Post Vasectomy Pain Forum

My Experience, with list of non-invasive treatments

Hello, I’m a long time lurker on this forum. I’m going to share my experience here and spell out what has worked for me in the hope it helps someone. I know these things are discussed elsewhere in the forum, but typically not all in one place or it gets buried deep in threads that will make your eyes bleed. I’m not really looking for a discussion but I’m happy to answer questions. I’ll be following up with a separate post about where I’m headed and I could definitely could use some input there.

First let me say PVPS is a living hell and no one deserves to suffer through this. Especially when the vast majority of us get led into it with no warning of the true risk. And lets be clear, risk is probability of outcome scaled by severity of outcome. It seems Urologists minimize the probability and neglect the severity. Mine mentioned neither. Being that its an elective procedure, the regret alone is enough to kill you. Between this and other horrible care I’ve received, I’m done with the US health care system. I’ll be staying clear of it the rest of my life. Not even another flu shot, nope, I don’t trust you jags one bit. But I digress.

I had my vasectomy in August 2018 at age 36. I was healthy with no history of anything other than seasonal allergies, sinus infections, and mild back pain (due to desk job). It took a lot of courage to get my self in there and I was, of course, only doing it for my wife. I thought the only complications might be short term and correctable (infection, hematoma, or granuloma). The informed consent paperwork they shoved in my face the day-of briefly mentioned PVP. I thought “yeah I’d expect some pain while I heal from this”. Adding the S for syndrome, really changes the expected duration and severity in my opinion. But now I have no legal recourse.

The procedure was not painful except for the anesthetic injection and an uncomfortable tug on the right side. They used an electrical cauterization device which grounded thru my butt cheek. I thought it was unusual, but I’m not necessarily blaming it for anything. I went home and felt fine. Rested for the weekend and returned to work on Monday. The entire first week, it was like nothing had happened. No pain, just itching and prickles from the shaved pubes.

Starting the weekend after my testicles started to ache and I had some discomfort in my lower abdomen. That gradually increased over the next 3 weeks into the worst longest lasting pain I’ve ever had. At this point I didn’t much notice my testicles, as the pain in my abdomen and legs was dominant. Along the way the urologist office admonished me to keep icing and taking ibuprofen. That was good for nothing and I think the ice actually made the shooting nerve pain worse. Screaming at the receptionist on the phone finally got me in there. I had developed granulomas at the vas site sites. They started me on some meds which significantly decreased the pain. I found it odd they claimed I was one in a million, yet knew just what to prescribe. Since then I’ve been on a magical journey through PVPS land. My pain and symptoms have been on a roller coaster through almost every manifestation mentioned on this site. I’m going to break it down by treatment rather than time line now since that’s probably more useful to others.

What Has Helped

  • Massage therapy: this has given the most relief from pain overall. For myself scrotal pain never exceeds a 4/10, but the pain spreads elsewhere and left untreated eventually becomes worse than the scrotal pain. I found a massage therapist with experience treating chronic pain. She typically does trigger point and myofascial release all around my hips, upper thighs and lower back. This mostly eliminated the itching/burning nerve pain in my inner thighs that was driving me insane. There’s a feedback mechanism at work here as it decreases scrotal pain too. It does tend to make things a bit worse for a day following an appointment.

  • Methylprednisolone: I credit this with knocking down my initial flare up. It definitely brought the inflammation and pain under control. Inflammation is your enemy and can leave you with permanent damage. I have not had another dose since, though it may have been warranted at times. If you are early on with PVPS you should demand your uro or Dr prescribe something to address inflammation.

  • Pelvic floor physical therapy: In a similar vein to massage therapy this has been very helpful. But more so in teaching me things I can do at home. In particular using a foam balls to massage my psoas and pelvic floor around my anus. They suggested a tennis ball but I needed somethign larger for the psoas and something smaller for pelvic floor. I tried dry needling, which relieved some very tight leg muscles, but it set off a lot of nerve pain after each session. Massage therapy was far more bang per buck.

  • Exercise: exercise has been 50/50 for me. Sometimes its good and I feel better, other times it sets off a flare up. Walking was usually best. Anything more intense risked a flare up. I mostly credit the increased circulation, as I don’t have any other dysfunction which the physical therapists and medical imaging have confirmed.

