Post Vasectomy Pain Forum

If nerve issue, how did you get relief?

Hi All…Had the nerve block last wednesday… still feel more pain/tenderness than prior to the nerve block which is a bit disconcerting. thought it might get worse for a day or 2 but 5 days is unexpected and worried because it does not seem to be improving oh well try and give it more time. What is the general consensus how long till the nerves settle down again after nerve block on GF does it take a week or so for the steroid to kick in?

Hey @ johnnyg42978
Hows is going? Any relief lately?

Your first post in this chain really resonated with me so it’s nice to know (sincerely wish it weren’t at all) that you guys are out there!

Little background on me. Had my ‘1st’ vas in January '18 and after pretty consistent discomfort with the uro not giving a shit, I started seeing a second uro in August '18. A year later I’m pretty much where I started. Had a ‘2nd’ vas in January '19 where a granuloma was detected and cleaned up. The tubes on the left side were also capped again so I’m calling that a ‘2nd’ vas. I was opened up twice so…yeah…

My new uro has gone with an overall pretty conservative approach thus far, but tried (for the second time…first time was on the 2nd visit with him after my 1st vas) a cord block a couple weeks ago that not only didn’t work, caused pretty significant bruising AND I really think rattled the nerves more than they were already. I mention nerves because overall my uro thinks that this is the main issue I’m dealing with. Hard to explain fully, but he feels the nerves are firing off due to a blockage that really isn’t there causing all this inflammation and they just need to calm down. When !!!

There are times when I’ve actually gone back to the gym a couple times a week, but can’t even imagine doing that at the moment. I’m just seeing If I can back to a ‘baseline’, but I’m not even confident I know what the ‘baseline’ is.

I’ve also had two ultrasounds and both times he detected what calls a ‘small varicocele vein’. He keeps saying that this is probably not the cause of my discomfort but when I looked up the clinical definition of what it is and the pain associated, it lines very very well with what I’m experiencing so that makes the whole thing even more frustrating. Going back this Friday for ‘next steps’ so I have a lot to discuss with him. After I told him about my bruising he still planning on giving me another core block. No fing way! Just cause I was feeling a ‘little better’ doesn’t mean he should shoot me up again. I honestly don’t think he has any malintent, but he’s guessing! Sorry for the rant, but its been a while since I posted and a lot has happened.

I honestly I’m going to request going on some sort of pain medication. Gabapentin seems like the logical choice, but we’ll see. I’ve also been on and off (currently on) with papaya seed and am intrigued about CBD cream (don’t think it’s legal in NY though) and acupuncture, but haven’t done anything about it yet.

Hey @Jdubb64321 I feel your pain…this is some really hellish stuff to deal with.

Since I haven’t posted in a little while, here’s my update:

Unfortunately, I’m in pretty bad shape still, really no improvement at all.

-I tried gapapentin again but, like my other flare ups, didn’t help at all.

-papaya seeds have done nothing for me either.

-and neither did CBD/THC cream

-I even tried putting biofreeze cream on my right nut - kinda sorta helped but only for a short time. I wouldn’t recommend this.

-I’ve had about 12 acupuncture sessions, but it’s provided zero relief so think I’m going to stop those as it seems to be a waste of time.

-I’ve started pelvic floor physical therapy (not pleasant - but I’m willing to do just about anything and have heard some folks have had success with PF PT, including some posts on this forum). HOWEVER, in the 3 weeks or so I’ve gone I have had zero improvement and actually seem a little worse off (the PT says this isn’t abnormal as she’s trying to stretch out my abs/pelvic floor muscles and sometimes it gets worse before getting better). I’m going to give PT a few more weeks and pray it starts to provide some relief though…as hard as it is to be patient, I’m really trying to be. It seems weird to me that a vas would trigger/reveal pelvic floor dysfunction (and weird that I’ve had periods of feeling fine for several months, with symptoms coming back seemingly at random). So, although the therapist says I have very tight pelvic floor and lower ab muscles, I’m skeptical this is going to work. That said I’m doing an hour of stretches every day and will keep doing so and am trying to get appointments with her as much as I can (she’s very booked up which adds to frustration…I’m trying to sneak in whenever she has cancellations).

