Post Vasectomy Pain Forum

Fear and Loathing in PVPS Hell

I’ll preface my story thus far with the fact that I have never been so angry and scared in my life.

I’m a 35 year old, single professional man. I have no children. Don’t want any. Hence the reason why I got a vasectomy approximately one year ago. The surgery was unremarkable and aside from normal post-surgery pain, I had no issues. Didn’t even really have any swelling. I was very happy with the result.

A few months ago (about 9 months post vasectomy), I noticed that my balls were achy. Like everyone else on here, I figured it’d go away after a few days. It didn’t. So, I started doing some research. It took a little while, but I finally stumbled across PVPS.

So, I found a doc near me who was highly recommended by this forum. We tried the first line NSAID approach. It helped, but I was shortly thereafter diagnosed with a stomach ulcer and had to stop NSAID therapy.

The ultrasound showed enlarged epididymis on both sides. Then I went through the diagnostic spermatic cord block - which was an extremely painful procedure. Twig and berries were numb the rest of the day but the pain came back and actually got worse. Additionally, the sides of my balls, right below where the needle was inserted, are now very tender to the touch.

Doc is starting the process to obtain pre-approval for a reversal from my evil insurance company. In the meantime, he wanted my to start on testosterone gel to slow down sperm production to hopefully get some relief. Evil insurance denied it. Doc is scheduling a peer 2 peer with the insurance demons to hopefully get it approved.

Meanwhile, I’m in pain constantly. Can’t take NSAIDs, Tylenol doesn’t do shit, can’t take tramadol because I’m on two serotonergic drugs. I asked the doc for something else (i.e. opiates) for the pain until the testosterone (if it ever gets approved) kicks in and was told no.

So, here I sit with sore balls, regret, and despair.

I wish I had never been snipped. Nobody told me this was a risk. But, I can’t change it. I’m just terrified that I’ll never be back to normal.


Take solace, at least you found a doc who’s taking you down a good path. Even some of the best ones here won’t tread near TRT to shut down sperm production despite a well-done study by a US Army urologist who proved its efficacy.

Your situation sounds remarkably similar to mine as my pain started about 8 months post-vas. I had a reversal and, after a 6-month recovery, achieved 9-10 years pain-free. Suffered a relapse a couple years ago but nerve and cord blocks finally knocked that pain down. Up and down battle, but don’t despair that you’ll never get better. Try to be patient and follow the course. I rode 17 miles on a mountain bike today followed by a 3 mile hike. Just celebrated my 13th anniversary of reversal last week. You’ll get there, but it takes time.


Thank you for your words of encouragement. I hope to have some good news of my own to report in the near future.

Any suggestions on what to do for pain relief for the time being? The only time I get a break from that kicked in the nuts feeling is when I’m asleep.

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Welcome to the club, could be a long journey. I’m 6½ years post-vas. Have you discussed epididymectomy with your doc? Or denervation? I take Rapaflo and ice sometimes, and avoid lifting heavy objects. These seem to help.

First, I’m sorry you’re here. Second, are you in a legal state? For whatever reason medical cannabis in 1:1 THC:CBD has helped me with pain relief. Even more so than the opioids I was on for a short time.


I hate hearing that you’re 6.5 years post vas and still having issues, man.

I’ve done a lot of research on the issue and have decided that pursuing a reversal is my best option at this point. It seems to have a high success rate for pain relief and it kinda makes intrinsic sense to reconnect what’s been severed.

At this point, I don’t like the idea of an epididymectomy because it has a lower success rate for pain relief and eliminates the possibility of a reversal. I also don’t want to mutilate my balls anymore than I already have.

With respect to denervation, it also has a lower success rate and permanently mutilates your nuts. I’ve also had the nerve block and, if denervation is anything like that, I really don’t like the idea of my balls being numb for the rest of my life.

I’ll have to look into that drug you mentioned.

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Thanks, man.

No, I’m not in a legal state.

Drinking seems to help, but I don’t want to get in the habit of drinking all the time.

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Same here but only lasts the night. Next day can even be a bit worse sometimes.

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I am 13yrs post vas, always in pain since 3 months post vas but luckily average pain of about 1-2 (on 10 scale) with periodic pain levels of 4-6 5-6 times a year. I got on TRT about 2 yrs post vas when I found my T dropped from 820 pre vas to 290 post. Even though my T was low the injections eased the reoccurring high pain levels. I agree with EVIL insurance companies, I tried reversal w insurance because of chronic pain- went nowhere… Sorry to hear of your situation. raising4girls is on track, have patients & save-pay for reversal.
My wife went through menopause 2 yrs ago now im saving for a reversal.

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Thanks for the advice, man.

