Post Vasectomy Pain Forum

Pelvic Pain Syndrome - Hope

It’s been an interesting few weeks.

I had a consult with Dr. P about two weeks ago. It was positive, and brought some hope and it was a relief to talk to a Dr. who knows the issues, has helped others, and has a larger data set to draw on.

Also, from a previous post here @Acschiro suggested I look into the possibility of having pelvic pain issues. Which I did starting a the day after talking with Dr. P. In my area there has been only one PT who seems to specialize in Pelvic Pain disorder, and even though her next opening is the end of September she spent some time on the phone with me and suggested 4 different books to read which I ordered and am about done with the second one and 1/5 of the way through the 3rd one (Listed below if anyone is interested).

Through my reading I am fairly certain (though I haven’t been officially diagnosed) that I was having pelvic tightness before my vasectomy, and the vasectomy triggered my body and caused the issues to escalate. In addition, my anxiety (which was high already) has been off the charts over the last few months contributing to my pain issues.

Over the last couple of weeks I started a medrol pack prescribed from Dr. P, started taking anti-anxiety medication, and started a stretching program from book #3 listed below and I have seen a lot of improvement over my pain levels. This is hopeful, and though not everything is solved, and perhaps never will be, I am back to a more functioning level with long stretches with no to minimal pain.

Most of my symptoms have been pain in my groin (where my leg meets my body) as well as a burning feeling in the tip of my penis (negative for UTI or other urinary infections) which is a pain symptom discussed in the pelvic pain books.

Without this forum this possibility would have never occurred to me, so thank you to those who have been willing to share their experiences and knowledge here. It is possible that I may get better in time and I feel terrible that so many of you are still in pain and have had the experiences you have.

I wanted to share this in case anyone else coming here might be experiencing something similar to myself.

Pelvic Pain Books:

  1. A Headache in the Pelvis, 2) Pelvic Pain Explained: What you Need to Know, 3) Heal Pelvic Pain: The Proven Stretching, Strengthening, and Nutrition Program for Relieving Pain, Incontinence,& I.B.S, and Other Symptoms Without Surgery, and 4) Ending Male Pelvic Pain, A Man’s Manual: The Ultimate Self-Help Guide for Men Suffering with Prostatitis, Recovering from Prostatectomy, or Living with Pelvic or Sexual Pain

What anxiety meds you taking?

Citalopram - 10mg right now. That seems to be enough to take the edge off.

That’s an SSRI. Those work really well for some people. I’m glad it’s helping you. One benefit of those medications is they can sometimes really help with neuropathic pain as well. If that’s what it takes then you will probably be in good shape.

I have problems with them. I have weird deficiencies in the enzymes needed to metabolize those medications so I get bad side effects. SSRIs give me bad sexual dysfunction (hard to orgasm etc…) so I don’t like taking them. For folks they work for they are good medications, preferable to tranquilizers.

Not to pooh pooh stretching but if you are taking Citalopram it’s possible a lot of the relief you are feeling is the action of that medication calming your pain.

I just want to also say that this type of pain you have “Most of my symptoms have been pain in my groin (where my leg meets my body)” is almost exactly the same issue I have. My original urologist accessed my spermatic cord in that location in stead of more in my scrotum during my original vas and that’s where all my problems are at.


Thanks for the insight. In talking with Dr. P he did mention that the anti-anxiety medication could help with the neuropathic pain as well. You might be right that the med is helping and most of my relief could be attributed to that. Or possibly in conjunction with helping to calm my body, which is helping with the pelvic muscles getting to relax as well.

I did take another anti-anxiety medication a couple years ago when my panic attacks started (Effexor) that gave me the side effect you described (could not orgasm). But this one seems to be working ok for now.

Do you think that it’s possible that after a while of being calmed down for a while I can quit taking the medication (my current plan is to take for at least a year)? (I realize you are not a doctor so will take your possible opinion with a grain of salt)

@MikeO -

I’ll add that I suspect pelvic pain syndrome is also a culprit because of a few other issues that can present when dealing with pelvic pain issues: urgency of urination, constipation, lower back pain, inner thigh muscle tightness, pelvic joint pain.

So agreed that the medication is probably limiting the pain censors, which is also calming my body, allowing me to be able to relax and the stretching is helping additionally as a way to relax my pelvic muscles (this is all my very unscientific, officially undiagnosed, and untrained opinion :slight_smile:)

I have heard doctors talk about how pain can create “memories” in the nervous system and more specifically that the longer you are in pain the harder it is to control so I would think anything that turns it off might work in reverse.

I have been back at work not even two days and the niggles are starting up on the left side again where it gets pinched when I sit.

So of course - as the universe seems to have it, I wrote this post yesterday, was feeling good, and then started to experience some ringing in my ears yesterday. Apparently tinnitus, or ringing in the ears, can be a side effect (in a very small population) of SSRI anti-anxiety medications.

So not sure if I am actually having legitimate side effects or if my anxiety is now playing with my head.


I’m sure it’s just a brain tumor.

Haha I’m sorry I couldn’t resist.

The really sad thing is with a brain tumor at least physicians would know how to treat you and you would have a good chance of getting better with a good quality of life.