-In conjunction with the PT, she recommended a psychiatrist who deals with chronic pain, I’ve seen him once and he has me doing some relaxation exercises. No help yet but it’s only been about a week. Never hurts to just try and relax, and just to talk to someone about the pain.

-Also, feeling around down there I do think I may have another granuloma (I had one last year, had it removed surgically and it did NOT help my issue so not sure how much it was really contributing to my pain…or at least if it did, it took 2 months to actually feel normal again). I’m going to see my Uro next week to confirm that - I may try testosterone injections (which I did last year too and it didn’t help). He also says he’s willing to do an orchiectomy (it’s only my right side) and thinks denervation/reversal won’t work.

-I am also going to visit a holistic doctor who says injections of BPC 157 may help (also suggested taking Lion’s mane, which I’ve started…no help yet though). So she’s ordering me the BCP 157 solution and I’ll see how that goes.

-I also am supposed to do a spinal stimulation trial using a device by Nevro - I highly doubt it’ll work though. Just waiting to get the go ahead for the trial.

-I do have an appt. with another pain management doctor in a couple weeks - I have not tried GF or Pudendal nerve blocks yet but I have a feeling they will not help, based on my IH/IL nerve block which, like @ljtomono1’s experience, it put me in much worse shape for awhile (I could barely walk).

I am thinking I just may schedule orchiectomy surgery for sometime mid-October, this way, in the next month I can see if the physical therapy (or the other stuff) starts to provide some relief - hopefully it does then I’ll cancel the procedure. I’d be nervous getting orchiectomy because I don’t know it’ll work (I would guess it will provide some, maybe total, relief…but naturally hesitant to do something when I’m not 100% sure it’ll work…). But I just can’t live with the pain I have for much longer, after over 2.5 years I can’t take it any more, so I feel like I need to take the leap to do something a little more drastic. If it doesn’t work that will be awful, but at least I tried and I think I can get by with one ball!

Thanks for the quick response johnnyg42978

Really sorry this is happening to you… I’m not exac 2.5 years in, but there really hasn’t been much progress for me lately so I’m trying not to let it get down emotionally… I generally am ‘ok’ during the day at work. A busy mind helps, but I take Aleve as much (3 doses every 24 hours) as I probably can or should.

Uro told me not to take any Aleve or Advil 3 days before my appt on Friday, but Tylenol doesn’t work at all! Maybe I will just keep taking the Aleve so he can’t poke me (also pretty mad at him cause I wasn’t warned that he was going to do the cord block last time so I didn’t stay off the Aleve). I think that contributed to my extra bruising!!

Are you in pain all day every day??? How do you sleep?

My back also pretty much hurts every morning cause I haven’t been able to sleep on my side since January '18! Awesome…

My back also pretty much hurts every morning cause I haven’t been able to sleep on my side since January '18! Awesome…

Have you tried putting a pillow between your thighs?

FYI on Advil - I took so much ibuprofen for this that I ended up getting an ulcer and a hiatal hernia - so I try not to take it much at all anymore, not that it helped much anyways. I was put on protonix and think that stuff is all cleared up. So be careful to take too much ibuprofen. Tylenol doesn’t do anything for me either (even norco doesn’t really do anything for the pain, it’s that bad).

Sleeping is tough, I was doing THC edibles almost every night - it didn’t really help with pain but it made me so tired and less anxious so I could fall asleep. Psychiatrist strongly advised cutting down on the edibles though so I take melatonin now which helps too.

I will try that, Ethan, thx!!

Despite all the different surgery and drugs tried the only things that have ever helped me so far is, in order of impact 1 - Lyrica - best thing for me and i kinda wish i had stayed on this now 2 - seeing a pain counsellor 3 - Pelvic physio. 12 days in after nerve block… lots of ice, hot baths and anti inflammatories are starting to make a difference now i think but still worse than when i went for the nerve block, at least pain levels are low enough to reasonably comfortably now! Next appointment is 1st of October so hopefully at least back to baseline by then!

