Post Vasectomy Pain Forum

New guy needing suggestions

Had a Vasectomy in august 2019. Ever since I’ve had problems. Did 3 rounds of antibiotics over the next year. In October the real hell hit me. Felt like someone was pulling my testicles out. Went to ER twice. CT scan. Nothing. Did 3 ultrasounds between November and February. Last one show bilateral varicoceles

November and December was in bed most of the two months. Hurt to walk. Had ice packs and heat on them. Been to 4 urologist of which 2 said in my head. Went to 2 gp with not much help. Finally got on some gabapentin in February which gave me mild relief.
Now my back hurts and I’m December it was like I felt water moving up my spinal cord. Guessing nerve Damage.
Everyday now sucks. I don’t know if I should try a reversal or not. My entire body hurts
Taking that over counter zyflamedn and nerve shield for 2 months which may be helping but not like I want.
I’m afraid a reversal won’t help with nerve damage. Also afraid it will make it worse.
Anybody in the Midwest (Nebraska) have suggestions on Dr. I also tried PT pelvic which maybe helped but stopped after 2 months. Felt like my body was on overload.
Went to Nangia in Kansas but he wanted to operate and I was in no state mentally in November for that.
He seemed like a great Dr but what I’ve learned is not to jump on real quick like I did with Vasectomy

Worst decision of my life

Anyway suggestions would help.

Nangia is definitely one of the go-to urologists. Not a ton of press here, but he’s been researching and treating PVP for at least a couple decades, so while he may not be the biggest advertiser, he’s a good resource.

It’s so sad reading that there are still urologists in denial and telling men that their pain is in their head just because of a clean ultrasound. It’s the height of arrogance. There’s a special place in hell for them.

While I’m not promoting surgery, at nearly 2 years post-vasectomy, it’s not too soon. I take Zyflamend and Nerve Shield and do notice a slight uptick when off them but, candidly, I think they provide nominal benefit. If one is at a pain level 8, these get you to 6 or 7, not 2.

I’m a fan of trying injections before trying surgery as a next step of interventions of the nerve pain meds like gabapentin aren’t cutting it. Injections aren’t risk free, and I’ll probably get chided for this, but I stand behind the perspective that a needle has fewer risks than a scalpel. That said, I think pain management injections are less likely to help than surgery…lower risks, lower probability of rewards.

Surgery? I think this forum is almost unanimously opposed to epi removal. I know I certainly am. I still haven’t met a man who had his epis removed for PVP that didn’t go on to need further surgery.

Reversal does seem to be the most popular option here. For me, it just made intuitive sense back in 2005-2006 before there were forums like this. Cord denervation was much rarer then, too. Cord denervation doesn’t seem to have a lot of fans here. The data sure seems to indicate that it’s not as effective with PVP patients as it is with other scrotal pain cause patients.

Seems like radical orchiectomy is gaining popularity…remove everything rather than just pieces. Several have been helped. To me, it still seems like a last resort option, but I do understand why someone might go right to that option, especially if pain is one-sided.

It’s such a tough call. Does Nangia offer multiple types of surgery? Nothing wrong with a guy who specializes in one approach, but those are tough to get objective advice from. Like Warren Buffet says, don’t ask a barber if you need a haircut. Or, your only tool is a hammer, the world is a nail.

Best wishes.

Thanks for the reply. Looks like I should try a nerve block as a first option

Do most people like Dr P in Florida or Daniel Shoskes, in Cleveland for nerve pain. I can feel my nerves in back along with testicles. Boy I never thought this would have an effect like this to my body.

In the US, I think that Dr. P. and Dr. Shoskes are the two highest volume providers of spermatic cord denervation. I’ve seen them both. Both will do a cord block before doing cord denervation surgery. Dr. Shoskes does not perform vas reversals, but Dr. P. does both.

I believe Dr. Nangia did his fertility fellowship under Dr. Anthony Thomas, my reversal doc, at the Cleveland Clinic like Dr. P. Just pointing out that if you go down the reversal route, Nangia and Parekatill learned from the same great guy. My guess is they’re both quite competent, so I’d opt for convenience and proximity.

Hi. Sorry to hear you’re dealing with this.

I’m not an expert, but from my experience, even the “experts” seem to be guessing as they go when it comes to treating PVPS.

Reversal seems to work with a lot of people. I’m pretty sure I was suffering from nerve pain, but reversal helped. It doesn’t help 100%, but it helps and it slowly got better over time and seems to keep getting better. I’d say I’m at like 90-95% now after a year and 4 months.

From what I’ve read here, and it makes sense, reversal can work like a denervation of sorts by (1) cutting off the stumps / claps / cauterization sites where nerves might be entrapped, and (2) allowing the nerve endings to be put back into close contact where they might heal.

Obviously there are risks with reversal, but my reasoning was that it was a fixing surgery, where as everything else was just more destruction and a one way path. With a reversal, all those other options still remain on the table, were as once you start cutting more, you can’t go back.

My reversal set me back in the short term, but in some ways I felt better almost right away, and I got better and better afterwards.

Best of luck friend.

1 Like

How long after the vasectomy did you get a reversal.

About 4 and a half months. I got my vasectomy 26 Aug 2019 and my reversal 15 Jan 2020.