  • Yoga: It is gentler than exercise and has been very helpful without risking a flare up. There are lots good of videos specific to pelvic floor issues on YouTube. I highly recommend the FemFusion Fitness channel on YouTube. I would add inversion is helpful in loosening up my low back and relieving nerve pain there. Just get a chin-up bar and ankle straps, the inversion tables very expensive.

  • Papaya Seed: early on I shrugged this off because I had so many issues and was trying everything under the sun. However it definitely decreases the pressure and swelling in my epididymis but it is slow acting. I’d say at least 3 weeks for full effect, 1-2 tsps per day. For myself it never brings complete relief but gets me to a point I could almost live with it. I prefer the organic brand on Amazon. The others taste foul. It tends to give me soft stools but no other side effects. I do worry about the safety of using it long term.

  • Supportive Underwear: Early on I could only wear boxers. Any pressure on my scrotum or thighs was unbearable. Once that calmed I should have switched to supportive briefs earlier. The best for me has been the Sepratec brand which have a separate shaft compartment. That keeps my shaft from bouncing around on the top corner of my epididymis. The relief was immediate and substantial. I don’t know if the scrotal support is as important for me, but it keeps my nuts from knocking around. I often still wear boxers at night because giving my nuts time unrestrained seems to help.

  • Celebrex / celecoxib 200mg per day: of the NSAID pain relievers this gave me the most relief with no stomach upset. Only one pill a day and relatively low cost.

  • Gabapentin 900mg per day: I was prescribed this with the methylprednisolone at the initial onset. It definitely calmed down the shooting nerve pain in my legs and abdomen. For me it seems to be effective in short bursts of just a few weeks. It helps me sleep too. The side effects suck so I don’t see it as a long term solution. It made me a clumsy idiot. I would forget words mid-sentence and drop things. Every sensation was dull and muted. I decrease my doses slowly over a week to zero and I’ve had no issues getting off it. I felt it also prevents some muscles from releasing fully.

  • Hot baths / heat pad: Like many reported here, heat helps. I think its a combo of relaxing muscles and slowing sperm production. I would add epsom salts seem to enhance the effectiveness of a hot bath. Its frickin salt so just get the cheapest thing you can find. I found an epsom salt rub from ProCure to be pretty effective for muscle tightness soreness when you don’t have time for a bath.

  • B vitamins: I believe these definitely help with the neuropathic symptoms. But it can be too much of a good thing. Some of the neuropathic specific formulations have obscene amounts of B vitamins in them. Those make me irritable, unable to sleep, and make my skin itch in the areas I was already having pain. I also can’t imagine its good for you liver or kidneys when you’re piss is highlighter yellow. My happy medium is Garden of Life Vitamin B Complex. I haven’t tried alpha-lipoic acid by itself yet.

  • Tumeric & Ginger: I believe this helps with inflammation to a limited extent. Maybe like a low dose of ibuprofen without any stomach upset. Tea seemed more effective than pills form.

  • Magnesium: This helped me with muscle cramps and neuropathic pain. Its the same ingredients as the epsom salt soak, just taken internally. It can cause diarrhea. SloMag never gave me diarrhea but seemed much less effective.

  • Cialis 5mg: This absolutely provided pain relief. Maybe I should rank it higher in terms of effectiveness. But its too damn expensive and only provides relief for a limited time. After taking it for more than a week its efficacy starts to wane dramatically. Side effects include feeling hot and raging boners at the most inopportune times.

  • CBD cream and edibles: I felt the creams help some what with the neuropathic pain in my inner thighs but not so much in my scrotum. Taken orally it provides some anxiety relief but not much for the pain.

  • Ibuprofen/Naproxen: These do what they’re supposed to do. But you just can’t take them for a long time without messing up your guts.

  • Marijuana: What can I say I love weed, I just wished I lived in a legal state. It helps with pain and mellows out the anxiety. However when I was at the initial peak pain it sent my anxiety soaring because I was a mental wreck. Its no good when your head is a mess.

  • Kyolic Garlic / immune booster supplements: I really think there’s an immune response element to all this. The lymph nodes in my inguinal area have felt huge and hard at times, usually corresponding to when it is worse. Taking immune supplements seemed to help a little but we’re approaching placebo level here.

  • Mindfulness/distractions: I listed this last because ultimately you are tricking yourself that you are not in pain. But relief is relief. I found simply focusing on sensations in my fingertips or feet very helpful. Don’t forget to breathe and breathe deeply into your abdomen. You gotta get your mind off your nuts. Find something immersive to do like video games or reading.

