The gold standard is don’t get a vasectomy.
The only exception being men who are highly motivated to get one and are seeking to do so for themselves and not influenced by any pressure from their spouses/partners. Those men should also be aware of the literature and statistics on chronic pain going into it. If those two conditions are met they will minimize the psychological fallout of a bad outcome and make it easier for the sufferer to deal with it.
All that being said there will still be plenty of men willing to do it even with all the gloss and sugar coating taken off of it.
I note that reversal is conspicuously absent from the “Gold Standard” even though they mention that vasectomy is a cause for CSP.
The uro that did my vasectomy offered Neurontin and denervation.
The second uro that I consulted with offered a cord block.
The third uro that I consulted with suggested nerve blocks, and only acknowledged that reversal was an option when brought it up.
None of them mentioned reversal as an option. Shouldn’t they at least mention it?
I have non Vasectomy related idiopathic testicular pain. And this article pretty well lays out the options that are available with the exception of Botox. Which I can’t find anyone local who does this! My urologist does not …
Just some more complete articles that you may find helpful:
Targeted-Denervation-2018-sm.pdf (422.7 KB)
When I went back to my vasectomist, he told me I’d be better off having my testicles removed than get a reversal. Thank God for the internet as even back then, late 2005, there were papers written stating 70% complete relief and 90% partial or complete relief from reversal.
I think there are some urological zealots so convinced that their righteous delivery of vasetomies are so good for humanity that undoing them is a personal affront. What else can it be? They continue to deny that vasectomy doesn’t work out for minority of men and tell us our pain is in our heads, yet even in the face of a couple decades of evidence to the contrary, they continue to deny the truths. It’s almost like vasectomy is a religious cult among some uros.