Post Vasectomy Pain Forum

My Journey (PainInTheNut)

I’ve decided to share my story here with the hope it may help others. I don’t believe anything about my experience is exceptionally unique, or that I have any special advice to offer, but I personally have found it therapeutic just reading others stories and being able to relate to them so here it is….

August 2016 - Original vasectomy with Dr. Patrick Frey. Right side was performed first and was uneventful. Left side seemed to be more challenging. It took significantly longer, it seemed as though he was having to dig or make multiple attempts to grab the vas but this is just a guess. I don’t know if he originally had it and it fell back through, maybe I tensed up too much, not really sure but it was a very different experience and I felt a fair amount pressure/pain that I did not feel on the right side. I have subsequently come to believe this additional trauma ultimately led to a higher than usual amount of scar tissue.

September 2016 - January 2019. Pain on left side was 0-2/10. No pain in right side whatsoever. No issue with sexual functions/pain. It was always fine in the mornings but the more active I was the more discomfort. I believe we tried antibiotics and/or steroids in the early months but that did not do much so I just lived with it, and for the most part, it did not have a major impact on my quality of life for ~2.5 years.

February 2019. Everything changed. My pain became a constant 4-5/10. Trigger unknown but I have now come to believe it was the onset of congestion.

March 2019 - May 2019.
- Ultrasound - noted small bilateral hydroceles and varicoceles but otherwise unremarkable
- Doxycycline
- Prednisone
- Meloxicam
- Many types of different underwear
- Anti-inflammatory dieting

June 2019. Spermatic Cord Block with Dr. Parekattil at Pur Clinic. I had viewed this as a diagnostic test to help isolate the source of pain. I did not experience meaningful relief (even temporary) which led me to believe my pain was less likely to be nerve related. In any case, the results (or lack thereof) made me feel it may be congestion so I started taking papaya seed powder. Interestingly, he did comment that my varicocele was Grade 3 - which nobody else had noted so still not sure what to think about that….things were pretty flared up at the time which could have been misleading.

July 2019. More tests:

C-Reactive Protein (CRP) Test: <0.40 mg/dL (normal)

Testosterone Test:

  • TESTOSTERONE, TOTAL = 315.0 ng/dL
  • FREE TESTO, CALC = 68.9 pg/mL
  • BIOAVAIL TESTO, CALC = 175.8 ng/dL

September 2019. 3-day Intensive with Dr. Susie Gronski in North Carolina. By this point I was pretty set on a reversal. My goal of the sessions was to be better equipped to manage my pain both pre & post surgery as well as get my body (specifically pelvic floor) in the best condition possible. She really exceeded my expectations - addressing not just physical but emotional and mental aspects of this condition as well. I went in not being comfortable walking more than a half mile around our neighborhood, and by the second day, I had the confidence to go on a 3-mile hike in the mountains with no significant pain. I’m sure you can learn much of this from her and others books - I just prefer the hands-on one-on-one personalized experience.

As you can see, a fair amount of conservative treatments, and by this point I was regularly at 1-2/10 not getting much higher than 3-4 in the rare flare-ups which I was now equipped to get under control quickly. I cannot pinpoint exactly which treatment(s) helped the most but collectively I was in a pretty good spot relatively speaking. It may sound a bit odd that I still chose to proceed with surgery when I was feeling the best I had felt in 8 months, but at the end of the day, I wanted more and went with my gut. I was also at the 3-year mark which factored into my decision.

October 2019. One-sided reversal (vas-to-vas) with Dr. Marks at ICVR.

  • No sperm granuloma noted
  • Noted dense, vascular peri-vasal scarring tissue which he said was more than he normally sees. He removed what he could and injected steroids directly to remaining tissue.
  • Noted definite tubule fullness. He said there was tremendous backpressure, it came “pouring out”, he did compression and there was significant fluid.
  • He did not feel the varicoceles were prominent or likely to be causing issues.
  • I am happy to share more details about procedure if anyone is interested.

Leading up to surgery, I had come to believe I suffered from two different sources of pain - one from original surgery (scar tissue) which flared up with activity and a second constant pain (congestion) which was relatively recent. His comments seemed to confirm both so I am cautiously optimistic and hopeful.

I am only one week post-reversal so it is too early to tell of course - just trying to follow doctor’s orders and stay positive.

