Post Vasectomy Pain Forum

July 1st Reversal with Dr Burrows at ICVR

I have a reversal for pain scheduled with Dr Burrows at ICVR on July 1st (this Thursday). I’d like to say I’ve come to a clear process around this choice, but the reality is that I’m terrified of going under the knife again and have come close to cancelling multiple times.

I had my vasectomy 3 years ago. For the first 12-18 months, I had significant off-and-on nerve pain in the balls. A maddening dull pinching ache. With time, this has diminished to more-or-less zero local nerve pain. I’m able to be pretty active and live a normal life.

What I’m left with is:

  1. Often a full, lightly bruised feeling in the balls – esp after sex/ejaculation
  2. Discomfort with extended sitting (esp long drive/flights) that radiates down into the testicals and up in the inguinal area, groin, and abdomen.
  3. Less satisfying release with ejaculation… a sense of needing to “squeeze” the semen out.
  4. Higher levels of anxiety. Even very low level sensation (see 1) seems to cause anxiety/distraction for me.

If I stay active, avoid extended sitting, do stretches/yoga, and keep my mindset positive then I feel fine most of the time. In many ways I’ve escaped the worst, which makes the reversal decision difficult.

As I see it, reversal pros are:

  1. ~80% chance of seeing some improvement to symptoms
  2. ~50% chance of complete resolution per Burrows (although I don’t see these stories on the forum much)
  3. By reversing now, there’s less chance of upstream epi blockage that could create new problems
  4. I’ve already paid for it so it’s free now…

Cons are:

  1. Likely looking at 3-6 months to getting back to baseline (oof)
  2. Low (1-3%?) risk of ending up worse off
  3. Chance of regression later due to scaring/pulling on reconnection site later
  4. I’ll be fertile again

I realize that there’s no knowing what the right choice is and I have to make a decision. But thoughts/reflections are appreciated and I’m reserving the right to change my mind until the day of. No amount of sunk cost is worth getting a procedure I don’t need.

All this said, I have some optimism that if I get the reversal I’ll have closure to have given it a shot and, assuming a normal distribution outcome, that I can live with the results.

@Ethan_Scruples I’m interested in how this matches your own process, as last I knew we were at pretty similar junctures.

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Yeah I’d say you and I are in exactly the same place, except that you scheduled your appointment. :blush:

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@alden - I cant tell you whether your symptoms justify getting a reversal, only you can make that decision. I can say (from reversal experience) that Dr. Burrows does excellent work! I am almost 2 years post reversal and still considering additional surgery for pain, but I have a complicated issue.
I do feel that the reversal helped some aspects (more complete feeling orgasm and removed painful granuloma), but for me it also introduced some additional nerve pain and possibly exacerbated my varicoceles.
Again, each individual’s case is unique.
Wishing you the best!

Please post your progress. I’ve Been dealing with pain since Vasectomy from 8/2019. Really didn’t get to the unbearable place 10/2020. Really praying this gives you some comfort.

I’m a few days out from reversal and so far so good. Dr Burrows and ICVR seem top notch.

There’s bruising/swelling (as expected) but so far nothing that feels like new onset nerve pain. Really, really hoping that stays true :pray:. So far the recovery has been very mangeable. I haven’t required any pain meds (although I think the anti-inflammatory dampens pain a little).

I feel good about the choice to reverse. Burrows said that the original vas was a sloppy job. The permanent stitches resulted in a lot of scar tissue. But more importantly, the cut was made too close to the testical, resulting in excess pressure in the epi which was swollen as a result. Of course if I scar over… but I’ll cross that bridge when if/when it comes.

I’m resting/icing, but feeling optimistic. I’m so glad to have the decision aspect of this behind me. The psychological side of this is no joke and my decision making style was borderline pathological. It’s gonna take some time to regulate after the decision anxiety in the weeks leading up to the procedure. I didn’t sleep at all the night before and really made the choice to go through with it in the office.

I’ll avoid flooding this thread with daily updates, but will update periodically on my progress. Next update probably in a couple of weeks when the acute healing phase should be concluding.

Glad to hear so far so good. Just keep taking it easy the next couple of weeks.

Sending good vibes your way!

Thanks @Lee1985! That’s the plan :slight_smile:

Also @GoingNuts, sorry to hear that your reversal backfired at least in some respects and thanks for sharing the update here. Wishing you the best as you explore additional interventions.

And @Hurtin, so sorry you’re also dealing with this. I hunted up your thread. Your symptoms are more intense than anything I’ve dealt with. From the research I’ve seen, I do think reversal is the most expedient surgical option for most guys (although not without risks). But the intensity of your pain would seem to warrant taking a chance. As I understand it, reversal can help with nerve pain. No one is sure why, but likely reasons include removing clips or scar tissue that are interacting badly with nerve endings. If you do pursue a reversal, I highly recommend ICVR, not only for the doctor’s expertise but also for the honed aftercare experience. Wishing you the best whatever you decide.

I get all 4 of your issues listed, especially for #3, I am leaking semen for hours afterwards where as pre-vas it was like a .50 sniper round, could’ve punched a hole through a wall, now it’s like toothepaste oozing out of a tube.
I have an “urgent time sensitive” referral waiting in public hospital, hopefully sooner rather than later - I am 9 months post-vas

@alden I’m so glad things seem to be looking up after your reversal. I can imagine how difficult of choice it was to go ahead with the procedure. I’ve been struggling with how I’ll address making that choice (which I hopefully never have to make), given that my pain levels aren’t near as burdensome as most on this board. I’m way earlier in the process, having crossed 5 month mark a week ago, but symptoms 1 & 2 you listed above are spot on for me although I haven’t seen much of a correlation between bruise/ache feeling and ejaculation. I’ve averaged about 2-2.5 on pain scale over last month, and under a 2 for the last week. If I can avoid long sits/drives and just a couple other triggers, I have mostly good days. But the thought of always having to deal with this makes me think I would potentially consider a reversal at 12 month mark of I don’t keep improving. Again, I hope I don’t get to that point.

