Post Vasectomy Pain Forum

Pain began 8 months later. Comes and goes

I had my vasectomy in Either August or September of 2019, I took a full week to recover, everything healed fine. I was even back doing Jiu Jitsu 1 month later and didn’t feel any pain or discomfort in the boys. February 5th I had some pain and tenderness in both, Urgent Care found some swelling and inflammation (ultrasound) so I was given antibiotics for epididymitis and everything got better. April 18th, it started again, severely. It started as I was taking my daily walk. I felt a random pinch in my left vas, and it lasted all day. Nurse advice line was scared for torsion so they sent me to ER. Ultrasound again, all was fine. Ice, call my urologist for followup if it doesn’t get better.

It doesn’t, so a week later Urologist calls me (damn covid, can’t get in person checks yet) does the usual asks, and tells me its probably a granuloma or PVPS. He thinks my need to pee all the time is just anxiety. (which I admittedly was having a bad episode) So I suck it up for a week. Eventually see an Urgent care doctor in person who says I’ve got some swelling in the prostate, its tender, so he prescribes me antibiotics. Coincidentally, my testicle pain gets better for a few weeks. Still minor nagging pain, but not enough that I need to take ibuprofen every day.

May 5th I go back to urgent care because now I found a lump, and it was tender, and I’m peeing more again. Ultrasound and pee tests later: its just a regular ol’ cyst. But doc gives me antibiotics again, just in case. While I was taking them, all the pain was completely gone, still had to pee though.

Two days after my antibiotics finished, the testicle pain started back up again, and after another follow up phone call with my Urologist, he’s convinced I’m just having neurological pain. But because it’s usually so minor except a couple random spikes here and there, he doesn’t want to prescribe nerve medication or shots yet, unless my pain becomes worse or interferes with my daily life. My pain is only usually a 2-3, and that’ll stay around for a few days, maybe two weeks. Sometimes I don’t even feel anything. The worst I’ve had it so far is a random spike that goes to a 5, maybe 6, but those moments are thankfully rare. The pain is most always located in what feels like my vas, shooting from inside down towards where the cauterization is.

So I’m here. Venting mostly. But I’m also wondering if neurological pain can appear much later like this, after a period of no pain and normal function. It feels out of nowhere. I’ve had several blood and urine tests (including cultures) from Urgent Care doctors and they feel confident I don’t have a chronic infection. So I’m left with the usual: inflammation, congestion, nerve damage, or pelvic floor.

I’m starting to do the usual suggestions to see if anything helps: Pelvic floor exercise, yoga, papaya seed, I’m finding an appointment to see acupuncture, see if that works. I’m also trying to get in contact with my Physical Therapist, to see if there might be any chance I’m experiencing a trapped nerve (because admittedly my lower back is generally in pain, and I’m a desk worker with awful posture).

Is it worth finding a second opinion from another Urologist? I don’t know if I could gen another diagnosis or things to try, but I’d at least like to find one that feels a little less flippant.

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Sorry to see you here. The answer to your main question (“can this happen 8 months later”) is definitely yes. Several on this forum developed PVPS weeks or months after a normal recovery, including me. My vas was early March 2005 and pain onset was late Oct 2005. Ended up chasing ghosts with my vasectomist through Feb 2006 when I found a PVPS conversant uro who reversed me after trying some pain management injections.

This is really hard to diagnose but, in the end, if it’s nerve damage (some uros call it Wallerian Degeneration), it’s very stubborn but can be conquered. I had 10 good years post-reversal but had a lengthy setback 2016-2018. Been pain-free again for about 18 months.

Personally, I think there’s a lot more of us PVPS sufferers with nerve damage than congestion, but that’s just my guess. Reversal (vasovasostomy) can help with both because of the excision of scar tissue. One uro called reversal a mini denervation.

I’m more of a fan of injections for pain than surgery, but I was very close to trying spermatic cord denervation or even laproscopic removal of the GF nerve. Either way, take your time and do your homework on those two options. Mixed feelings on the forum here.

If you’re comfortable waiting it out, that’s not a bad idea, but injections are fairly safe. Had them in groin and back. Personally, I find them to be lower risk than months of mind-altering pain drugs.

