Post Vasectomy Pain Forum

Help for my husband

I am here for my husband…He is somewhat scared to start reading on these forums. So I pull out helpful information for him and leave out anything I think would make him more discouraged.

My husband had his vasectomy in Dec (3.5 months ago) bc we had already met our deductible and he figured he might as well… that being said our lives have not been the same sense. His urologist dismissed him and said it would go away… it didn’t. We found another local urologist who at least took him serious and said it might be PVPS. He gave him an antibiotic and said if that doesn’t work (it didn’t)…the next option would be a nerve block or a medicine like gabbapentin (my husband doesn’t like the way any opioid meds make him feel so he said no and he gets migraines easily).

My husband had a prior history of lower back pain (due to disc degeneration) in L5/S1 and sciatic nerve pain in right side but after doing PT every morning he has been pain free for at least 7 years…until the vasectomy.

His right testicle, right hip, and right side of lower back have been in constant pain since the vasectomy. Left testicle hurt for a few days and then was just fine. He has no pain related to intercourse. But he can no longer exercise, run, lift anything heavy. My husband is only 41 and we have a 6 and an 8 year old and he can’t really even play with them in the back yard. We are prayerful for a solution and I am ready to tell anyone who will listen about the possible dangers of a vasectomy (zero risks were disclosed to my husband other than he had to sign off saying he would be sterile).

What would you all think are our next steps? Reversal? SC denervation? (Or at least a block first to see if that helps?) We are willing to do anything. We live in TN but will travel if needed.

Thank you all for any help you provide.

Welcome to the club. It could be a long journey. I’ve been here 8 years; some have been here longer. I remember the first urologist I saw at 6 months post-vas said it would probably go away. Well, I’m still here.

Hubby should start with the conservative therapies, things like tylenol, ice, ibuprofen, Aleve, nerve meds, antidepressents (some work on nerves), pelvic floor physical therapy, have an ultrasound, warm baths, prescription NSAID, Flomax, CBD/cannabis, Rapaflo (I take this), maybe testosterone or psychotherapy, injections targeting GF, II, and IH nerves, and then consider reversal. Next up the chain is denervation. There are more options like spinal cord stimulators (I tried with no luck), cryoblation, botox injections, and all sorts of stuff that other guys here have tried with varying results. Last resort (that some men here have had) is orchiectomy, again with varying results. And even this isn’t always the last procedure.

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It will have it’s up and downs, I am sorry that your husband had to be as they say 1 to 2% more like 15 to 20%.who experience pain discomfort all because of a 20min snip. Vasectomies are sold as the best option, of some men know they are not the best solution. Because of my ongoing problems I panicked and rushed into try any find relief and had more surgery, not a good idea. If you hear the words from an urologist like epididymectomy run for the hills that is not a good option. Be patient and do your research before you rush in looking for solutions.

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Sorry about your husband. The shitty thing about this condition, is that it’s a disease exclusively given to you by urologists. Which means they very often are very reluctant to admit anything at all about risks, and will also be reluctant to provide treatment. Unfortunately they are also the only docs with any substantial knowledge about pvps.

I believe the most important your hubby can to is to gain knowledge about all the various forms of treatments and variations of pvps, and he’ll be able to make an informed decision himself about what he should do next. You’ll have to tell him that his nuts won’t hurt more from just reading about it. This forum contains a wealth of information, much more than he could get from a consultation with a doctor. It’s a bit scattered around though. I had a vasectomy about 8 months ago, and was in hellish pain at the time your hubby is in now. Now, I’m in a lot less pain, and I think many of the advices I’ve found here has helped. Not cured, but better. I also have a very clear idea about the pros and cons of potential surgeries I could choose from should I feel I need it later.

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Welcome to the forum @PainTN and thanks for sharing your husband’s story.

Can you provide some more details? Not much to go on here.

When did his pain begin? Day one, in a matter of days, weeks later?

