Post Vasectomy Pain Forum

If nerve issue, how did you get relief?

Apologies is this topic is repetitive on this forum, but I’m pretty desperate.

It’s been 2.5 years since my vasectomy. While I have had periods where for several months where I felt pretty normal, I have had 2 major “flare ups” where my (very) painful symptoms have come back for months, including shooting pains from my belly button through my right testicle (seems like a nerve thing), as well as constant pressure and throbbing pain in my right testicle. In the past 2.5 years I’ve probably had about 10 months where I felt normal.

I’ve tried gabapentin, amitriptyline, and of course over the counter NSAIDs, Norco, etc. steroid injections into my lower abdomen, umbilical hernia surgery, sperm granuloma surgery, and lots of other things. Other things I have not tried include reversal, microdenervation, or testicle removal but highly prefer to avoid those because I am not 100% confident even those would work since it could be some sort of trapped never in my abs that was further irritated by the vasectomy process.

What I’m seeking is some sort of “go-to” pain relief process when these flare ups happen, because they are destroying me physically and mentally and no doctor has been able to help. I recently tried a cord block which didn’t give me temporary relief, and in fact seems to have made things worse.

I just pray that eventually the pain goes away on its own, which it usually does after several months, with no real reason. I can handle a week or two, but months on end is very physically and emotionally taxing, and sapping all joy from my life, feeling as if I’m missing on the joy of doing fun things with my kids and watching them grow up.

Has anyone had success with pain management doctors performing nerve blocks of some sort? Any other ideas or potential solutions to manage the pain?

This is a tough one as you’ve tried most of the traditional approaches.

You didn’t say, but I’m assuming the nerve blocks were to the GF and to the II/IH and that they didn’t work. If that assumption is correct and, like the cord block, didn’t provide even short term relief, the options are limited. Maybe tried injections with botox?? It helped me.

A surgeon like the one who did the hernia surgery may be the best option. I saw a hernia surgeon who also does laproscopic removal of the GF nerve. I also a plastic surgeon who specializes in peripheral nerve surgery. I’d recommend seeing the latter, Dr. Williams, in Baltimore. He was leaning toward a triple neurectomy for me.

Interesting. I haven’t actually tried nerve blocks specific to the GH and II/IH, so that may be what I try next.

The surgeon did do steroid injections basically where I told him to (right above my belly button and sort of right below, because when I get the shooting pains it seems to start from my belly button and travel down). I actually did get relief after those once, but have also tried them since after subsequent flare ups, and it didn’t work.

So I am hoping a pain specialist may be able to do some nerve blocks. However, it is impossible to get into a pain management specialist for MONTHS here (I’m in the SF Bay Area). So it’s very frustrating. I have an appointment booked in November.

Would this Dr. Williams be willing to have a phone conversation with me? Heck if I knew there was a permanent solution for this I’d fly across the country to get it…

I had two phone consults with Dr. Williams before seeing him. He is a protege of the famous peripheral nerve surgeon Dr. Dellon.

I’ll try reaching out - can you send me a link to his website? Googling “Dr. Williams Baltimore” came up with quite a few results!

It’s not been 100% relief for me, but acupuncture and a high CBD cream (legal in this state) have helped significantly. What you described is nearly exactly my experience; on again off again, shooting from naval, right side, etc. The acupuncture term for the type of treatment I received was for blood stagnation (an acupuncturist would know what that means).
Acupuncturists vary greatly so you may have no benefit at all from one but would from another. I’ve seen 4 and only one I felt made a difference.

Interesting. I tried acupuncture before, a couple different doctors, but it didn’t really help. CBD is legal here - I’ve tried high CBD pills but not actually any creams, perhaps I’ll try that too, thanks!

Yeah, I hope it does!
The creme I use has THC as well but it’s mostly CBD. So this is not a “legal in the US” creme, it’s only where THC is also legal. That said, a pure CBD could work? I just can’t speak to it personally.
If you see another acu ask them about blood stagnation and also see if you can find one that specializes in pain / nerve issues / groin or abdomen issues.
Cheers mate

Dr. Eric Williams, sorry about not being more specific. If that’s not enough, look for Dellon Institute.

Got a CBD/THC cream (in CA all legal, delivered right to my door!). Tried it, not a ton of relief but it was certainly worth a shot!

Oh – awesome, but I should have mentioned that for me it doesn’t acutely relieve pain (at least not much). But if I use it every day I notice a significant reduction in average pain. Start to really notice it after 3+ days.

Just an update, tried a IL block last week, but didn’t work (made my pain much worse for a few days actually). Saw the pain management doctor again today, but he thought it didn’t make sense to try a GF block since the spermatic cord block should’ve provided relief for that one (and he didn’t have any follow up treatment on that one anyways even if it did help).

