Previously healthy 49 year old physician with two children. Following much pressure from spouse, had vasectomy in January 2018. Lots of discomfort during office procedure. No immediate complication post-procedure, but developed burning pain on left side of scrotum, tenderness and soreness on epididymis, and achiness deep in the left testicle that never resolved. Returned to urologist at 1 and 3 months. Unable to exercise with out pain. Could have sex, but generally hurt for about 3 days afterward. Suffered depressed moods. Told by urologist to be patient.
Relationship with wife now different to be sure. Also missed out on cycling with friends which was both a method of exercise, and a large component of my social life. Occasionally, on good days, I still go rock climbing with my kid- but tend to pay for it afterward.
Tried gabapentin, which definitely cut down the pain quite a bit, but could not tolerate due to fogginess and cognitive slowing.
VR in September 2018 with another urologist. More swelling and bruising than first procedure. Pathology sent off that showed sperm granulomas and undissolved sutures. Post-op had painful lump under scrotum at base of penis about the size of a marble. Scar with dysthetic, burning pain along raphe. Marble size mass gradually decreased in size and softened over months. (Topical marijuana cream seemed to help with this). Mass not completely gone yet. No change in burning nor achy pain.
Tried duloxetine. Caused night terrors, night sweats, cognitive slowing, flattening of libido and depression. Still took it for nearly 6 weeks as it helped the pain.
Have had successful genitofemoral nerve blocks x 2 with good results. Relief was 100% on first injection, and 80% on second. Lasted about 8 hours on both occasion. (Lidocaine or bupivacaine only, no steroid)
Now 5 months out from VR considering options. Have started Pelvic PT as well as deep tissue massage of hip flexors (only one session each so far). A little better today(!) One person on this forum suggested stretching out the testes/scrotum which I’ve tried also- as it didn’t hurt. I do think it is SLOWLY getting better, but this trajectory would have me exercising by the time I hit 60.
The alternative that I would consider would be Spermatic Cord Denervation. My urologist gives me a 50% chance of total relief and a 75% chance of partial relief. The left side will hang lower afterward due to denervation of the cremaster. Penis and sexual function should not be affected as this branches off proximal to the spermatic cord. This correlates with the research that I have seen- and can post in the Library section. Spermatic Cord Denervation Articles
My inclination is to give the PT and massage another two months.
Thanks to all that have read this far. You are a great source of comfort and information. I may have posted earlier- if this is a duplicate, please forgive me, I just couldn’t find my own post.