Any physical findings? If a urologist gave him a physical examination, what did he/she say? Did they feel anything and comment about it? Sperm granuloma, anything congestive in nature, etc?

Has he had any sort of imagery done? Such as, but not limited to an ultrasound to find or rule out potential suspects: varicocele, spermatocele, hydrocele, hernia, etc?

Gabapentin certainly isn’t an opioid, but it certainly gets mixed reviews on this website. Many men refer to gabapentin as moron-ton because they feel like a bit of a moron while they are on it. Woozy, dumbed down, etc. It’s commonly prescribed, but it’s certainly not for everyone.

I really liked @Sentosa initial thoughts. There is no one size fits all perticular order, but I would try to stick to purely concervative options for the time being if he can handle it. Odds are he will make some progress over time, but there are no guarantees.

If it’s any hope to you guys, there are men on this website with a similar story to tell that stuck with concervative options for ~1-2-3 years and have a moreless positive story to tell. I didn’t say they didn’t go through hell getting there tho.

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Sorry I should have provided more details:

  1. Pain was day 1 in fact he said the right testicle hurt way more than left both during and right after surgery.
  2. He has had both a physical exam (from 2 separate urologists) and an ultrasound. Both came back totally normal with nothing significant or unusual.

Thank you again for all the work you all have done… I have spent hours reading.

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Also at this point he feels like he could live with the testicle pain (not ideally of course) but the back pain/hip pain is the biggest issue. He can’t exercise or walk for long periods of time, but testicles are still a problem.

He has been to chiropractor, done NSAIDS for weeks, and is already on a low dose of nortriptline for his migraines (from my understating almost the same as amitriptline).

Sorry you’re here.

Long shot, here, and the timing doesn’t make a lot of sense for my suggestion, but I learned in my 3rd bout with PVPS about the interconnection between nerve damage from vasectomy which causes core dysfunction and core weakness which leads to pelvic and lumbar instability. As background, I had a vas in March 2005, pain onset in October 2005 which led to reversal in June 2006. In July 2005, before the scrotal pain started, I suffered my first lower back injury simply trying to pick up and throw a softball. Never had back problems before that. I was 40.

The reversal solved my scrotal problems, but the core dysfunction led to premature wearing of my L5/S1 facet joints and, ultimately, spinal fusion in late 2012. I was almost 48.

I finally got PTs, uros, and orthos to agree in 2018 during PVPS bout 3.0 that my core and back problems were due to the vasectomy and reversal 12-13 years prior.

Sooooooo. there’s definitely some inter-play here. The scrotal nerves do NOT come from L5/S1. I believe they’re upper lumbar like T12/L1 or L1/L2. So, not a direct connection but something going on for sure.

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Couple of things that might help with the back and hip pain. Prednisone and pelvic floor physical therapy.

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Typically, these kinds of details suggest something that is related to the vasectomy to me. Cutting, cliping, clamping, cauterizing, poking, pulling, tugging, etc’s are more indicative of the procedure itself, not the latter.

Considering that your husband has his procedure 3.5 months ago, I would give things at least ~3 more months and reevaluate his progress. That’s not a hard fast rule, it’s just solid reasonable advise.

This stands out to me. If your husband’s body responds well to PT, something tells me pelvic floor physical therapy might be helpful. I could be wrong, and so could anyone else, but this is something that makes sense to try between now and ~6 months post vas. So, he’s got some time to give that a try. It might help.

At minimum, there seem to be several methodologies regarding PFPT. You guys might want to research some of those variants and who is doing what in your area beforehand so your husband doesn’t waste time on something with someone that he ends up inevitably quitting because it wasn’t for him. Some versions are invasive if you get my drift.

I have the same problem and then some and I have had it for nearly 2 decades. It pre dated my vas by at least ~7 years. In my case, I haven’t connected any dots that were previously posted and I haven’t came to many if any of the conclusions that several others have. In my case, I suffer from both conditions and they seem to be completely separate of one another.