I don’t know if this is too late for you. I saw a pelvic floor specialist 2 and 1/2 months post vasectomy and she got ALL my nerve damage taken care of. She did say that she had the had the best success was long as she sees someone within 3 months.

Now some specifics - she calls herself a hands on “manual” therapist. Ie. She’s literally started on my inner thighs with the first appt and now gives me actually testicle rubs. Her background previously was PT for post surgery folks so she was amazing.

Unfortunately, my epi’s never calmed down after 6 months and we (with her and doc help) determined a reversal would give best chance of success. But I had no nerve issues heading into the reversal and so far no nerve issues 5 days after reversal. (Knock on wood).

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Thanks @Recovery_road i did try pelvic floor physio, helped a bit i think but perhaps mental, i think Lyrica was the only thing that has ever helped me significantly.

Saw my pain specialist last week as it had been 5 weeks since my GF nerve block in 4 places…we agreed the nerve block had not done the trick… as it numbed the right area we knew more but for some reason had not worked. Booked in for Lidocaine infusion on the 15th November, lets see if that knocks out the pain.

Anyone had experience of Lidocaine infusion?

Trying pudendal nerve block today, wish me luck!

Also been keeping up with physical therapy and was doing Valium suppositories, but improvement has been very minimal and I’m still in a lot of pain.

Truthfully I doubt the pudendal block will work, but figure it’s worth a shot. I already have a GF block scheduled and also another block (forgot what it’s called but it’s actually done in the back it sounds like). If any of the blocks work then perhaps nerve ablation.

In between the blocks (each scheduled about a month apart) I’m going to try Lyrica and (if that doesn’t work) Cymbalta for the medication route.

Just praying something works since this is now month 4 of my current flare up…

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…and…I can already tell didn’t work…another potential solution off the board…

Anyone have success with either Lyrica or Cymbalta? Gonna start Lyrica tonight I think…

Yes with Lyrica, just too expensive to continue long-term on it since insurance won’t cover for me. Cymbalta made me jittery and gave me VERY dark thoughts. Had to get off it right away, but others have had luck. Roll of the dice with these drugs.

Cymbalta messes with my head as well. Insane dry mouth and anorgasmic. I didn’t even know that was a thing until I took cymbalta. Unfortunately for my wife I was taking testosterone at the same time. There weren’t enough hours in the night to get me to climax. Brutal!

Gents, as i have previously mentioned, I am staying away from this site for a bit as I am a few weeks post reversal and focused on achieving 100% success.

I wanted to come to the forum to share some good news in my nerve pain. I have been dealing with nerve pain the last few weeks. It’s been going back and forth between the surgical site and just knives everywhere.

I had massive releif today thanks to my pelvic floor specialist. She can’t work on my testies just yet as I am only 4 weeks post reversal. With that said she worked on my inguinal (stomach) area and it released a bunch. I almost don’t believe how that could be but man, the pain level is way down.

Note - I am barely taking nsaids. Only the occasional 2 200 mg of Advil about every other day as I am trying to get the best healing outcome. Warm baths have been helping the nerves but nothing like the Pelvic specialist.

Anyways, it may not be for you but it’s working for me. Unfortunately, I am stuck with my old beater of a car for a few more years as my money is going to therapy. It is what it is.

Best of luck to everyone. As always, please don’t send anything negative or down. I am keeping my mind on success and positive.

Cheers as we get through this purgatory

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Glad to hear you’re doing good.

Personal Update (since I started this thread and haven’t posted in awhile):

I’m still REALLY struggling with pain, but am less depressed/suicidal in general so I think that’s good!

  • Earlier this week (11/4) had another nerve block procedure, this one was (I think) called a T12/L1 injection. It didn’t help my pain at all, and I don’t know if they even hit the nerve correctly as I didn’t even feel much numbness anywhere.
  • GF nerve block scheduled for 12/6, which I’m thinking I may delay based on if I’m improving by then - these blocks never seem to work for me and usually seem to make me WORSE for several days, setting things backward. Has anyone here actually had a successful GF nerve block w/follow up treatment such as ablation?
  • I think I am very, very, VERY slowly getting relief from pelvic floor PT. I am also stretching on my own for 30-60 minutes/day and taking 20 minute warm baths daily, + valium suppositories. The relief certainly isn’t coming along as quickly as I’d like (hell this is now month 5 or this flare up, pain is still averaging 8-ish but at least not 10).
    *I’m taking Lyrica but I don’t think it’s working. 200mg/day at this point, 3+ weeks on it.
  • I have Cymbalta on standby, may start taking soon but would rather lay off it.

