Post Vasectomy Pain Forum

Genito Femoral nerve pain

I believe my pain is complex but the worst of it is, I believe, coming from the genital branch of my genito-femoral nerve. It is in the scrotal skin and not the spermatic cord. I have drawn a picture of where my pain comes from. I can roll the skin right where I got my original vasectomy and feel the scar tissue.

You can see circled in red where my pain is. Within that red circle I have a vertical ridge of scar tissue. My vasectomy access point was very high on that side. I am now looking for articles about pain in that region. I may look into some blocks to target that area to see if that will help me.

This is the guy that performed my vasectomy.

It’s funny, but none of us has a real clue. I mean, we all come up with ideas for where the pain really is. I’ve done it. You’ve done it. Everyone has done it. The “specialists” have done it.

What i am trying to say is given how many ideas people come up with it’s quite clear, no one has a clue of what is really wrong with us. And a couple of doctors have said that. That they have no idea what is wrong or what to do.

Which by logic standards, it should say DONT DO THIS!!! Don’t push this as an option until things are figured out. It’s like launching a rocket and having no clue why they keep blowing up! It’s totally insane what we’ve done to ourselves and how little support or care is given afterwards. And I know I am ranting here. Sorry for that. This whole thing is just crazy is all.

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Yes, it looks like your pain is in the genitofemoral nerve distribution. This is where I have my pain, as this is the nerve that was damaged by my spermatic cord stripping surgery. I think you should pursue the following treatment options:

Step One: Visit Dr. David C Chen in Los Angeles or Dr. Bruce Ramshaw in Florida (depending on which one you’re closest to.) They will likely suggest a laparoscopic genitofemoral neurectomy. This may very well eliminate your pain.

Step two: If this is unsuccessful, find a pain specialist in your area who performs Dorsal Root Ganglion stimulation. This has a great chance of eliminating or reducing your pain.

Step three: If the DRG stimulation does not work, find a pain specialist in your area who can implant a peripheral nerve stimulator in your groin. This will provide constant electrical stimulation to your genitofemoral nerve, and possibly greatly reduce your pain.

Step four: If none of the above 3 steps work, then you will likely have to live with the pain. But more than likely, one of the three above steps will help you.

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Mike - It’s a bitch that we have to do our own diagnosis, but I think we pain patients have no other choice.

I think Jesse seems to really know the sequence of therapies beyond the normal, usual ones by Pain Management. I guess before going down the path he suggests, I’d ask if you’ve ever had a GF nerve block.

At a minimum, it might be a good diagnostic. I believe most nerve blocks include an analgesic for short-term benefit and a corticosteroid for long-term benefit.

I’m wondering if the GF is also my source, but I’m still pretty well convinced that I have pudendal neuralgia or nerve entrapment. I know it seems likely multiple bouts of pain after a vasectomy would’ve been caused by the vasectomy, but since all my pain is perineal and not scrotal and I fit the PNE pain profile so well (and have instigated 2 of my 3 bouts by bicycling), I’m banking on it being PN/PNE and not PVP.

Best of luck and keep us posted on your therapies.


Don’t rule out the illioinguinal nerve. I have pain in the exact same area and that’s where it originated 36 hours post vas. Still hurts 18 months later. The structure you’ve circled is the opening of the inguinal ring within the scrotum. You’ve got two nerves here and even more arteries. The only way to find out which one it is is to block each one higher up and see which one eliminates your pain.

mines there as well maybe a little higher

I can really remember where my pain 24h post vasectomy started, in the ilioinguinal nerve region. It was a hearth shaped area where the pain originated. I think it was margined by the route of the vas. defferens and afferens. Later on it became congestive epididymitis. With groin pain both dull and stabbing, muscle pain in buttocks hamstrings and on bad days even calfs and kidney pain with a full blatter. And later on in time strange muscle twitches in my balls. My balls also felt warm on my thighs. I had have a ilioinguinal nerve block wich gave a bit of a relief for about there days. But oh boy it took also a day or three before it worked…
So I think it’s very difficult to pinpoint a single reason and I don’t believe we can. I think it has multiple causes and I don’t want to rule out the autoimmune factor. Even after reversal there is still an ongoing inflammation within the epididymus. My scrotum does have that same spot hurting at the touch as in the drawing. But for me it’s not the main thing. This weekend me and my wife are in Bruges, Belgium. Balls are not feeling that great, a five hour drive, walking a lot and yesterday a bike ride my balls are hurting. I think in my case it’s autoimmune induced pain and maybe nerve pain as well but it always starts with larger balls (inflammation) and increased sensitivity in the groin area. And after a while the pain area gets bigger and bigger. What I wanna say is, don’t rule out the autoimmune part.
Good luck ya all and hang in there


Mike I agree w choo choo that could also be ilioinguinal nerve Does any pain radiate to root of penis or pubic bone?