Always good to get multiple opinions.

All the best.

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My two cents. The correlation with antibiotics might be saying something. They often have anti inflammatory properties. Try the papaya seed but give it time, and take notes along the way, because it is slow acting. Celebrex has been the best nsaid I’ve tried for pain and inflammation. PT was good for me but ultimately it was treating symptoms, not the cause.

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I think you might be right with the inflammation, I’m gonna focus on diet, papaya, the usual health supplements for inflammation, and general fitness for now. Though inflammation typically has a cause right? Maybe that granuloma is still knocking around.

To be honest, most days I’m about a 0-2 on the pain scale (10 being worst) and only around the first two weeks this started did I have a few days of constant 3-4 with spikes of a 5 or so. Everything since then has been super mild. So I’m really curious how bad some of the other people’s pain here is, specifically the ones that developed pain (possibly nerve pain) a significant time after their surgery. I’d also love if I could find a story similar to mine that has success either 100%, or at least high 90’s. (my search results don’t seem to do well)

I’m gonna continue to shotgun all the conservative options and journal my pain daily to see if I find any correlation to a trigger, and just avoid those. I noticed handling my balls in the shower, specifically feeling around my vas where the snip happened caused me about an hour of pain, so I’ll just avoid doing that.

I’m also trying to be celibate for a week or two, completely avoid any sexual activity. If I get pain still, then I can probably rule out congestion as a cause. I finally have an in-person appointment with my Primary about my lower back. Hopefully relieving some potential nerve damage there (sciatic pain, tingling feet, hot shocks on my inner thigh) But given how it feels like its radiating between my vas snip site and my inguinal cal, it makes the most sense to me that I’m probably experiencing that nerve degeneration. We’ll see.

My pain was typically low like yours 0-2 but with bad short flare ups every few weeks, with pain often >6. Usually but not always triggered by activity, sometimes 9-5 at a desk was enough set it off. I’ve posted my timeline and treatments if you look up my posts.

Where is your granuloma? Mine were on the ends of the vas but developed within ~3 weeks. They are a sure sign that you are leaking sperm. Which in turn is a sign that your body can not keep up with the build up. The sperm in places where it shouldn’t be sets of immune and inflammation responses which seem to vary widely between men.

Unfortunately you are unlikely to find a story just like yours or success rates >90%. It either gets better with time or you get sick of waiting and try something surgical. General consensus seems to be wait a year before any surgery, but some don’t and I can’t fault them. I waited almost 2 years and I am right now recovering from a reversal, which is no picnic either, and I won’t know if it helped for sometime.

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I had the same pains, radiating all the way to my inguinal canal and flank, where the trousers belt is. For a while I thought it was either hernia and had scans.

One of my family uros explained that this is most likely caused by inflammation, as excess semen is being broken down and removed via lymphatic system, irritating nerves. Pains kind of went away after ~8 months, but were always there. Ended up having reversal, but even this isn’t a magic cure as it leads to complications too.

@WtfMyNuts Does it make sense that a leakage or inflammation pain would suddenly sprout up after 8 months like this? I’m sure there are a million stories where it has, it just seems weird.

I feel a lump on my right vas right where the incision happened. I was electrocautery, and I guess I just never thought about why that side was lumped and the left side isnt. The pain is definitely both sides, so it’s probably like you’re saying, and more than just exclusively the granuloma. Do those show up in ultrasound? I’ve had 3 so far and no one has called it out specifically yet. If I’m leaking sperm, is abstaining from ejaculation for a week going to show any difference? At least as a diagnostic tool.

@SomeGreyBIoke. How low did the pains get for you when it started to resolve? I’m assuming it was still fairly painful if you still opted for the reversal.

So 1st, I’m not a Dr. I’m giving you opinions heavily colored by my experience. That said…

Yes, only because there are stories on here where it has happened. Maybe it was something physical that put more pressure on them one day, maybe that’s how long it took for your body to build up an army of sperm, maybe it was leaking all along, maybe your immune system flipped out. There’s not much point in wondering what exactly happened unless you are entertaining the idea it’s something else not related to the vasectomy.