What Has not Helped

  • My Wife: Her silence is deafening. Any mention of PVPS gets met with a blank stare. She actually told me I was “emotionally dumping” on her when this all started. She hasn’t touched me in months. Our marriage has decayed to where she’s basically a live-in baby sitter, so that I can have some child free time which I spend stretching, soaking, etc to deal with this issue. If/when I get over this I’m going to gleefully serve her divorce papers.

  • Most Urologists: While my vas uro has been proactive in prescribing meds he’s been fairly dismissive and wanted to hand me off to the pain management dept. A “specialist” nearby rattled off denervation and orchiectomy options like they were no big deal. None offered reversal as an option. Only recently have I been talking with reversal specialist, more on that in follow up post.

  • Alfuzosin/Uroxitrol 10mg per day: I don’t think this helped or hurt. It made my ejaculations very weak which in turn decreased the pain from ejaculating. I don’t count that as a win. No other side effects. Its worth a try though if you are having pelvic floor dysfunction, see PT note above.

  • Prednisone 20mg per day: A local uro prescribed this recently given the methylprednisolone helped. One week in and its not helping. Maybe some of the neuropathic pain has decreased, but it hard to say as it has always been so variable. My testicles hurt worse which I think is due stopping papaya seed and other treatments.

  • Chiropractor: I was having musculoskeletal pain cause I was all contorted from my scrotal pain. Working on my spine didn’t do much. They used some electro-stimulation on my low back at the end of each session which seemed helpful in relaxing muscles and quieting nerves. I don’t really consider that core chiropractor work. Plus you can do e-stim at home. Massage therapy was much more helpful.

  • Accupuncture: What the hell led me to the point of desperation that I want some crunchy chick shoving me full of needles? It didn’t work for me. I’m not going to argue if it helps you. Lots of people swear by it.

What makes it worse

  • Sitting: This is the one thing that without fail makes it worse. I’m an engineer and spend most days at a desk. It ranges from mildly irritating to excruciating. I pleaded for a standing desk which helps. But I’ve got to remember to stand before I feel it come on or its already too late. My low back cramps up within 15 minutes from standing now too. Which it never used to.

  • Ejaculating: I get pain when I first get an erection and a few hours after ejaculating. Ejaculating itself is not a painful event. It took me some time to correlate this cause and effect but its definitely there. Mentally this is the worst part of PVPS. Makes me feel like eunuch.

  • Getting sick: Every time my germ bag daughter brings home some illness and gives it to me, it flares up. I got sick twice in quick succession this winter and it knocked me back big time. My pain now is worse than its been in the last 6 months. I’m slowly climbing back. I definitely believe PVPS has an immune response component to it.

  • Anxiety / Anger / Regret: These emotions definitely don’t help even though they’re perfectly normal responses. I would add spending too much time on this site can be triggering. Early on, anxiety made my pain noticeably worse. When I’m angry I tend to clench abdominal muscles which isn’t helpful. Regret is basically worthless, you have to keep moving forward.

  • Bad diet / sugar / carbs / alcohol: You have to eat well to help your body deal with this. Sugar and alcohol are known to cause inflammation. I went sugar free and low carb for a while and it helped bring down my pain. But its very hard diet to pull off, especially with a child in the house. I used to be able to eat whatever I wanted because I was able exercise regularly.

  • Poor sleep: needless to say you need sleep. Use sleep aids if you need to. I’m a side sleeper so I started using a pillow between my legs to keep my nuts form getting squished at night.

  • Self examination: I definitely irritated things by feeling it too much. Resist the urge and maybe set a time once a day if you are looking for improvement in swelling, etc.

Other thoughts and Conclusion

I’ve come to the conclusion that looking at this in terms of a diagnosis is futile. Whether it is congestive, epididymitis, or neuropathic is the wrong way to look at it. Its all of the above and its due to the vasectomy. That is why I am now looking into a reversal. All the neuropathic pain treatments I tried are helpful, yet a red herring. A physical therapist really openend my eyes this way. She said (paraphrasing) that the pain and muscle cramps I’m having seem to implicate all the major nerves in the inguinal area, and its almost impossible that the all of them were damaged during the vasectomy. Its the vasectomy stupid.

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Well said. Hard to add much more to that.