Sending good vibes your way for a good and speedy recovery. Keep us updated.

@vesto yeah it’s a tough call when symptoms are mild. I’m 8 days post op and the recovery has been a roller coaster. The first 3 days were fine, then had weird neurological sensations through my whole pelvic area accompanied with intense anxiety… not fun at all. But that seems to have calmed down for the most part after ~36 hours. Yesterday was feeling pretty good, but had some shooting nerve sensation in the left leg. On the whole I think my recovery is tracking well and I thankfully don’t seem to have any new onset ball pain, so I’m optimistic that with time I’ll be ok and likely get back to where I was and maybe see improvement. But don’t underestimate the risks or recovery journey. Nerve disruption is scary stuff.

ICVR doesn’t want me to ejaculate for the first 2 weeks, so can’t report back yet on whether or not sensation or ejaculation pressure is different.

My list is very similar to yours. I’ve yet to commit to a reversal as I certainly don’t want things to get worse. Hoping and praying your recovery goes well!

Regarding #4 (anxiety). I was able to document a sharp drop in testosterone and other hormone abnormalities post vasectomy. This coincided with a sharp increase in my eczema so I suspect or theorize those testosterone producing cells are or have been attacked. So to add to my list of should I get a reversal questions is can that process be reversed or once those cells are attacked are they done for (if that’s even what happened). Anyways, all that to say it might be worth getting your hormones checked a couple of times if you don’t experience improvement regarding the anxiety.

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@CRC – there are definitely folks on the forum who saw T increases after reversal, but AFAICT the causality isn’t understood.

ATM I don’t feel like I’ve seen an improvement to anxiety levels, but also recovery has been a roller coaster and psychologically really difficult, so perhaps no surprise there. Time will tell. It’s also just true that people can have high levels of anxiety after undergoing trauma… and PVPS is definitely traumatizing. Throw in COVID and (in my case) a divorce and two moves with kids and perhaps that’s explanation enough. Still, I do wonder if there’s a physical component and will report back as I continue to heal.

I’m 3 weeks out from reversal tomorrow and definitely still healing. Pain/nerve sensation comes in waves ranging from little-to-no-pain to really significant nerve sensation coupled with overwhelming anxiety/panic attacks. I’m not sure if the panic is psychological or if the nerves are directly feeding into the parasympathetic system… I’m guessing some of both.

Overall trajectory is positive though and I’m still optimistic that I’ll end up ok. Possibly better, but at this point back to baseline would be fine.

One thought I have coming out of this is that I had a lot of negative psychology around having gotten the vas (which I didn’t want) and imaging sperm backed up, etc. For instance, I’d vastly reduced my masturbation frequency in part because thinking about backed up sperm took the relief feeling away. For low grade pain + regret, before going in for surgery, it’s really worth decoupling these and telling yourself that you’re well/fine for a while to see where that gets you.

Still, if I end up ok (and I still suspect I will) I’ll be glad to have done the reversal if only to have closure. If I end up worse I’ll have deep regret. Jury is still out.


Your words about anxiety post vas trauma could be my words. Well said. I think we’re psychologically not too dissimilar (I’m divorced too and am taking care of my kids, with new location, job, school, etc) and I really really struggle with the decision to reverse, though I’m in a considerable amount of pain - now. I wish I had ICVR at hand but I’m far away I’m Europe and it’s tough to find a trustworthy surgeon here.

@alden - I hope your recovery is going well.

Ok, update time. I’m almost 10 weeks out.

The good

  1. My erections feel harder and there’s more pressure when ejaculating. It just feels better.
  2. It’s still sensitive down there when jostled, but there’s no pain at rest. Thank god.
  3. The blue balls feeling is gone.
  4. I feel psychologically better about my sexual health.
  5. I feel that I made the choice I wanted and that matters.

The bad

  1. The first month was a total bitch. I had pretty terrible referred nerve action through my entire pelvic region accompanied by panic attacks and severe anxiety. And of course not being able to be active for a month makes it that much harder. I was lucky to be able to take a month off of work and needed it.

  2. On the first SA test sperm were only barely getting through due to swelling. About to get a follow up.

The ugly
My general neuralgia symptoms when sitting is still worse right now and now I’m getting it more even when not sitting. Ugh. It’s slowly improving and I’m optimistic I’ll get back to baseline with (maybe a lot) of time.

Current summary
I think it’s a risky dice roll and wouldn’t advise anyone on how to make it in my situation. But I felt that at a personal level I needed to take the plunge and I don’t regret it. That could change though if the pelvic nerves don’t calm down. Will report back.


Nice update. Pray you get better with time.


My SA’s were initially lousy than like magic boom. Huge numbers. I got mine in December and I remember it was my birthday when the huge increase happened which was in April. I think it takes a while for swelling to subside but also for your testes wake up and start cranking out sperm cells.

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I was about to set up a reversal consultation with ICVR. Their website says free consultations but on the phone they said that’s only for fertility. They charge PVPS patients $500. I’ll wait to see how the other treatments I’m pursuing pan out before scheduling with them.

Might want to check out Lyrica for the pain. It might make you more comfortable while you wait, and might even give you a better outcome by letting the nerves learn to be quiet for a while. I had good results with Lyrica about 9 months after my vasectomy.

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How are you those days @Ethan_Scruples

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