Post Vasectomy Pain Forum

Looking for Advice

Hello everyone. I wanted to ask for some advise to see what problems I may be dealing with and what I could do to help. I had my vasectomy on Aug 26. I’m 30 with 3 kids and only went with the vasecomty because it was a “quick, simple procedure with rare complications.” I really wouldn’t care if I had more kids, but I was content and everyone I know that has had one never said a bad thing about it. I never would have done it if I thought for a second getting pvps was possible. I’m not nearly as bad off as some so I feel guiltily complaining. I could live with this level of pain and even no sex if I had to, but I’m mostly concerned because I am active duty USMC with a kid with medical issues so I need to be able to exercise to keep my job, but exercise would make this way worse now.

The first week I was supprised how little it hurt. I was a little sore but wasn’t worried about it. I first tried ejaulating 2 days after (my post ops instructions said they recommended waiting 3-7 days but you could whenever you felt able) and it hurt, but not horrible and no blood.

Around 1 week after I started noticing a “blue ball” feeling and a pressure like pain behind my testicles. It is worse when I have an erection and when getting close to ejuculation and when I would ejuculate it felt like someone was squeezing my testicles; like pressure needed to come out but had no were to go.

At 2 weeks after I saw the surgeon that did the operation and he referred me to a urologist. He prescribed Ibuprofenand and doxy for 2 weeks. I started taking 800 mg of ibuprofen 3 times a day for about two weeks and the antibiotics; id say over all I felt a little better but ejuculation and running or lifting deffently irritated things. I never had a fever and the area doesn’t seem warm. No weird discharge.

The around two weeks out I had having a lot of pelvic floor pain like I was sitting on a base ball, but I started to try to be more relaxed and not always clenched (stress didn’t help) and that went away. The pain then was mostly just pressure in my testicles or epididimis. The best way I can describe it is the feeling when you have an ear infection or sinus infection with ocational light burning. Sharp ball squeezing pain before, during and after ejuculation.

After 2 more weeks (now at a month post V)I may pain and discomfort was down from about a 3-5 to about a 1-2 with some spikes of 3 when walking or moving the wrong way. The Urologist said it was deffently strange that it had been a month and I was not better but he recommended giving it another month. If that didn’t work we could look into converting to an open vasectomy (which he said helps domes times but not always, but has never seen it make it worse) or reversal. I quite taking the ibuprofen and tylonal at this point to gauge how I was feeling and 3 days later I was pretty much back at the 2-4 pain. Only now it was just pressure and burning, but not that kicked in the ball feeling. Still sharp pain when ejuculating, but better than the first week.

I also feel like there is nociably less semen; like everything I’ve read says the sperm makes up 5-10%; I feel like total volume is about 75% what is was. Are there any hypothesises that conjestive complications are linked to above average sperm count?

I’ve read some people on here say it can takes months for conjestion to go away. Like I said, I’m active duty USMC, now on light duty, but can only be on limited duty for a year before I’d get forced out so I feel like I can’t just sit and wait too long. I started taking the bulk supliments papaya seed power yesterday; 1/2 tps st nights and morning. We’ll see how that goes. Taking ibuprofen again for now Incase maybe keepin inclination down will help everything heal.

What do those with experience think: is the connection or nerve pain? It always seems to hurt but the pain is very much linked to the epididimis contracting near and at ejuculation. I could deal with the slight burn with may or may not be nerves or just a result of inflammation. Orgasms suck but at this point I’m more concerned with just being pain free enough to be able to run and lift again; I have a kid with a medical condition so losing my job and medical insurance is something I want to avoid. I don’t want to push myself now and delay healing though.

I am concerned about going open vasectomy because it may or may not help; more surgery could mark it worse and would make reversal harder. I’ve read that reversals have never found a blow out if they are done in the first 2 years. My insurgence might cover a reversal if it’s medically nessicary, but even if they do, i won’t get to pick my dr. It would likely be a urologist but not one that specializes in reversals.

I am thinking of waiting until Feb-March when I get tax returns and getting reversal done by Dr. Daniels at Carolina Vasectomy Reversal if it’s not manageable by then. I live 40 min away and it seems he only does reversals, has been doing them for the past 30 ears and has great reviews. It’s $7400 but seems a small price if it gives me back my chance to keep a job for my family, gets ride of pain, and last but still important, the ability to have sex without pain.