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Great post. If you don’t find the relief you’re looking for, I would definitely look into reversal.

I most definitely am. Largely due to advice and experience this forum. I’d still be floundering around if I was still listening to my original uro.

I posted about it here.
Reversal Decision Time

Great write up man. I have tried almost everything non medicated related that you have listed. Your list is pretty spot on. The only difference is the chiropractor I am seeing works on nerve pathways and releasing nerves and fascia tissue in my body. It’s been 6 weeks, and I notice a slight difference in the burning pain in my thighs, less intense, but always around.

I didn’t see a high dose of fish oil on the list, you might consider that as well.

I just started seeing a pelvic floor therapist, and what a ton of fun that is…shes trying to manually release muscles from the inside of my ass…some days I just ask myself “What the hell am I doing?” “What the hell is going on?” Did your pelvic floor person do this? Did this help at all?

Also, I had to quit taking hot bathes. Sure, they felt great while I was in the water, but holy hell did I pay for it when I got out. I wasn’t sure if it was because the pain subsided some while in the water and then I had to get back used to the pain again or if it made it worse. All that extra blood going to my balls really made the back of them hurt. I would have to hold them walking around until I could get into some UFM briefs. Even then they hurt worse for a couple hours after. Did you or anyone else here experience this?

My mind is literally blown that so many people here have so many similar symptoms, yet doctors seem baffled by this.

I wonder if anyone can organize a rally somewhere to help bring awareness to this shit. People do Marches and rallies for other health stuff, why the hell can’t we do it? What a sight that would be, all us guys holding our aching balls, burning thighs, groins, perineums, inguinal canals. The lines at the porta johns would be longer than a women’s restroom as we deal with trying to get all our urine out.

Thanks again for the list.

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Yes, they work internally and externally. In my case didn’t help.

It´s happened to me as well. Can’t take even hot shower.

Thanks, I typed up that tome hoping it helps the next victim find their way to relief or recovery faster.

I never tried any fish oil. I might give it a shot as I prep for a reversal. I want to get inflammation knocked way down prior to that. How would you say it helps you?

Yeah I had the PTs finger up my butt once. She said my muscles in there felt “high tone”, i.e. a little bit tense but no specific problems in her opinion. Not a pleasant experience, no relief, and I had the same reaction “how the f*** did I get here?” Well at least I know I never wanna get pegged (see there’s always a silver lining). My pain usually isn’t up around anus, more often in my perineum, but rolling out that whole area with a small massage ball helps in general with all the neuropathic pain. I notice when I get constipated or have a big log on the way it can cause me some pain in my scrotum. Those nerves are all connected and messed up from the vas. I had a bout of what I think was candida overgrowth in my intestines. When I cleared that up my symptoms improved. So I believe diet and GI health are definitely important factors.

Hot baths were never bad for me afterwards. In fact anything that improves circulation helps me. I had about the opposite reaction with icing. It felt good during, but the nerves would reactivate and go crazy immediately following.

That would be a sorry rally indeed and in my condition I avoid traveling if I can. But I would love to see this get more attention somehow. It kills me to see new men joining and posting here weekly. If the prevalence and severity of PVPS was on my radar I never would have done it.

Needs to be opened up mate vasectomies are just bull shit I believe ìt nèd to be brought into the open let the truth happen. Only problem is how do we do it. I agree if it was a women’ problem it would be head lines

@WtfMyNuts got to be honest about the fish oil. I cannot confirm if it has helped me or not. It’s hard to tell if any fucking thing helps some days. I just take it every day because why the hell not. It’s 1,000 MG in the morning, along with the rest of the shit I take now. Its supposed to help with inflammation.

As far as the pelvic floor stuff, I am going to give this girl a few more tries poking around up my ass before I give up on it. She seems very positive that I could get some relief out of it. I am trying to stay positive and her attitude is a huge help. She almost makes me believe I will feel normal again one day. I too have learned ass play is not for me. What a miserable experience.

I’ll have to try rolling out my perineum, I have a vibrating massage ball I could use, see if that helps. Thanks for the tip.

@Arynoso I haven’t read your entire story yet, but have you found anything that works for you or what you have tried? If you don’'t feel like typing, and you got a link to it, you could just paste that here and I’ll check it out. I am just trying to find people with common denominators with me to see what I could try.

@Lee1985 Here is a summary of my journey. I should update it… 5 years on! And all is well