Post Vasectomy Pain Forum

My reversal is not helping (yet, 3 months)

Thanks for the advice - I’m pretty nervous to try nerve blocks. I am in South Africa, and there are not a lot of doctors that are attempting these approaches, if any. Hopefully things will improve on their own with time…

should those injections have worn off by now? i am 14 months post reversal an in a rut right now. throbbing and aching all of the time. since the blocks, are you able to run or be physical?

Yes, absolutely able to exercise. Hiked about 5 miles today through the Metroparks. When I do that (or work out at the gym or bicycle) wearing a jock, I’ll go from no pain to a 1 on pain scale. Think I have some scarring near the left epi that can get irritated, but it goes away.

I think in my case and some others’ cases, the injections do a better job of breaking the pain cycle of pain->inflammation->pain. I think mine got down to a low enough level that I can live a normal life with minor twinges and only taking supplements. I’m a fan of injections since they’re putting the medicine on the hot spot but, as always, YMMV.

I’m getting a genitofemoral nerve block in several hours. I’ve been through a lot and my first pain management doctor only offered one block. My new doctor is all about targeting each nerve. We already did ilioinguinal/iliohypogastric which made me about 10% better. I think a pudendal block may also be in order. If the pain is sympathetically mediated, then we will do a superior hypogastric plexus block. She wants to target peripheral nerves first.

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Good luck and keep us posted!

how is it going man?

Hey Mike - not too bad, mostly 2/10 days… I’ve run out of things to try (not keen on nerve blocks) so now I guess I wait, and wait, and wait… How are you doing?

hey @Regret2 sorry to hear of current and consistent struggles even after reversal. Am 3 months post reversal and not getting the results i hoped and prayed for. Even though my Uro said no one got worse with reversal well guess what Doc!! as of right now i am!! I feel like i went back 2 yrs when i was at the height of my vas related pains. The good thing is day to day my pain is usually a 2/10 but, when i ejac or have intercourse my pain goes up to a 5/10 for the remainder of the day. Same issue as i had post vas, so right now am in this wait and see holding pattern. I have seen overall improvements as long as i don’t ejac am pretty good. On the flip side over time i did get better after my VAS so am hoping the same will happen with reversal. At this point i hope and pray for a full recover but will accept a new normal of little to no pain including post ejac which is my chief complaint right now. Waiting on SA test results and seeing Uro next week to see next steps. he did mention about another surgery to remove a portion of my epi or nerve blocks but will see what he recommends after a physical examination. Question to anyone reading is there a high resolution ultrasound that would be able to identify if there is a blockage in your epi? i.e. granuloma in epi or scar sites on epi that would cause partial blockage?

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Been struggling brother. On June 19, it will be 15 month post reversal and still have bad achy pain at connection sites. I don’t know what else to do either. I made another appt with my surgeon, hoping we can come up with something. Do we just give it more time? How long could it take? I don’t know, s ok frustrated, just when I think j am I n the road to recovery, I go back into hell and lose hope. Just so unsure and getting depressed right now.

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Sorry to hear of your struggles man - I feel much the same. I don’t see myself ever going back under the knife, unless things get worse. So far each surgery has made things worse than before. I can only hope that over years the body with change and adapt.

Hey NC79, sorry to hear that you are not getting results with your reversal! My theory is that our pain is caused by nerve damage, not pressure like some people, and that additional surgery has the unfortunate effect of worsening rather than improving our pain. I don’t believe it is possible to see blockages in epis, too fine detail? Be very cautious about epidectomy, I have not read any good outcomes on this forum from that surgery. Nerve blocks also seem to be hit and miss, but please let us know if you have any success. All the best.

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Hey @NC79, sorry to hear that you are struggling.

At this point, I would advise following up with Dr Jarvi, and get that SA to confirm whether you are open with good numbers or not. I certainly wouldn’t rush into anything else for the first ~6-9 months at minimum. Go slow and make smart educated decisions as you move forward through time. Don’t let desperation lead to bad and/or hasty decision making.

Don’t forget that the last guy that posted about his post reversal recovery with Dr Jarvi basically said that the reversal made him overall worse around ~4-5 months into his recovery. By month ~7 he posted that he was nearly pain free.

Don’t give up, and don’t prematurely assume the worst. There are peer reviewed papers out there to be read regarding typical surgical recovery timelines (in general) and they suggest at timeframe of up to ~12 months (+/-).

Good luck brother

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hey @RingoStar and @Regrets2 thanks for the sound input. I agree at this point it’s best to continue waiting and don’t make any harsh decisions based on desperation and emotions. I do feel some improvement in past couple weeks with the scenario of up tick of pain post ejac/intercourse, which is good and hopeful will continue to improve. I now established some what of a routine which is no ejac/intercourse first thing in the morning as i will have an up tick of pain all day i.e. 1/2-10 --> 5/6/10 in pain. Things are more manageable as long as if i defer sexual activities to later on in the evening.
Also i got my SA results and seems like am fertile again!! Sperm Count is 47 million and motility is 50% (this is right on the border of normal range as anything 50% or above is normal). Based on the ranges of the test says am in range… also appearance/viscosity were normal. Abstinence was 4 days…
I had phone consult this morning with Dr. J’s associate and he suggested next steps would be a nerve block. If i get relief then will do a series of blocks. If no success then will have to discuss other options. They wanted to scheduled me fairly quickly but i told them lets wait till Sept as i want to give it at least 6 months before any other intervention. Office is closed right now due to pandemic so hopefully by Sept i can do onsite visit where they will do a physical exam and possible nerve injection if i want. My hope is by sept i will be in a much better position and i won’t need to do anything but will wait and see. For the time being he suggested to continue with scrotal support, take celebrex as needed and icing/hot baths if they help. Uro thoughts are i just need more time and that based on SA tests both sides are opened but its hard to tell, i could still be in scenario where one side is open… Also asked about doppler ultrasound and he mentioned it won’t yeild the results were looking for. So for now i will continue with the wait and see approach. I was taking 200mg celebrex and 300mg of lyrica daily for a month. I have been off both for about a week now and haven’t seen any uptick in pain overall which is good, so for now am only going to take these meds on a as needed basis. Appreciate the input and support of all on this forum as were as i feel were all part of a brotherhood that we don’t want to be in, but glad there is a place we can go to for reflection/input/and venting!!

That’s impressive that you came off your Lyrica and Celebrex without problems - good news there. Interesting that you are seeing a difference in pain on ejaculation depending on time of day. Do you think its because you sleep through the pain if you ejaculate at night, whereas during the day you’re aware of it? Worth trying! :smile: