Post Vasectomy Pain Forum

New non-surgical treatment option for chronic testicular/groin/PVPS pain - Dr.P, Avant Concierge Urology, Winter Garden, Florida

Dear all,
Just wanted to inform you a a new non-surgical option that we offer for chronic testicular/groin/PVPS pain. There has been a lot of research focusing on the use of stem cell derivatives (exosomes) in the treatment of chronic pain. We now offer targeted exosome injections in the peri-vasal/peri-cord area to try to help reduce the pain. It is a simple office based injection procedure, just takes a few minutes, under IV sedation or nitrous. So far we are getting about a 60-70% response rate (>50% reduction in pain). Not sure how durable it is (only have a few months f/u so far). It is not covered by insurance, and is expensive. It costs $5000 for one side, $6000 for both sides. If you are interested, feel free to contact us at:

I still think, reversal is a great option for men with PVPS and I tend to lean in that direction as the first line surgical option, followed by targeted denervation, and then cryo, and then botox. However, exosome injection could be an option for patients who are just not ready for surgery.

Dealing with PVPS or chronic testicular/groin pain can be quite debilitating. We are trying our best to give patients as many options as possible and we are always looking for better ways to help these patients. The key is to stay positive and have hope. The technology and treatment modalities in medicine keep getting better. Our understanding of PVPS is not great, but we are making strides and we are trying diligently to try get more awareness and options for patients dealing with this debilitating condition.

Sijo Parekattil, MD
Avant Concierge Urology
Winter Garden, Florida


Thanks Doc. Great to know there’s another conservative option.

Do you have an opinion on Radio Frequency Ablation and Pulsed Radiofrequency?

@myballshurt, I’d like to know that, too.
And also, what do you think about GF or triple neurectomy?

Hey Juno, hope you’re doing better these days. These are really good questions by you and @myballshurt.

I had pulsed RFA on my left GF, and it didn’t help. That said, the GF injections done by that same Pain Mgt. specialist didn’t help. GF injections done by Dr. Williams in office, by a radiologist while doing a dynamic ultrasound, and cord blocks by Dr. P. and Dr. Shoskes ALL WORKED, so I’ve concluded there might be something wrong with my Pain Mgt. specialist’s technique. To his credit, his injections and pulsed RFA on my pudendal DID work. I would try pulsed RF again, likely just with someone else.

I spent a lot of time researching neurectomy. Dr. Williams at the Dellon Institute recommended triple neurectomy for me. As I recall, his opinion was that there was too much risk of nicking the II/IH while removing the GF, so he suggested doing all 3. Dr. Krpata at the Cleveland Clinic favored laproscopic GF neurectomy and wasn’t concerned about potential damage to the II/IH while doing that. Different surgeon, different opinion I guess.

I have a rough time still. Struggling with testicular pain, swollen painful toes and fingers and lower back pain since November. Still battling my divorce case, so also mental load is still high. I don’t see no light yet, and have no clue what to do about my PVPS. I need to wait for my private life to settle, before taking on the pain.
I’m thinking lately a lot more about reversal again.

Hang in there brother!

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