All questions, comments, tips welcomed!

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Hang in there. Keep us updated on your recovery.

What specific recommendations were you given for post op care? How long should you wait to ejuculate, then hoe often after?

I’ve seen it suggested that antianflamitory mediation can slow healing but that inflamation can increase the risk of scarring. Did they give you any specific advise to avoid scarring and inflamation?

I often read that people that get reversals for pain had a lot of pressure build up; I wonder if people without pain don’t have the same level of pressure, if their bodies are managing the sperm buildup better somehow.

Wishing you a good recovery.

First 72 hours are house arrest and really trying to stay off your feet as much as possible. Ice 30 minutes on; 10 off all day long except when sleeping. After the first few days, continue icing at least a couple times a day for months. Wear athletic supporter 24/7 for the first 2 weeks.

He wants first ejaculation at 2 week mark, then every 24-48 hours to keep the vas connection open. Not sure how long that goes on for but will ask at my next follow-up.

I too have read a lot of varying opinions about both icing and anti-inflamatory meds so not entirely sure what to believe. I chose Dr. Marks for a reason though so am planning on following his instructions - 4 days of antibiotics, now on 10 days of prednisone, then switch to meloxicam for 6 weeks. There is also a whole list of vitamins/supplements I need to get started on. Honestly I would be perfectly fine if it slows healing / increases recovery time if it ultimately means I have less scar tissue.

I also plan to continue working with Dr. Susie from a physical therapy perspective in hopes some of the techniques will help the tissues heal.

He seemed pretty emphatic that my buildup was higher than a normal reversal. He said he had to take quite a bit of extra time to basically let it drain so he could get back in and start stitching. He also commented that he has done some reversals for pain where he did not notice very much buildup and questioned whether that was really a source of their pain. Those comments lead me to believe there are difference and congestion is a real thing. It is pretty ironic outcome given my original urologist flat out told me he did not believe in that theory, and even after spending time on this site, I personally did not really think that was what I had until very recently.

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Thank you for sharing your story.

Good luck - and keep us posted.

One thing I found pretty interesting is the images Dr. Marks provides following the procedure.

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Thank you for sharing your story!!!

Could you give us a little summary of the work (excercises?) you’ve done with Dr. Susie Gronski?

And how do you feel these days? I think you did the reversal 8 days ago, right?

(Edited to add the last questions)

Sure thing. I did her 3-day intensive course which you can read about on her site - although I would probably recommend the 6-day course if you can make the time/cost work. I will say it was the most thorough evaluation I have had through dealing with this pain. It is amazing how much better you can feel just ‘getting it all out’ mentally/emotionally and knowing you are in the hands of someone who gets it - hard to find someone so knowledgeable, compassionate, and able to spend the hours it takes to listen and understand what makes each of our cases so unique.

My pain had begun to spread out to inner thigh, perennial, upper pelvic area, etc and I really wanted to get that under control prior to the reversal. It was primarily stretches, yoga, and light massage that helped in that regard. I’m not sure I can do a great job describing them but they are all surprisingly simple. She just published a short blog series with some of them Part 1, Part 2, Part 3 (actual positions). Pretty sure some of them are in her book as well:
Pelvic Pain: The Ultimate Cock Block: A no bullsh*t guide to help you navigate through pelvic pain

Things have been going about as I expected so far. Very little swelling at all and I have not even taken a single Tylenol since surgery. I still have minor bruising, soreness, discomfort but all seems pretty normal for this type of surgery. A couple days ago I slept 10 hours through the night (no icing) and felt fine in the morning. I do find things start to heat up after sitting OR standing for more than 30 minutes - just switching between the two or lying in bed / ice calms it back down.

Friday will officially be the 2-week mark when I can start to ‘let things flow’ again. I’m anxious to get past that milestone. Also ready to get back to stretching!

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Thats great news!
So, the first 3 day you should remain in bed, and then how was your experience to be back in move?

Many thanks for the links!!!

I have been taking it really easy - more out of caution probably than necessity. I am fortunate that I can work from home as-needed which is largely where I have stayed since returning from surgery. A few short trips to the store but that is it.