All I can think to do for the rest of the day is drink on it. It’s a shitty solution, but it’s the only one I’ve got.

I wouldn’t wish this shit on my worst enemy.


There’s another guy on here @mklamut79 who’s met with both the fertility uro and the SCD uro at the Cleveland Clinic. The fertility guy told him, I believe, that reversal is a better first option since it’s restorative. I tend to agree with that unless it’s highly suspected that the pain is strictly neuropathic and that sterility (congested epis) isn’t causing the pain. There’s the rub. If the pain is neuropathic only, then reversal has a good chance of making matters worse.

I’ve often wondered about the efficacy of doing reversal and SCD at the same time.

Awesome. Seeing as there’s no diagnostic test to definitively distinguish between pain from congested epi v neuropathic pain.


Especially for guys like you and me where the pain comes 8-9 months after the vas and a normal recovery. I’ve always felt the guys with pain from the get-go are likely experiencing neuropathic pain and guys with later onset are congestive. But, even then, in my case, since I was leaking at both vas tips, my reversal doc said he didn’t think I was congested but had pain from the granulomas that formed. Who freaking knows.

What really concerns me is that the longer this shit goes on unresolved, my chances of a vas 2 vas reversal success diminish as an epi blowout = a vas to epi reversal, which, I’m sure you know, has a much lower success rate.

Yes, you hit on the truly evil part of this ailment. Doctors preach patience which is understandable. Many surgeries, not just vasectomy, take time to heal from.

But, by waiting, the odds of successful reversal decrease. I had a reversal 15 months post-vas and based on a recent SA 12 years post-reversal, I’d say I’m still open. So, it worked. But, if I had waited longer, who knows.

Same with nerve pain. There is a risk of central sensitization to the spinal cord which makes surgery on the peripheral nerves useless.

Well, finally got some good news. Insurance finally approved the testosterone gel. I started it today. Hopefully I’ll get some relief soon.

I will say that I can already feel some increased aggression and jitteriness. Mind is also on overdrive.

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Get your T tested asap (after a week or 2 most) of using T gel. You want to take as low a dose as possible. I had to figure my dosing out for myself, local doc was no help and very poorly informed.
Fake T for me is definitely a different world. Kind of animalistic horny at first till I lowered my dose. Side affects (male breasts) can also become a problem from to high a T dose. When you get your blood work done insist on getting E2 done (Estradiol), it indicates if your taking to much T because if you take to much T it gets converted to Estradiol (a form of estrogen) and could give you male breasts, very bad news and only surgery can reverse that… If your on T for a while your body will stop making T. After several months your balls will shrink, not fun. Mine went from about 1" round to 1/2" like an almond… was scary. But I found that HCG works on the boys to keep them producing T. Side effect of taking HCG is it will also make your balls produce more sperm and that could give you more back pressure & thus pain. Took me about a year to find a good balance of some T injections and some HCG to keep balls from shrinking and not producing to much sperm which made me more sore…
Ive done years of research on T balance and ball shrinkage, hormones… If you have more questions I can answer. My local doc actually started asking me for advice for other guys…

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Thank you for your words of wisdom.

I’ve been off the T gel for a little over a week now and am getting pretty close to being back to normal.

The shit did not agree with me mentally at all. But it did help with the pain pretty quickly. However, the cost-benefit analysis weighs in favor of staying off the T especially considering all I’ve found out about it after I stopped taking it.

I’m getting my T levels checked in about two weeks. Doc wanted me to get them checked about 4 weeks after starting on the T gel. I haven’t told him that I quit taking the T gel. I’m curious to see what my baseline levels are.

Right now I’m waiting to hear back from the insurance company on the reversal pre-certification. I’m sure it’ll be denied, in keeping with the trend. Hopefully my doc can bully the bastards into approving it eventually.

Well, as I suspected, my insurance company denied the preauthorization for the reversal. No real shocker there.

What I didn’t count on, however, was my doctor’s office telling me that I’m on my own with respect to appealing the decision. They also haven’t even requested a peer 2 peer review. I requested a call back from the nurse over a week ago and have heard nothing.

I go in on Tuesday to have my T levels checked and I plan on speaking with the office manager.

I’m fucking livid. Battling with the insurance company is one thing, but having to fight with the goddamned doctor’s office is just adding insult to injury.

This whole experience thus far has taught me that no one really gives a damn about us. We’re on our own. This forum has been the only place I’ve received any real assistance with our shared plight.

Piss on insurance companies and urologists.


Sorry for your plight mate it’s not good at far as insurance companies they are there for the divie mate. And sorry to say so are the neurologists I have been there and paid for my reversal myself. I was told on many occasions that it was all in my head. My advise would be hang in there and find someone who can help.

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