I can’t think of anyone that did well with this procedure that was less than 1 year post vas. I certainly don’t know everyone nor everything, but I certainly wouldn’t recommend rushing into that one. Generally speaking, I have seen far more positives than negatives with reversal, but it’s another crap shoot as well.

I recently wrote an in depth discussion about reversal for pain for beginners. It might be worth checking out.

I also recently wrote some thoughts about an interesting dive into tubal ligation reversal for pain, side effects, etc’s. It’s not about vasectomys, but it might be thought provoking as well.

Plenty of PFPT threads on this site too.

Hope that helps.

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So if I am summarizing this info our next steps should be: PT for pelvic floor, potential medications, anything else? It sounds like you all recommend at least 6 months before doing anything surgical? How risky is a nerve block? A local urologist said that could be an option? Is there a lot of risks with that option? Thanks again…

A nerve block is simply an injection of local anesthetic into a nerve. I had it done in my spermatic cord (without a positive result). Pretty safe, although some men here have reported pain and what not from it. Typically, they do this to see if you’re a good candidate for denervation or orchiectomy, and these are generally considered higher risk than reversal. I had my cord block after reversal.

At this point, your husband should be trying to figure out what increases pain for him and what decreases it. For example, tight briefs increase my pain level, but some men on this forum report the opposite.

My left side did a similar thing to me. I have a left sided granuloma and what I discovered was that it would cause pain that radiated all the way up to my hip and to my lower left back. I almost had a back injection done March 2020, but waited it out. July of 2020 I was able to definitively say the granuloma was causing my hip/back pain. Anytime anything puts pressure at a certain location of the granuloma it can cause my back to spasm. Mine will also occlude/pinch blood vessels. This creates a scenario where the granuloma causes the vessels to become engorged with trapped blood which puts pressure on the granuloma causing pain. When I am able to keep my scrotum relaxed and nothing putting pressure on the granuloma, I have no hip or lower back pain.

As for his next steps, I would start with conservative treatments, try some hot bathes and sitting on a heating pad at night for a bit. See if he notices any difference when his scrotum is relaxed or not. Can he perform a self exam and feel any lumps at the end of his vas deferens?

I am 26 months post vasectomy, and I have exhausted all my conservative treatments. I am getting reversed on Monday.

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You are going to have to do some more research @PainTN.

There is no one size fits all answer regarding your last message. Some urologists, including those whom are very aware of PVPS suggest vasectomy recovery isn’t a sprint, it’s a marathon.

I realize that is a rather contradictory statement considering how vasectomy is sold to men (and woman) beforehand. What happened to the idea that vasectomies are quick, safe, fast recovery, all good in a matter of days or weeks? We are all aware of such BS. I digress.

There certainly are a lot of negative reviews on this site regarding various kinds of blocks, including the common cord block. There are a significant amount of positive and neutral reviews as well. They certainly are not without risk, including - didn’t work, hematoma, made the man worse for quite some time, etc’s. Some men would not recommend a cord block or various other blocks to anyone, and others will. In related or relevant literature, various blocks, including the common cord block are refered to as diagnostic or therapeutic - not cures.

I am always happy to help others think stuff out, but I generally don’t want to influence anyone to do anything specific, especially things that carry a significant amount of risk. I typically warn people about many things to consider, because I am aware of what is at stake, what can happen, etc. I don’t want to steer anyone into anything specific and have them hate me because they felt like I influenced them to do something they ultimately choose for themselves and wish they never did afterwards. I prefer to stay out of harms way and let people make educated informed choices and decisions for themselves. This is your husband’s life and over all well being we are talking about here, nobody else’s.

Remember, it’s quite possible that your husband will pull through in a matter of months, but he’s got to be proactive on some level. There are countless men that have posted on this site that did exactly that. I realize that you and your husband probably we’re not aware of what he was potentially getting himself involved in prior to the vasectomy. That scenario is all to familiar to countless men and women.

