by the urologists that my pain seems to be caused by the scrotal skin, the small cutaneous nerves in the scrotum, it’s like a form of neuralgia, ilioinguinal nerve neuralgia. I have my doubts as I’m still not convinced that my pain is not coming from the cord, some things just don’t add-up.

I’m now waiting again to see my surgeon, I may end up seeing a neurologist.

Hi Chip!

Wow that’s crazy that you and him are so similar! For so long, we just kept cycling through ultrasounds and finally the urologist wanted to take the testicle. I was like why, and they said maybe it’ll help. I refused, so then he stopped helping us. Sooooo frustrating!

His pain goes into the abdomen more than the thigh, but he has complained of pain in the “upside down V” shape down into his legs just a bit. Since the MDSC, the pain has changed but still as disabling.

He had to wear sweatpants for a while after his surgery, but honestly driving is by far the biggest trigger.

The pain is mostly on his right, but it can be both.

I hope you see a neurologist soon. I feel the longer it takes, the more unhappy everything gets and then you have more complex pain since all the other nerves/muscles/tendons are triggered.

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@Hopeful88 We are so similar, I have pain in both sides, right side was always the worst, hence why I had it removed. I requested cord denervation, but my urologist did not recommend it, he said the same, that orchiectomy may help. It’s helped a little, but not enough to make a real difference, they say that it may still continue to improve, but I don’t reckon it will, the trigger points are still the same, wearing clothing, sitting, standing, walking, driving is still painful. It has been 4 months since the orchiectomy, I would have liked to think that I would start to see more of an improvement by now.

Thankfully the orchi has not made me any worst, the recovery was a bit up and down, my body seems happy running on just one testicle. My remaining testicle plays up more since the orchi, that has me a little worried. But there is one key point to all this, and that is when I woke up from the operation I was pain free, I’ve never felt so good. The anaesthetic that was injected into the end of the cord and into the scrotal skin took all the pain away. This must mean something important, surely???

It could! The nerve block has a similar effect for my husband, but then when he had the MDSC, it just changed the pain, not an elimination like the block.

Oh our docs didn’t want to do the MDSC either. We did a gofundme and had it done privately in British Columbia. It’s not an approved surgery in Canada.

Yeah it sounds like if the anaesthesia helped it is nerve-based, like my husbands pain

So frustrating. He says he avoids tight underwear, walking, stairs are a real problem. Driving over bumps is like the worst.

Try lorazepam
Doctors aren’t keen to dispense it and rightly so but your husband has chronic pain, nothing else seems to be working so give it a go and use it sparingly. If it works, use it to get through the most important engagements in daily life and take holidays from it which will seem like torture. I recently had Inguinal mesh removal, 3rd surgery after hernia mesh placement and spermatic cord denervation and in post op lorazepam was more effective than morphine. I stayed on the hospital analgesics as long as possible to give me a solid break from the lorazepam. Am recovering slowly but lorazepam still 10/10 pain relief. Lorazepam does not touch my sciatica since 14 years ago or radial nerve wrist pain but it does something for the pelvic region. I’d love to hear if it helps your guy. Love from Australia

Some antidepressants like amitriptyline are known to have nerve properties. Could be worth a shot.

There was a clinical trial running up in that area for a long lasting nerve block for scrotal pain (was due for completion recently actually) https://clinicaltrials.gov/ct2/show/NCT04026945 they haven’t updated it in a while so it may have got cancelled all together with covid. But if you live in that general area anyway and the nerve block gave complete relief temporarily it might be worth reaching out to them.

Interesting! I had no idea. Thank you I will look into this further.

Hey Winston,

Interesting! Yeah we don’t have many holiday engagements right now, but I’m hoping for something that will allow him a gradual return to work. I’ll see if I can get a doctor to consider lorazepam.

Thanks!

Lorazepam is addictive and has tolerance issues, but if it works and you’re disciplined with the use of it, it can give some good short term respite. From all my research it works as an analgesic in only about 5% of people, but I reckon that might be higher for pelvic region pain. I use it to go to a function, family gathering. You could ask the doctor for your mans pain or you could just try get a script for “anxiety” and see if it works for his pain.

And move to a warm climate, I’ve worn loose gym shorts or board shorts for 2.5 years since I woke up with sore plumbs. Have they ruled out hernias with your guy? You can’t always see them- they’re called occult hernias. Hernias can push on the main nerves and spermatic cord. Surgeons have said I should never had mesh placement for my tiny hernias. I’ve just had a long robotic operation removing one side of mesh which are about the size of an iPhone plus and it was wrapped around my spermatic cord. If hernias are presenting, ask for non mesh repair.

I do like the idea of moving to a warmer climate! I wish it was possible. I’m not sure if hernias were considered in all this time. I will look into it. Thank you!