Post Vasectomy Pain Forum

Go see a pelvic floor physical therapist!

To all the guys on here that read this, it may be your cure, and so far it has been working really well for me after only a month. I went to 3 urologists, my family doctor, 2 chriopractors, and an acupuncturist, and I was finally referred to a pelvic floor physical therapist who told me she could help. Everyone else was clueless.

She said it takes men an average of 7 years for men to be properly diagnosed with pelvic floor dysfunction, and for some men such as myself, a vasectomy is simply the straw that broke the camel’s back. Pelvic floor issues are more common in women, and oftentimes it’s overlooked with men. Urologists are simply unaware of it as possible diagnosis as well. After my vasectomy in Feb 2018 all my muscles tightened up and I was miserable, but I didn’t know it was a muscle problem. All I knew was that my testicular pain wouldn’t go away. I was trying everything to get better. I tried the papaya seeds powder, every supplement and diet trick you could imagine, and taking hot baths sometime 5x per day. I couldn’t eat, sleep, and I was depressed and all around not myself. I won’t go into any more detail about how much this affected my life, but it was really grim for a while.

If you have tight hamstrings and hip flexors, weak abs and back muscles you’re likely a prime candidate for pelvic floor dysfunction. All the issues I had from those muscles refer pain into my groin and testicles, and the guarding the body does after a vasectomy can really lock up the muscle and cause the nerve pain that I was experiencing. I was told my pelvic floor muscles were locked in a constant kegel. My pelvic floor physical therapist referred me to a urologist she works with that prescribed two specific medications that help with relaxing the pelvic floor muscles. Amitriptyline-10mg at night, and Valium which is taken as a suppository. The valium doesn’t have a systemic effect, it just relaxes your pelvic floor muscles. I really feel like I’m on the right track to completely healing and wanted to let people know about this alternative as it doesn’t get much attention because so little is known about male pelvic pain.


@gsculli were you given any specific exercises to perform as well?

i was given some yoga poses, and told to work on transverse abdominal muscle. You would need at PT to show you what that is, or look it up. It’s a little tricky to do it right. The biggest thing was that I was told to relax. I internalize stress, like a lot of people, and that is a big part of it. I started going to yoga class for the first time this week now that I’m feeling much better.

not sure how long you’ve been on amitriptyline, but be careful. that stuff messed me up. i was wired for 3 days straight. had some seriously bad thoughts. told my GP who prescribed it as a helper since i was stressed and pretty miserable. he told me to get off it right away.

I tried it PFT and had no improvement. I dont want to be a downer on things but anyone who states on this forum you are better but living on daily meds you are not better. Its meds masking the pain i have been through this. But at the end of the day its what gets you by. I would rather suffer pain than be taken daily pills, Thats just me i dont want to live my life on pills.

i’m the same. i hate drugs. and they usually don’t work for me anyways. so it double sucks. i tried PFT and it didn’t help. but then again, i have pain when i wear tightie whities. the pressure hurts me.


@gsculli It’s good to hear you are feeling better. Thanks for posting your positive improvement. I think any man dealing with PVPS should look into pelvic floor PT. Out of all the PVPS treatments available, it seems to be effective for many with no appreciable risks.

Also, I disagree with the others about suffering with pain. If a medicine works for you and has no or minimal side effects, then why not take it. I don’t like the idea that I’m taking daily medicine, but I’ve had a pretty good improvement over the last few months. I’ve even had a few relatively pain free days. My wife, friends and family have noticed I am happier. I’m still considering a reversal in the fall, but I’m grateful that these next few months won’t be riddled with me fighting pain. I’m even hopeful now that things may improve on their own. Who knows? I do know I’m in a much better mental and physical state than I have been in a long time. Good luck.


I know that all of our bodies are different and many may have separate issues. For me, the medication is to calm both me and my muscles down. The muscle tightening and spasms have been the primary issue causing the referred pain. I am taking the medication as a temporary bridge to get me over the initial hump to a place where hopefully I am pain free. I know it’s extremely tough to stay positive, but the meds aren’t what’s making me better. I am making myself better. I still feel pain and the meds aren’t masking that, but they are helping me to relax the muscles in my PF and I work very hard each day to relax, and I truly believe that one day I will be pain free.