Yes, I believe a granuloma should show up. My uro was able to diagnose those by touch, so maybe they don’t look for them in ultrasound?

I don’t know. It might help you with pain that’s congestion/epidemitis related. Many men report pain after ejaculation. But I don’t think it would help you diagnose sperm leakage more specifically out of the broader bucket of congestion.

The only thing I’m considering that is not vas related would be my low back pain. I’ve read stories here that vas pain can occasionally cause sciatica pain, but I’ve had sciatica for years before my vas, so a small part of me Hope’s that working from home and pandemic, all this sitting has caused some lower disc to pinch a nerve, but I know it’s a fools errand.

I havent seen my uro in person since the pain started because of quarantine, but my state is finally allowing in person specialist visits again, so I’m scheduling an actual look. My hope is that I can just narrow down if this is nerve or congestion (or something else) so i can at least tune the right knob with my self attempted therapy. If it’s all nerve damage, for example, and has nothing to do with congestion, at leasr I can go back to my normal sex life without worrying that I’m aggravating things. No need to abstain a few days a week if i dont have to.

Maybe not really painful, but I was mentally battered and just wanted some closure. It got to the stage where I had costant low level dull ache from the inside of the testicles, maybe 1 on the scale, and feeling of pressure building up in the epidydymis. If for whatever reason I was a bit more physically active, then it would get to 5 for around a day.

I wouldn’t say the sciatica connection is a fools errand especially if you have a history with it. Going down the PT route has almost no risk and might help you pin point the issue. Pelvic floor PT, yoga, stretching, chiropractic work all helped diminish my “secondary” pain and locate the source.

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I saw my doctor today about my sciatica and the thing that stood out to me the most was how through and willing to explain things he was. He talked to me about the tests he was doing, and why because they were all good that he sees no reason to order an MRI, but to increase my PT, and take more time to focus on posture and stand more. I feel very reassured with all this.

But also a little disappointed that it likely has nothing to do with my ball pain. Finally got a referral for acupuncture in network, so I’ve got that coming up to try.

I’m feeling emotionally up and down, but I’m finally coming into the more level state where I am accepting that this pain is here and looking for ways to manage it, more than I’m looking for ways to stop or prevent it. I’m not panicking as much that something unknowable is wrong with me.

The two things left to deal with mentally for me, is worrying that I’m waiting for the other shoe to drop and going to get a flare up of 6+ pain or something, without knowing what specifically I did to cause it, or it’s just pure random. And the other being not wanting to end up having to feel like I need to take tylenol or an ibuprofen every day for the rest of my life. I tend to like my kidney and liver quite a lot.

I went to another Urologist on July 2nd for a second opinion. I haven’t had much pain at all since my last post. Maybe a little tenderness, or some slow radiating 1-2 pain in the vas area.

What amazed me about this Urologist was how much more willing to explain things he was. Gave me time of day, explained the mechanics of pain, what was likely causing my pain (in his mind my all day sitting and stress were major contributors) and gave me a full 25 minutes of face to face time to answer all my questions, and gave me avenues of things to try. He looked at my Ultrasounds, gave a physical examination to check for anything out of ordinary.

One thing that stood out to me as he explained was about my cyst. He explained it like blowing up a circus balloon. The first few breaths expanding it are the hardest. So it would be normal to feel the most pain when my cyst started to grow.

Which kind of sucks, because today it started to grow again. I was feeling normal aside from a headache and decided to go for a walk like I have been the last two weeks. After a few minutes I got a random spike of pain around 4-5, and got 2 or 3 more spikes before getting hit with an 8. They never last more than a second, but man, it got my anxiety spiked up again, checking for torsion just in case. I noticed that my cyst area was tender again, so body is probably just acting up. Maybe from the lack of exercise the last 2 days, maybe from trying to eat a butt-load of sushi last night, maybe just random. Either way today I’m back to doing stretches and icing my balls.

Thankfully though my constant nagging pain seems to be subdued for at least a moment. Again either random, or because of the pelvic floor exercises and papaya seed. I’m desperately hoping that they’re working, because living with this as just completely out of my control would suck.

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