I stayed off my feet most of the first week only walking around for 10-15 minutes at a time. As I increase time on my feet I notice a slight burning sensation and the longer I am up the more the sensation spreads - damn nerves/tissues recruiting neighbors! It is not particularly painful per-se, and I still haven’t taken any pain relievers since surgery, but it is a sensation I notice and use it as a signal to rest. Of course I have the same sensation being on stressful work calls or trying to wrangle the kids at times so who knows :wink: Luckily I know it is all temporary and it is easy to calm down with light stretching / gently tissue massage / or of course ice.

I still find myself walking pretty gingerly, but again, more for protective reasons than active pain. Still wearing the jock 24/7. I am so ready to stop wearing this thing (Dr. Marks says 2 weeks) but I know it is helping reduce risk. I will likely keep wearing it during the day for a while, as that does not bother me much, just ready to be free when sleeping.

I’ve completed the Prednisone and am now on Meloxicam which I believe I will be on for months. I have also started all of the supplements.

Today was a really great day. I did a good job keeping my mind positive, distracted, and worked in some stretches. I’ll end on that positive thought.

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Thank you for your answers. They give me a lot of hope!

A quick two week update for those following along.

The bruising is completely gone. No swelling is visible from the outside but if I feel around the connection site there is still some swelling/inflammation there. The incision itself looks about 80% healed - just a tiny piece left that has not fully closed. All of this is normal as I understand it.

Everything is ‘hanging’ fine same as before. Visibly, just looking at things, you wouldn’t be able to tell I have had a recent surgery without close inspection.

Things are still tender to touch/movement and I plan to continue wearing the supporter during the day but will try sleeping without it. The boys need a little freedom!

I had my first ‘release’ today which was nice after 2 weeks. There was a very small amount of blood which was expected. No pain noticed at all though which was a relief. This was not an issue for me pre-reversal but I was a little worried how it would go based on some stories I have read here. Thankfully a non-issue so far but will know more as I try to clean the pipes and empty the epi over the next couple weeks. Dr. Marks says every 24-hours is ideal.

That’s all for now - just trying to keep up with my supplements, stretches, diet, and positive mindfulness while my body does the healing.

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Glad to hear you’re improving. You said you didn’t have any pain during ejaculation prior to reversal? I thought that sort of always came along with congestion. This whole issue is just not we’ll understood. It needs more research and data collection.

Correct, I did not have any pain during ejaculation prior to reversal either. I’m honestly not sure how prevalent it is for guys with congestion. It could very well have a high correlation…I just haven’t looked into it.

Prior to reversal, I was only about 51% confident that congestion was part of what I was dealing with - and I only got to the extra 1% after the cord block with Dr. P did not provide relief (making me feel it was less likely to be solely nerve related). Part of what confused me is that I only had the pain on one side. However, post-surgery, Dr. Marks comments about back pressure, how long it took to drain, etc gave me a much higher degree of confidence there was indeed some congestion. I guess time will tell.

Edit: I should also add the other reason I went the reversal route (as I wasn’t highly confident about congestion) was to do a full clean out and remove any potential irritants such as scar tissue, etc.

Thanks for all the input. If I do any surgery I’m just going Reversal. I don’t want to go down the one way dead end road of cutting off more and more parts, hoping it will work.

Sucks, cuz I’m in enough pain that I don’t want to live this way for life, but I could. It would just suck. Worried I might make it worse but leaning towards taking the risk. Gonna wait a few months either way just to see while I save money and get it all set up.

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I was in a similar boat. I did a lot of work physically and mentally to get to a place that I could have lived it but I wasn’t willing to accept that I had to yet. As long as the reversal does not make me worse I can accept my situation and will not have regret about trying it.

If for some reason this reversal + the other work I’m doing does not get me where I want to be then blocks are about as close to surgery as I plan on going for a while. It would take either significant medical advances or some extreme increase in pain for me to consider other surgical options.

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Just so crazy that most insurance won’t cover the only corrective surgery: reversal. Everything else just causes more destruction. It’s all a money game; they don’t want to pay for more kids, even though reversals have a decent chance of helping.

Crazy how every dr I’ve seen so far, when I bring up reversal, says “what are you going to do for birth control then?” Like who gives a scheiss about birth control; I’m just trying to have a functional, not painful set again! I would gladly sign a contract to never have sex again if I could hop in a time machine and undo the vasectomy.

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