I think if I just stop with the needles and only do PT I’ll eventually get better, I just wish it was coming along faster.

@johnnyg42978 Do you see a pelvic specialist or a pain specialist? In my area, we have both and I’m not sure who to go to. For the record, I did get some relief (not total) from the nerve block, but the next day, it did feel like a setback because the injection site hurt quite a bit and did for several days. I have been doing acupuncture for a few months and thought I was making improvements, but the last couple of days the flare up seems to be gaining momentum.
For me, this is nearly 10 months. Some days I’m not sure if I struggle more with the mental or physical side. I write computer software and some days I literally feel like I get 1-2 hours in because I can’t concentrate. I do praise God for the improvement I’ve had, and I always remember that it could be (has been) worse. At one point it constantly felt like someone was holding a lit candle about 1/2" from where the nut sack connects to the penis shaft. Those were dark days, and I was so irritable I don’t know how people could stand to be around me.
In either case, I’m going to keep on keeping on, so please let me know who you are seeing, as I’m not sure where to go for the best chance of improving with PT.

*by “who you are seeing”, please let me know what sort of practice you go to, pain specialist or pelvic specialist

@Chronic-Pain . The answer is both+a urologist, because my #1 priority is pain relief and I don’t really care who/how it’s done - I can kind of tell what is working (and not working) even though I’m working with all of them simultaneously.

I’m seeing a pelvic floor specialist 1-2 times per week, but I’ve also had visits with pain specialists, who are the ones doing the nerve blocks (they also prescribed me Cymbalta but I’ve held off on taking it yet).

Note the pelvic floor person is a physical therapist, can’t prescribe anything so it’s just physical therapy. Thankfully she’s super friendly and we are able to have some fun conversations while her fingers are way up my butt!

Which specific nerve block did you have (or was it a cord block?). The only nerve block I have yet to try is the genitofemoral nerve block, which I have scheduled in a week but I may push it out because all the blocks thus far have not worked at all and seem to set me back, and I’m slightly improving and don’t want another setback.

Urologist - I am now on my 4th urologist in the Bay Area - she used to work at the Cleveland Clinic which is very well renown. She has prescribed me valium suppositories which I take in the evening (my pain tends to get worse as the day goes on, and around its peak I take one of those and it helps a little). She also has me on Lyricia - currently I’m at 350mg/day, titrating by 50mg each week until I reach 600mg, or if my pain goes away before that then I’ll manage my doses and titration back depending on how I feel. Lyrica does make me a little loopy/tired so I take a higher dose at night than in the morning.

I also do about 30 minutes of stretching and 20 minute warm baths at night, beginning about an hour after taking the suppository, which helps relax me and eases the pain such that I can watch TV and fall asleep pretty quickly (which is helped by the Lyrica as mentioned above.

Physical Therapy can take a long time to work (same with Lyrica), and nerve blocks via the pain specialists seem to be very hit and miss and as noted can often seem to make things worse. Plus they only provide temporary relief and you’d have to do nerve ablation for more longer term relief…not sure I’d love doing that, I think combination of medication (if you have no really bad side effects) + PT seems to be helping me the most.

But again, I’m still struggling. At my worst point in the day I’d say my pain is around 8/10. A couple months ago it was like 11/10 though so slowly but surely, there’s been some improvement. It seems pretty stubborn still but it’s like sometimes I have a mini-breakthrough where overall pain gets just a little, but noticeably, better…and even though it’s slow it helps attitude get better and feel generally more positive because I know and pray (I’m pretty Catholic) that one day this pain will be gone or down to 1-2/10 so it won’t affect my quality of life so much.

Hope that info helps, and hope you feel some relief soon whatever route you take.