Post Vasectomy Pain Forum

Epididymis tender and sore - 5 months post op

My surgery went well but I believe my job as a truck driver - with the constant bouncing and banging around - has really prolonged my recovery.

I have had a persistent soreness and tenderness in my right testicle and epididymis since the surgery. The testicle is very sensitive to the touch - even a slight brushing against it can cause pain. The epididymis is tender to the touch and painful when pressed.

I went to an appointment this week and the urologist who performed the surgery injected a short and a long-term anesthetic with steroid. I experienced some slight numbness for a few hours but the injection site was sore for several days and the overall soreness of the epididymis is worse, not better.

The urologist believes it is inflammation and not epididymitis. I usually have pain relief after ejaculation, and no issues other than this persistent soreness.

Hey mate, sorry you’re here.

As you may have read, many on here had their pain resolve after 6-12 months through conservative approaches. Have you been noticing a slight improvement month to month?

Re the steroid injection, it can take up to 2-3 weeks for it to fully kick in and start reducing pain and inflammation so give it a bit more time. Don’t be too concerned as an upswing in pain is normal for a week or two but as that fades hopefully your pain levels will recede too. Keep a bit of a pain diary during this time if possible.

Some here have had some good results with steroid blocks. If it helps, then another 1-2 follow up injections may knock the pain and any inflammation completely out.

Good luck and keep us updated.


Echo John’s comments. The steroid component of injections, for me at least, took a week or two to kick in, and I’ve been slightly worse after every injection once the short-duration anesthetic wore off. Makes sense. While a needle isn’t a scalpel, it’s an assault on an already sore area.

My opinion (and it’s JUST an opinion) is that anyone with vasectomy pain commencing right after the procedure is dealing with nerve pain. We talk a lot about congestion on this site, and I’m not a congestion denier, I just can’t imagine congestion occurring overnight. Even the best men have gone a week or two in their lives pre-vas without ejaculating and not had pain, I would think. Plus, prior to a vasectomy, it’s estimated that only 50% of a man’s sperm exit through ejaculation. After vas, we ask the epi’s to go from processing out 50% to 100%. Again, my non-medical opinion.

I’ve gotten my most durable relief from Dr. Parekatill’s “mega” nerve blocks that he performs under sedation. First block in 2017 got me 5 months pain relief. When pain returned, we decided to do two mega blocks separated by a couple months. That was in 2018 and I’ve been virtually pain free since then.

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What is included in the “mega” cord block injection?

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My first injection was anesthetic and steroid, but I believe he hit me 5-10 times in different spots; hence, our forum phrase “mega block.”

Second and third injections included botox which, unfortunately, wasn’t covered by insurance.

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Welcome to the forum @Kevin_K and thanks for sharing.

Hard to say what is going on with any certainty. What you are experiencing isn’t unheard of by any means. If you have doubts regarding your current urologists assessment of your symptoms and findings, you might consider getting a second opinion.

Perhaps you are only suffering from purely inflammation, but spermatic congestion, or vascular congestion are possibilities - the former is the most common of the two and it is widely recognized as a common post vasectomy risk or complication. Perhaps you are experiencing several complications simultaneously?

Statistics on congestion recovery timelines typically hover somewhere around ~2-12 weeks post vasectomy. In the majority cases, the 2-12 week timeframe is referred to as usually, typically, etc. 2-12 weeks isn’t a hard fast rule, it’s just usually or typically.

What is the mechanism for congestion resolving itself? It’s commonly referred to as homeostasis.



The tendency toward a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes”.

The link below contains an example of the term hemostasis being used by Dr Lipshultz, whom is one of many top tier urologists or super urologists, and based on my research, he is very qualified to speak about spermatic congestion with authority.

I don’t think this is unreasonable myself. Everyone’s system, anatomy, sperm count, etc, seems to be a bit different by default, let alone the fact that a single vasectomist isn’t performing everyman’s vasectomy. Bad days, good days, easier to find vas’s, harder to find vas’s, structural abnormalities, open ended, closed ended, the experience level varying surgeon to surgeon, etc - there’s a lot of variables to consider.

I’d guess that you have already seen the congestion pain cured with papaya seed powder thread. That’s a concervative option that you might consider as a potential option. If you haven’t skimmed through that thread, here you go.

Have you tried a course of antibiotics yet? Or did your urologist just skip that very common potential option?

I’m not thinking this means anything definitive. Hard for me to comment much on this part with any level of certainty.

Can you elaborate on your timeline a little more? What was your first ~24-48 hours post vasectomy like? First week? Second week?.. Etc?

Do you know what kind of vasectomy you had? Open ended? Closed ended? Might not be relevant, but it would be helpful to know.

Have you considered trying various kinds of underwear? A little more support? A little less support? Just a common thought…

I suppose I have more questions than answers.

Hope that helps.

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I have and it gives me hope for the long term, but the progress is still slow, and it causes anxiety and frustration.

Thanks for the information about the steroid… Puts me at ease.

It does make sense. Thank you.

It’s tough to remember precisely how I felt immediately after the surgery but I think my pain was at it’s worst from the 30 day to 90 day post op period.

It feels like some sort of congestion to me. The epididymis is a bit hard and swollen feeling to me and I usually get relief from ejaculation.

I read a little about it and ordered some capsules last night. It’s worth a try.

He didn’t mention anything about it but I will contact him and ask.

The vasectomy was closed.

It is tough to remember exactly the timeline. I wish I had kept a journal. I was a little sore after the surgery with a blue balls type feeling that lasted for about three months. I started to become concerned about a month after the surgery when that feeling wouldn’t go away - and as I became more active I really noticed the testicle sensitivity and some soreness near the clip site. A little bump in the right spot gave me blue balls for a day or two.

I also had some right side groin pain, some pelvic floor type soreness, and that tugging feeling during ejaculation for two or three months after surgery. Those have all gone away thankfully. That blue balls feeling has almost completely gone away as well - and if I do bump it the pain is brief.

I iced daily and and wore a jock strap for the first two or three months. Now I find that wearing no underwear and loose jogging pants is most comfortable. It’s counterintuitive, but a brisk walk or brief jog while going commando is great for pain relief.

Thank you for your reply.

Apologies… Having issues with the format here…

Thank you to everyone who replied. In my short time reading here I have found everyone here to be helpful, understanding, and informative. It is comforting to know that I am not alone in this.

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No worries, you will get the hang of it eventually. It’s really simple. Thanks for the additional details and information as well.

Based on everything you have said up to this point, your timeline reads like you are slowly trending in the right direction. That said, my thoughts are - stick to purely concervative options for the time being. You’ve had some good ideas suggested to you.

I lost count regarding how many stories and/or timelines that read like yours are on this site to date, but it’s a lot. With any luck, you might be mostly or completely out of the woods in a matter of months.

Good luck and keep us posted.


Kevin just wanted to see if you had an update