@MikeO -

In my best Arnold voice - “It’s not a TUMAH”

For real - damn it man, was feeling good. Then you had to bring up the SSRI information, now if I have to change medications and I can’t take the SSRI type the pain might come back…FML.

Tinnitus and pressure at the ears can also be a side effects from vasectomy itself. And yes, several medications have affected my tinnitus in a wrong direction.


Did you have tinnitus previous to taking medications? Did it make it worse permanently or did it subside once you got off the medications?

I have never had anything of the sort before. And honestly, I was stressing a bit after posting here yesterday (even though this site has been very helpful it also increases my anxiety a lot) so I’m wondering if I just started freaking out and the slight ringing episodes (which I have had before, random ringing in my ears) is a side effect of the anxiety.

My tinnitus comes and goes… and it got worse with some meds. And wore of again, when i stop with the medds.
Neurologic pain / neuropathic pain can give you these tinnitus symptoms. The only thing that helps me is tramadol.
I read your story, and try pelvic floor stretching sounds very wise.
You have to go slowly

Thought I would come give an update:

Pain levels have been essentially at zero. I have been seeing a pelvic floor PT who is awesome. My pelvic floor and the surrounding muscles are super tight, I’m pretty sure I’ve been this way for a long time, but the vasectomy and ensuing anxiety was a major trigger.

Fortunately, I think I’ll be able to get out of this with some more work and making sure I keep up a stretching/relaxation regimen. I feel for many of you here that have things much worse, and I keep praying/hoping that you all find the relief and peace that you seek.

1 Like

@SunbeltRed what kind of stretching have you been doing? What things did the pelvic floor person do for you?

Echoing JSH, if you don’t mind because I know first-hand that pelvic PT gets a little graphic/embarrassing to describe, please let us know, especially your at-home regimen. How often, what stretches, any “devices” for internal massage of the internal pelvic floor muscles etc. Don’t worry if it’s TMI. I did 8 pelvic PT sessions last year this time. It definitely helped, and I’m starting again tomorrow.

@jsh and @raising4girls -

Will try to post more details later when I get home today or tomorrow.

I haven’t had any internal massaging done. It’s been mostly a lot of her deep massaging the soas? muscles (where the abdomen connects to your hip area), quad, hamstring, thighs, and then stretches that she can do that I can’t do on my own.

She did connect me to another one of her patients that I was able to have coffee with who has been through worse PVPS than I have. She uses a dry needling technique on him, which I have been hesitant to do yet…but maybe one of these days. I’ll try to post some pictures of the stretches I do (or am supposed to do at home) later when I can.

@SunbeltRed Hey Pete. I’ll second some of the other guys and would like to know what the PT is doing. I’m going back to mine to help figure out a tight rope like muscle I’ve got in my pelvis. I think it’s probably the psoas but I’m not 100% on that. An orthopaedic surgeon offered to order an MRI for me. Since it was only a $100 copay, I took him up on it. However, nothing was found and he was only guessing at would it could be, so I’m going to go back to her and see what she says. Glad to hear your better. Thanks for the updates.

As similar to the OP I know somewhat what your going through. I have had bad anxiety over the last few years. Prob pelvic dysfunction prior to vasectomy although I never noticed any symptoms Also mild crohns ( in retro spect prob had for 15yrs since mid twenty but the flares I did get but didn’t know what was going on always resolved within a few months) that didn’t get diagnosed until after the vasectomy ( wish I knew prior I would have never had it done) and pelvic pain syndrome ensued about 2 months post vas and progressively gotten worse. It’s been absolute hell. Every single muscle in my pelvic floor is in dysfunction.

I also was on celexa for about two years prior to all this starting. I stopped on my own because I just didn’t feel right. Also depression with the anxiety. I tapered off appropriately but had horrible suicidal thoughts too so be careful with these meds.

I’m considering a reversal once my crohns is under control (few months away still). I started pelvic PT with one of the best guys in the country. It’s mostly internal myofascial release techniques. I’m going on week 4. Problem I’m having is my PVP symptoms are starting back up. Not sure if it’s from the PT itself but I was doing fine the last two months pain, sexually and testicular area wise but not rectal, strain to go both ways, prostate type issues, etc. I was just happy I was able to have fairly normal sex with my wife.

Now left testicle is very sore and tender, burns when I pee, no infection, etc. Maybe I’ll consider going back on celexa. Not one provider I’ve seen has mentioned it for pelvic pain. I’m so resistant to it for multiple reasons but it did help those years back anxiety wise but lost its affect somewhat and that’s why I stopped.

I’m currently on imuran, budesonide, and 3 antibiotics for crohns. Xanax for anxiety but my doc limits me to 1 a day so honestly not much help. And gabapentin for what it’s worth. My current depression and anxiety state is through the roof ( stressful job, 4 young kids, stay at home wife, sole financial burden, you name it) and everyone is telling me I need to control it but not giving any viable options. Relaxation techniques and the like just are not going to work at this point for me I’m to far past that and they never really have because it’s a chemical imbalance/response issue IMO. I can kill myself trying to change my perception and outlook but the reality is the external stressors are not going away and cannot be changed at present time. I cannot overcome them mentally or possibly even physically at this point.

Just sharing and venting at the same time so thanks to the forum and members

It’s been a couple of years now. I hope you’re still having zero pain! Any chance we could get an update?