What do those with experience think: does this sound like connection or nerve pain? Would you risk the open vasectomy if it reduces chances of successful reversal? I know I don’t have it nearly as bad as some here. I could live with the pain I feel when I’m siting still, wouldn’t be a fun life but I could manage, but sex is off the table and I need to be able to exercise for my job. I’m now at 5 weeks post vasectomy. I’ve very depressed because of regret for this stupid decision. I feel like my wife is unsympathetic because everyone else we know never had problems (that they’ll admit to) and thinks a lot of it’s in my head. I really wonder how many men have problems but won’t say anything because they don’t want to admit that they’re “manhood” is messed up. Men need to be more open about this and earn others. If PVPS is so common I can’t belive the military lets service members get vasectomies; I can’t be the only ones whose had this happen. With them so worried about force protection I would think this would not be allowed knowing what I know now. I can’t help but feel there is a depopulation push and the insurance companies want to cut costs by reducing the amount of kids they have to pay medical bills for.

Thank you.

Sorry to hear you’re not healing as advertised.

Try not to beat yourself up. It wasn’t a stupid decision, given the facts that you were aware of at the time. It was a reasonable decision, and a very generous decision on your part. You just fell into a trap and were unlucky enough to be harmed by it. Sometimes that happens – it doesn’t mean you did anything wrong.

Standard answer is at 5 weeks you still have good prospects for a lot of improvement over the next year. Be patient and don’t jump into surgery right away.

I understand how difficult it is for your wife or anyone to accept that PVPS is a real thing. Here are a couple of examples from the military with reputable sources, in case something like that will help you or your wife get your head around this:

Here are some fairly well done statements for mass consumption that acknowledge the chronic pain risk:

Mayo Clinic

https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580

Harvard

Yale

Here are some national level urological society statements:

  • Canadian Urology Association give the chronic pain outcomes for vasectomy at between 1-14% (Link)

  • American Urological Association says chronic pain serious enough to impact quality of life occurs after 1-2% of vasectomies. (Link)

  • British Association of Urological Surgeons, patient advice reports troublesome chronic testicular pain which can be severe enough to affect day-to-day activities in 5-14% of vasectomy patients. (Link)

  • UK National Health Service says long-term testicular pain affects around 10% of men after vasectomy. (Link)

Many people like this article, which might be the best one to help explain things to your wife:

https://vasectomy-information.com/post-vasectomy-pain-syndrome-scientific-review/

2 Likes

Thank you for the feedback. It is frustrating because the Dr. at naval hospital that did the the surgery never said a word about any risks other than possible regrets over not being able to have more kids. Never mentioned PVPS and there was nothing in the handouts about it.

I just don’t know how no one’s is finding a connection. They are just doing vasectomies left and right there; there were 3 other guys doing it the same morning I did; it was like an assembly line. The Dr was surprised and said people rarely come back in with problems and when they do it’s because they over did it and go a hematoma.

Could I have caused nerve or scar damage by ejuculating too soon? Also, I lifted objects heavier than I was supposed to a week after because we were preparing for a hurricane and I had to put boards up on the windows. No signs of hemotoma, so I don’t know if lifting things early could have caused inflamation. There’s little visible swelling. The urologist said my epididimis are swollen but I don’t see how lifting would cause that, seems to just irritate it from straining.

I’m kicking myself because I avoided looking into it on the internet too much because I knew I would freak myself out. If I only knew then what I know now.

How exactly is ones body supposed to cope with the pressure? Does your body reduce sperm production or increase degradation? Like I said, my ejulate is noticeably (about 25%) less. I wonder if some guys produce more sperm and that increase pressure faster. I’ve read that usually early onset of pain is nerves and not conjestion but it feels like the area behind my testicles is swollen and I have a full/blue ball feeling and it hurts the most during ejuculation.

I’m going to try to take it easy this month the. I have a follow up with the urologist on Oct 24. I am nervous because converting to an open vasectomy if that destroys the chances of reversal. If I go reversal I would rather have a dedicated expert do it than a urologist that rarely does then if that’s my only shot.