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Funny you said most urologists don’t know about pelvic floor therapy. 6 weeks post vas I specifically requested my urologist to refer for me for pelvic floor therapy. 1) he had no clue what I was talking about which makes no sense I figured it out with a simple google search of pudendal symptoms 2) he said i will send you but your just wasting your time and money your just having epididymitis
Which all proved to be wrong since I had direct nerve damage which led to RSD of testicles and other multiple symptoms.
The pelvic floor therapist I use to see was an instructor for Herman Wallace. I highly advise anyone who does pelvic floor therapy to find a PT who went through their courses, they are the most thorough.
Unfortunately pelvic floor therapy would give me 1-2 hours of relief and I did it for 1 1/2 years. My PT said she had eliminated multiple pvps sufferers and pudendal patients but said mine acted like nothing she had ever seen. She would relax a muscle move on to the next area then come back and original muscle would already be in a spasm again. I did see Dr. Weiss in California who is an old school urologist who admits pvps numbers are way above 25% and he had me on a special suppository also can’t remember all of the ingredients but they definitely helped big time. Now my pelvic floor is basically gone no strength at all shortened and weak from 4 yrs of spasms. If it’s helping stick with it and do the stretches in Amy steins book or a headache in my pelvis


Buy Amy steins book on pelvic pain very cheap or a headache in my pelvis they both cover all of the stretches and proper strengthening. Amy steins book is the easy to read dumbed down version, thin paperback. Headache in my pelvis is 300 pages or so very detailed and a lot harder of a read.


So the suppository is what helped you the most? If you can find out what it was I’d love to know!

Thank you kindly, ordered

As I recently stated, I really think this a big part of my problems, and very likely affects all of us to some extent. I don’t think my original problems were pelvic floor issues, however I think its possible that the pain I was experiencing then made me more of a ticking time bomb so to speak, and pushed me closer to the edge. My reversal may have been the trigger or the straw that broke the camel’s back for me.

I owe this forum my entire story - which I will add later - but I wanted to bump this one, as my story is almost exactly the same.

Had my vaso in March '16. Was fine for 8 days, then the ordeal began.
I also went to my urologist who was dismissive, 2nd & 3rd urologists, GP, acupuncturist, chronic pain doctor - all of whom had little to no efficacy, and certainly didn’t have solutions.

18 months later, in deep desperation at having tried everything, my wife recommended a pelvic pain physical therapist.

In my first meeting, she asked me to “check in” with my abs and pelvic area muscles. As we chatted, I realized I was clenching. The more I continued to “check in” with these muscles, I realized I was subconsciously clenching almost continuously.

My PT showed me some medical documents, outlining where referred nerve pain presented and referred, and most of the testicular-area nerves are also rooted in the abs and muscles in the “taint.”

Short story - after 3 weeks of light stretching of abs and pelvic muscles - I started seeing major reduction in testicular pain. After 3 months of deep stretching and actual physical manipulation (massaging and dry-needling of pelvic muscles) I was pain free.

Glad to report that I’m still 100% pain free!!

I can not stress enough to folks to consider this conservative option.
I thought there must be some sort of structural issue that was causing my pain, as my pain levels were so high - and I really didn’t see how muscle imbalance could cause this kind of pain - but for me, this has been a lifesaver.

I’ll post more details of what the PT had me do in my full background, but wanted to share for others…


FWIW - my Pelvic Pain Physical Therapist recommended valium suppositories. I had my GP prescribe them, and a local speciality pharmacy created them. I used them for 2 months, in addition to the stretching (most of which are indeed in Amy Stein’s book, but my PT also did local massaging).

My PT’s point was that the body’s reaction to pain is for the muscles to contract. After 3-4 months of subconscious contraction (and in my case +12 months), it takes conscious effort to get the pelvic muscles to relax. Valium (administered “locally” through a suppository) helps, in conjunction with consciously relaxing, warm baths, massaging ab & pelvic muscles.

Worth a try, as you can find out in a few weeks if you’re seeing improvement.

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I’d say all pvps sufferers end up w pelvic floor dysfunction from constantly tightening pelvic muscles and core muscles due to the pain. Bodies natural reaction


Good to hear of a good news story @gsculli going to look into pelvic floor therapy and like @Acschiro said will look for someone trained through Herman Wallace. Any suggestions for a good pelvic floor therapist in the Toronto or surrounding area?

@gsculli Do you have any update, now that you have been going for a while?

I have been exercising for around 20-30 mins every night, and can confirm that the combination of the excercise and supplements I am taking must be helping, as pains around the pelvis area have definitely diminished.


things have definitely improved, and I am am starting with shockwave therapy at the Cleveland Clinic next week to give that a try next. Also, had a call with Dr. P, but will remain with conservative treatment for a few more months.

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