I too hated meds, wasn’t very fond of modern medicine, etc. That said, he’s in now, and at minimum, it’s very trivial and/or difficult to simply turn back without a significant amount of risk involved, which includes the financial risk. It is recommend that he stays proactive, which includes everything that was posted in the former. He can bank on conservative options, bank on time, make his own informed choices and decisions, etc.

Beyond that, there are options, but solid reasonable advise is always sticking to concervative options for a while. There isn’t a one size fits all answer to give you. Some men this, some men that, and some men the other. Everyone is different, and we all have to make our own educated choices for ourselves.

Hope that helps. Keep us posted.

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Ringo is right here. I’d add that it’s a marathon with hills, valleys, mountains, rough terrain, and water crossings. Think cross country, not pavement running.

I had my vasectomy 16 years ago with no unexpected events until 8 months post-vas when MASSIVE pain set in. Tried all the non-invasive therapies but ended up having it reversed 7 months later. After a 5-6 month recovery period, the pain went away, back to normal…I thought.

In late 2008, the pains returned. Same drill, but this time, they were short lived. Five months of Celebrex and Neurontin calmed things down in early 2009. That beautiful “remission” lasted until April 2016 when the first bike ride of the year set things on fire again. This most recent, stubborn bout was worse because it radiated into the perineal region. Finally, after numerous injections and medicinal therapies, I got things to calm down by late 2018.

The sad reality is that, for many of us, vasectomy creates an injury that we have to nurse along for the rest of our lives. I’ve concluded that my scrotal and groin nerves are damaged, sensitive, and prone to easy re-injury much like someone who suffered a knee injury or shoulder injury playing football…it’ll never be like new.

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Wednesday scheduled here!

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Husband is considering getting reversed by Dr P on just right side where all the pain is…his right testicle is only a Level 2 pain but his lower back pain on that same right side is about a level 5-6. Again this lower back pain started right after vasectomy.

We spoke to Dr P who believes a reversal could help and it is nerve related. Would you all do a reversal if we are only 5 months post vas and his testicle pain is not the main issue it’s the related lower back pain? Or would you wait longer? (Maybe less chance of more scar tissue if we go sooner per Dr P).

We have tried NSAIDs, nortiptline, chiropractor (which is the most helpful but relief only lasts a few days). Also if my husband walks (he no longer runs or lifts or cycles) with compression underwear it is a trigger for the back and testicle pain.

I had my reversal 3.5 years after vasectomy. I think that was a little late. Five months seems a little early, but it depends on many factors. If husband hasn’t tried nerve meds like gabapentin or Lyrica, those could be worth a shot. To some extent, it depends on how badly you want to keep the vasectomy. Most guys who end up here are more than glad to get rid of it, of course.

For what it’s worth, my left-side reversal did not improve my left hip problem, which started after vas.

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Just be careful. Lots of guys go into surgery with pain at level 2-3 and end up with pain 5-9.

I had a sperm granuloma bugging me. Had it removed, and now I’ve been in worse pain for the last 8 months. If he’s at a 2, that’s pretty liveable when it comes to his nuts.

Maybe look into massage and physio for his back? That’s what I’ve done, because that sort of stuff can be worked on. I’d rather do that then risk my nuts getting even worse.

Also, its nerve related. How do you know its not going to be made worse? My nerve was entrapped in a granuloma, and now I’m in worse pain than before. A pain of 2 can be easily be made into a 9.
Food for thought.

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Honestly I would ride it out for a while, I would wait to it pans out. I panicked and had an epididymectomy and it made the pain almost a 7 to 9. They say that they don’t know what causes some men to have pain after a vasectomy but if you block your garden hose what builds up. The pricks know alright.take your time in the long term I did have a reversal only on my left side so things did improve for me but it doesn’t for everyone. By the way I am still sterile so reversal doesn’t work out as they say either.

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