1 Like

This may go back closer to normal after a couple of months. I don’t know why some guys have this, but maybe it is because the muscles are not coordinating normally yet? Anyway, some guys report this goes back to normal.

It’s just too early in your case to know what’s temporary and what isn’t.

Hi there. I’m open ended from the start, still have that swollen and congested feeling. I’m not sure how long the ends stay open for, my testicles are extremely swollen. When I ejaculate it definitely feels as though something is going to burst due to back pressure, I’m scared to even squeeze the muscles during the event.

I’m almost three months in and in a seriously bad position, including low T, nerve pain, and constant flu like symptoms, I’m looking at a reversal.

Thanks for your feedback. That helps me be a little more weary of risking a conversion to open surgery. I’ve heard of it helping some to convert to open but I’ve also wondered how it wouldn’t just close up. I wonder if in those cases it was the removal of the site of inflamation that helped? Or the cutting out of trapped nerves? Seems like it could help if it stayed open, better have the weak point there than in the epididimis, but maybe it doesn’t make a difference. I read one study that said pvps was 6% for closed and 2% for open. Thanks for sharing.

I still have inflammation right at the site, lumps, maybe sperm granulomas stuck to the open ends. From what I understand in some people sperm granuloma can form and cause a seal at the open ends, and blow off from time to time, but they can also hurt, like in my case. I’m not sure if these lumps have trapped nerves, but they are definitely causing me issues. I’ve heard of people actually converting to closed, I think it’s all a roll of the dice. Me personally, If I’m going to be opened up, I’m going to take a shot at back to natural and hope for the best, I’m done with this experiment. Hope you find a solution that works for you man.

Thanks for the feed back. That’s kind of how I’m feeling. I don’t want to risk making it worse and or throw out any chance of reversal if converting to open doesn’t fix anything. Probsbly will just wait until the spring and reverse around 6 months if it’s not at a level I can work with.

Tyler,
Have you tried a pelvic pain specialist. My snip was about 2 weeks ahead of you and I started Pelvic work on July 1. It took care of my nerves and other tightness. Unfortunately, my epi’s got worse as my wife and I increased sex and that’s not something she could resolve. Just throwing it out there

The second week in I started noticing some pelvic floor tension but have been able to work through it for the most part just by keeping relaxed and stretching. I looked up some of the stretches. I’m sure seeing a therapist would be better, I just wouldn’t know were to start. I’ll have to see if there are any physical therapists I can get lined up with.

Sbnick, when did you have your vasectomy? What made you decided to go with a reversal? Like why made you take the plung and go through with it?

I’m about 5 weeks post vasectomy currently. I’m very uncomfortable and sex is out of the question but I could live this way (although miserably); I’m mostly considering reversal in around 6 month mark if I’m not better because I have to be able to run for my job (active duty military) and am willing to roll the dice on recovery, but at the same time I know it could get much worse with more surgery.

Hi Tyler,
First off, I am no expert or even someone speaking from a recovered stand point. I am 8 days post reversal and still a wreck, though a bit more conscious of the pains this time around. And i am very sorry you are going through this. I had a bad feeling about this but my wife really wanted me to get it so I wanted to be a good husband (now I am a terrible husband).

So here’s my story:

  • Snip April 15, 2019. Recovery sucked.
    -At week 5 I went to the original doctor. He was not empathetic and a candidly a dick. Told me to take Aleve twice in the morning and twice in the night for 2 weeks for inflammation. In hindsight, I had nerve and inflammation going on
  • week 8, i scheduled another appointment with my wife this time. He still was less empathetic and said “it could take years, deal with it”. I wanted to punch and I have never really done that. He ordered an ultrasound which did nothing.
  • i searched for a specialist and at week 11, we saw a specialist. He diagnosed massive inflammation and put me on steroids which helped. He also did.l the best thing and referred me to pelvic floor specialist and I got a good one experienced previously as PT for post surgery. note: he also told me it was too soon for a reversal and give 3 months.

Fast forward, weeks 12 (month 3) - month 5.5 lots of progress on inflammation and nerves. I credit pelvic floor specialist. In fact a few times in month 4 I felt good and moments of no pain.