He referred me to another doctor who may do a different type of GF block, but this is at Stanford hospital here in the Bay Area and likely I can’t even get into see them for 2-3 months. In other words for the PM specialist I was seeing, he just doesn’t seem to have the experience necessary to treat me. Now I dread it’s going to be months before I can see one who might be able to help nail down my problem.

Also currently trying CBD/THC cream, and acupuncture (been 3 weeks now - and he does deal w/blood stagnation), but neither has provided any relief.

I am going to see a surgeon to do some steroid injections into my abs, which is done somewhat blindly. 2 years ago, I did that twice and it seemed to help. Last year I tried again, it didn’t help. So basically I’m going to try that again (maybe give it more than one try) to see if it helps. In other words, this whole thing has driven me literally insane because I’m trying the same things again expecting a different result.

I also scheduled appointments with my orthopedist and also was referred to a pelvic floor PT here in the bay area, so I guess I’ll give that a try too. Pretty frustrating just throwing a bunch of darts in the air and hoping one hits the bullseye…any other suggestions, I’m all ears…my quality of life/ability to feel any joy is pretty awful right now.

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A bit surprising for a PM specialist. Injections are what they’re supposed to be good at.

There’s something to be said for the not doing a GF block if a cord block didn’t work, but I’d still pursue it. For one, I’ve heard/read that the GF is more likely to be damaged during vasectomy than the II/IH which doesn’t go as deep in the scrotum. I’ve had GF blocks from Pain Mgt., from a plastic surgeon, and from a radiologist. With proper guidance, I don’t think it’s a particularly complicated procedure for a trained physician. Surprised he’d refer you elsewhere.

Perhaps a visit to Dr. P. in Orlando would be in order. To my knowledge, he’s one of the few in the US treating scrotal pain with a cocktail of steroids and botox.

Thanks, yeah it’s tough/frustrating. I think I’ll exhaust all my options in the Bay Area before flying across the country, but certainly will keep Dr. P in mind too if this doesn’t settle down soon!

My pain is all abdominal spreading out from around the navel. I found that 300mg of Lyrica per day really helped me over a long period of time, however it did give me a few side effects such as feeling fuzzy headed, chilled out (too much for my liking) and bit of dry mouth to start with. Was a real life saver for me and got me through a real dark period. You have to be real careful with the drug though and make sure you slowly increase it but most importantly slowly wean off it. I took it for year and life was really good… weaned myself off it in January and slowly my pain has come back over the last 6 months. Now looking at GF/IL Nerve blocks. I know i have Lyrica to fall back on if nothing else works, not my preference for how i want to live but at least it is something in my locker!!

Interesting, I haven’t tried Lyrica yet - thanks for letting me know. I am just now starting back on gabapentin (3rd time), will see how that goes (PVPS has driven me literally insane, trying the same thing, expecting different result). I will ask my doctor about Lyrica if Gabapentin is ineffective.

Right now just hoping/praying acupuncture starts to work (been 3 weeks and zero improvement), and I had one session with a pelvic floor PT (but my next appointment isn’t for a month - I think a common frustration, at least here in the Bay Area, is that seeing specialists takes months). So hoping the PT exercise she gave me helps and that she has some cancellations so I can see her again sooner.

I had a pretty dark episode this weekend where I just mentally went crazy, screaming at the top of my lungs, caused destruction to items in my house, scared my wife pretty bad…I really let the anger and frustration of my situation get to me, it’s like this situation is eating away at my soul. Next step is to find a good psychiatrist…the PT recommended a couple so hopefully one of them can see me soon before I go even more crazy from this.

I had similar symptoms for about 1.5-2 years after vasectomy, and family urologist said to me that it might be caused by imflammation, where body is attacking and trying to get rid of dead sperm and causes irritation in the epidydymis near the nerves. Have you tried papaya seeds, which would lower your sperm production, see if that would help you? Or maybe testosterone gels?

I had reversal year ago, and since then haven’t had these types of horrendous pains , but am still “delicate”

Thanks, I’ll give papaya seeds a try as I have seen that mentioned throughout this forum (I did do testosterone injections for awhile but they didn’t help). Although in my case I don’t think it has anything to sperm production or granulomas or anything like that. I did have a granuloma removed last year but it turned out that wasn’t the source of my problem as I was in worse pain after that sugery for several months.

My PVPS seems to be more muscle/nerve related.

Reversal, spermatic cord denervation, or testicle removal are all on the table for me, but I’m not convinced any of those would actually work and would rather avoid surgery.

Yep, in that order. Just so you know, I had left removed, and reversal on the right one, it was that bad

Hi All had my GF nerve block carried out yesterday 2 jabs in the scrotum and one each side in abdomen. Went fine very little drama. Pain in abdomen has increased a little but i am told that is normal for a short period of time. Lets see what happens over the coming days and weeks!

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