Definitely the root of the penis. It’s not constant though I almost feel like someone yanked on structures all around the spermatic cord. Like the entire thing has been pulled to the point of stretching nerves. So pain kind of all around but the worst most noxious pain is high up at base of penis where leg meets penis meets scrotum. My original access point was there. I remember getting home from my vasectomy and thinking it was so high it was wierd. Like it was more the side of my dick than my sack.

I will say I can feel a ridge of scar tissue high up in my scrotal skin, not attached to my spermatic cord. It’s a vertical ridge of tissue that when rolled in the fingers burns and radiates up higher up into my groin. It’s near where I was originally accessed. I also have burning underneath down towards my pelvic floor.

The ridge of scar tissue is the source of the most noxious pain.

I have had some remissions. I think if I could relax all that tissue and relive any and all stress for a spell the nerves would calm down.

Yeah the damage was mostly done during my vasectomy. The reversal got rid of a couple purple daggers of hardened, sutured up flesh. If I could show you guys what was removed from me… I think the dickhead that did my vasectomy went nuts on the cautery.

So today I did not wear my usual boxer briefs over flyless “sport briefs” (about as close to womens underwear as you can get without being womens underwear).

So I wear something like this:

over this.

I wore Mack Weldon compression briefs alone which can be seen here.

When things are not held up I get more issues. I definitely feel the sting in the scrotal skin where I have a scar from being punctured with just the Mack Weldons on. I am not sure how or why it would be so sensitive there but that skin is pressed between your leg and penis when you sit. Perhaps it gets pulled more without support from underneath. If I could numb that one spot I think it would help me a lot. It’s not my spermatic cord.

Before vasectomy I would probably wear something like the Mack Weldon briefs because they are comfortable, give some support and look decent. Now I have to wear what are basically “man-panties” under boxer briefs just to be able to function.

I am a two pair underwear guy myself.

I’ll tell you what really sux my scrotal skin to the touch triggers burning sharp shooting pain so wearing underwear makes the scrotum feel like it’s on fire but when I wear boxers then the legs go numb and shooting tedticle pain that is unbearable it’s like a dual edge sword damned if I do damned if I don’t. Mike o I still say the pelvic floor problems are from guarding and tightening it due to the tedticle pain just a natural response if the tedticle pain were to go away the pelvic muscles would relax and go away on their own

Mike, have you contacted Dr. Chen or Dr. Ramshaw yet? That should be your next step.

Too much talking about your problem and not enough action pursuing a treatment. Get on it.

I’ve said before I can function. My pain is on the line between acceptable and unacceptable. I have a job and am allready barely hanging on due to gut issues. I’m double-fucked basically.

I’ve been preoccupied since my reversal with the development of serious gut issues. I have had two bouts of 103 degree fever that lasted for 3 days and one that ended me up in the ER. I also have now gotten to the point where I can’t eat for days at a time due to gut pain. I am finding I’m sick more often than not now. I was going to get a bowel resection last summer but put it off due to a work project. It’s pretty bad. If I eat something like a peach or grapes with thick skins it makes sick for a week. It completely fucking sucks. My sex life is shot now and I can’t even eat what I want anymore.

A guy can put up with about anything if his dick and balls are in tact. The happy zone. You take that away and eating too? I will probably be getting gut surgery before I address nerve pain from Dr Robert J Shers screw up.

But yeah Jesse, I’ll look at Chen I think next. I appreciate the gentle prod. I’m a long ways down the road though man. I had those years where I tried a bunch of stuff and I’ve watched others on this board. I was in hell 4 years ago. Now I’m just in like Detroit.

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During my surgery I felt a sharp searing pain in my right testicle when the cauterizing was done. I am actually afraid to have anyone else touch me because I fear being butchered again.
I was in the same boat wearing double up underwear until I developed jock itch from too much moisture being trapped down stairs. My wife came home with women’s underwear that do work for me. I’m getting used to wearing them, but it’s hard to feel like a man while wearing women’s underwear. Like I said, it’s been two years and I’m fairly pain free until my boys hang which causes my pain to raise greatly locally and into my stomach.
Now I just tell guys not to go down the vasectomy road.

This is where I notice the most discomfort. I recently had a nerve block below this area and have no discomfort in the testicle and scrotum, but still have the pain and pressure feeling in the circled area, maybe slightly higher. My other chief complaints are discomfort in the perineum, low ejaculate volume, and poor erections.

Has anyone with similar issues had luck resolving them? I plan to stay conservative for several months with physical therapy as I do have pelvic floor issues. I’m not sure if that’s a root cause or secondary effect of what’s going on with me. I would entertain a reversal if it makes sense. I’m still researching and looking at all options.

Editing to add: I learn toward thinking that the pelvic floor issues are a secondary effect. I noticed an immediate decrease of like 75% in ejaculate volume and some upward pulling sensations after my vasectomy. IIRC, the pelvic floor floor pain didn’t come until 1-2 years later.