Unfortunately, my epi’s kept swell up and eventually could not sit in a chair or drive cone month 4.5-5. We did take a relaxing family in the middle of month 4 and my wife and I had sex a few times. Pain came on fast and my epi’s were full. At the end of month 5, we determined a reversal would give me the best chance at long therm success.

Some people say wait a year which maybe i jumped the gun. I figured I wanted to get this healing over with and possibly have a normal next summer. Also, I wanted to get relief in the epi’s as soon as possible as I feel they were damaged by the day.

So there’s my story which has not concluded yet. Hope that helps.

1 Like

Thanks, I hope your recovery goes well.

@Tyler1, I would give it more time. I had open ended vas 3.5 years ago. I was diagnosed with blowout and swollen epi on the right side this year. First relief of 3-6/10 daily pain I got after about 8 months at which point I decided to wait to get better. No reversal, I am at 0-3/10 pain level. Level 3 only occasionally. I am started getting relief from papaya seeds powder after about 2 months after I started taking it.

I’m leaning towards waiting to the 6 month mark to see where I am. At this point, knowing the long term risk, I might want to chance reversal anyway. I wish I had looked into this first rather than trust that everyone knew what they were doing. Mostly, if I’m not getting to where I can run at 6 months I’ll probdbly try a reversal to try to keep my job. I’ve been in the military 12 years and I’d hate to have to throw that time away; I’m still working on a degree so I’d get thrown out without a job with a family to support. Trying to avoid that for them. Still can’t belive the military allows this knowing the risk.

Yes, we all have different situation and levels of pain. At some point I may get tired of constant low to medium pain level and opt for reversal, knowing that it carries some risks also. You asked good question why not to repeat vas, change to open ended. I was wondering the same. I have pain and blockage on one side only and not sure if cleanup rather than reversal would help, with best surgeon. Few commenters on this forum wrote that it is better to do it right, reversal, bring to natural state, rather than to go for the same, unnatural, procedure.

That’s what I’ve been seeing Vincent. Closed to open seems to not have the same chance of success as reversal and decreases length of vas for future reversal. I read a study that said pvps is 6% for closed and 2-4 % for open, so it must help for some, but people with open still get pvps. If I’m rolling the dice I might as well try to get back to normal instead of going down the one way road of hacking off more and more, hoping it works, until there’s nothing left.

1 Like

Here’s a slightly different take. I think the many more of us have the neuropathic type of PVPS than congestive. Even though my reversal worked, it wasn’t due to congestion. Doc said I was “actively leaking” at both vas tips. Reversal is a mini-denervation in the words of a uro often cited here.

If you go from closed to open or closed to re-do vas, as you said, you lose vas material for a future re-connection AND you also take the risk of addition nerve damage. From reading here, there are gobs of invisible nerve fibers in the scrotum and along the vas waiting to be damaged by a uro’s scalpel. If you read Kevin Hauber’s pioneering book on PVPS, If It’s Not Broke, Don’t Fix It, he says his biggest regret was doing the closed-to-open conversion. He felt that caused him a lot of extra nerve damage.

Thanks for the input. Do you think your reversal helped by stopping the leaking and thus stopping inflamation ad a result?

I really don’t think I have nerve pain; it’s all localized to my testicles and epididimis. Before I started taking ibuprofen everything felt inflamed and my pelvic floor was really tight but now it’s judt a constant dull ache like how one feels a few minutes after getting kicked in the balls. Before and during ejuculation it feels like something is going to pop then aches very badly afterwards.

My situation is complicated because I’m on active duty military, even if my insurance pays for it (which they might for pain) they will try to send me to a dr “in network” and not a reversal specialist. So I will probdbly opt to pay out of pocket if I have to to see a specialist. If they try to block me from doing it I might just have to roll the dice and go do it on the down low. I don’t want to risk some butcher making it worse.

Yes, the reversal definitely stopped the inflammation and autoimmune response from the leakage. My prostate was badly inflamed. PSA was over 4 and I felt it like an onion. T levels have climbed since reversal, too.

Feel badly for you being active duty. I was already done with my National Guard tenure when I developed PVPS.

I THINK you sound like a good candidate for reversal. I also think you should find a reversal specialist no matter the cost. This is your life, even if it costs you your military career. Don’t let some general uro attempt it just because it’s covered by your military insurance. Easy for me to say, I know.

Best wishes.