Post Vasectomy Pain Forum

Please Recommend a Urologist in Orlando

I’m dealing with my second major bout with testicular pain, and this one has been going on 2+ years. I do think it could be post vasectomy pain, and I’m hoping to get some recommendations for who to see in the Orlando area. I saw a couple different uros several years ago, but that facility is gone now, and I wasn’t too keen on the guy I saw most recently (Brooks).

So, fellow O-towners, please tell me about your awesome urologist!

You’re kidding right? Go to the PUR clinic. One of the few doctors that treats post vasectomy pain is located right in your back yard.

I don’t know your situation but they will work with you. They will help with medical management and non-invasive treatments as well as surgical interventions if necessary.

Post your story in your profile so we can see where you have been and what you have gone through.

Good luck.

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I’ve seen Dr. Parekatill at the PUR Clinic outside Orlando and think he’s great. I have a call with him today as a follow up and may go see him in April.

Remember that scrotal/groin pain is REALLY hard to resolve. None of the uros has a perfect record in treating us victims of vasectomy, and there aren’t that many to really choose from. You’ve got Dr. P. in your backyard, so you’re almost obligated to see him. There are others out of town, maybe better, maybe worse. As the old saying goes, “your mileage may vary”, but I like Dr. P.

This is awesome news. I had basically given up for the last year, and just decided to jump back in and dedicate myself to figuring this out. I did actually come across this place over a year ago, but I was still convinced it had nothing to do with the vasectomy, and just forgot about it. Thank you!

Boy do I know it. This is not a new issue for me = ( Thank you for this recommendation!

Just know that if your problems are minor and livable any interventions you choose have a chance to make you worse. Read about other guys experiences. I have started encouraging people to use their profile to create a history of their procedures (dates, provider names, procedures, outcomes etc…) so people can quickly see how other men have traveled this path.

Dr. Parekattil is a compassionate guy with a good bedside manner. He has some novel medical (as in pharmacological) interventions that you should probably explore before doing anything else.

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I understand. I’m definitely worried about that, which is why I’ve been super cautious these past couple years. But this is debilitating. I feel like I’m being randomly stabbed in the nuts throughout the day, every day. And that’s base level. At its worst, I’m laying on the floor screaming. I was about to write out my journey this morning, but a lot of the timeline is fuzzy for me, as I did most of the testing and such several years ago. I’ll try to make time to do this though. I’ve been reading through many posts over the past few days, and I see plenty of people who got no results or worse, so I’ll be going as conservative as possible. I’m VERY pleased to hear you describe him as compassionate with good bedside manner. This is super important to me. I’m in it for the long haul, and I’m fine with trying and re-trying all the less invasive procedures. I have some things I’m not willing to do though. Not interested in nerve pain meds like gabapentin…that shit turns me into a zombie and it’s not worth it. I also will not allow cortisone in my body ever again. I’m hoping he’ll listen to my experiences and agree that if we’re going to try a block, that we only use the anesthetic without the cortisone. It should still inform if the nerve is involved, even if it only numbs me for half a day. The cryoablation seems like the best option to me, but obviously I don’t know a bunch yet. Denervation seems like cutting a bunch of stuff to fix stuff that was harmed by cutting in the first place.

Sean please update your profile. There is a post here that describes the type of information we want people to put in your profile.

Well this is annoying. I just spent over an hour typing this and it’s too long for my profile (even though my word count shows it being way under 3000). Anyway, I don’t have time to try to revise this, so you’re getting the full, giant story right here:

2007 - Vasectomy - Dr. Arthur Albers, Orlando

No complications, the procedure wasn’t too painful and recovery was fine. First orgasm after a little over 2 weeks and it hurt quite a bit…a cramping, shooting pain deep into the right side. But it subsided quick and didn’t seem to happen in subsequent orgasms.

The timeline after this is a little fuzzy.

~2009/10 - Epididymitis - Dr. Albers, Orlando

Aching/throbbing in testicles, on and off. Not too horrible, but went on for a while and decided to go back to Dr. Albers. I recall asking about post-vas pain, but no, he didn’t think it was that. Antibiotics prescribed. I don’t remember how well it relived the symptoms, especially since it was sort of on and off anyway. But I do know I had to go back sometime within the next year, and was once again prescribed antibiotics. I don’t think it fully went away, but it came and went and was tolerable.

2012 - No diagnosis, think it might be musculoskeletal, maybe something to do with my back - Dr. Lemoine/Jablonski, Orlando

This was the first major stint of things getting BAD. It seemed to come fairly suddenly one day. I just remember starting to get these nasty, intense shooting/stabbing pains in my testicles when I walked or stood too long. Then it started happening even when sitting or lying down. The pain tended to come in random waves of shooting/stabbing sensations throughout the day and night. It was hard to tell if sex made it directly worse, because everything seemed to. Any activity or position that put pressure anywhere on my pelvis. I went through the usual gauntlet of tests and checks. Antibiotics, didn’t help. Physical check and Ultrasound for lumps/anomalies, negative. They didn’t seem to even consider post-vas pain, and they ended up sending me to a pain management guy. I don’t remember his name, but he put me on oral steroids. They did help, but as someone who deals with moderate-severe depression, I have an extraordinarily intense reaction to steroids, in the form of super mood swings/depression. I also have stomach issues. Not like I could stay on steroids forever anyway. And the pain did come back.

2012-2016 - Semi stable, occasional shitty flare ups
I just dealt with it, mitigating pain with OTC anti-inflammatories, and working with my primary doc now and then to try various things, from changes in underwear, to special seats, to stretches and exercises. The thing that finally ended this daily pain, was seeing a massage therapist that helped me adjust my ab/core workout routine so that I wasn’t putting so much extra stress on my pelvis. The pain never went away, and it was still hard to figure out what exactly triggered it when it did act up, but it was bearable.
I stayed in this semi-stable state until Jan 2016, when my lower back gave out on me. I had been running for a few months (a new exercise for me), which was causing me some pain, but it didn’t seem like something I couldn’t handle. One morning before a run, I did a basic legs-out-in-front, reach-your-toes stretch, and my back seized up and started spasming like crazy. Massages eventually got me upright again, but the pain was bad. Now since the nut pain had never really gone away, and any physical stress seemed to set it off, it was spiking to super intense levels as well.

Feb-May 2016 - Herniated Disc L5/Compressed Nerve - Dr. Willey, Orlando
Got an MRI and they saw the herniation and compressed nerve. Went to Orlando Ortho and saw pain management guy, Dr. Willey. I asked him if the back issue and nut pain could be connected, but he said no. The nerves from L5 don’t run into the groin. Prescribed physical therapy for back, which I was all about since I’m an exercise lover. PT didn’t help though, both back and nut pains got worse. My PC doc did seem to think it was either directly or somehow indirectly related to my back pain, and my Uncle mentioned getting some nut pain with his back issues, so it seemed at least somewhat plausible that they were related. Even though I had serious reservations about cortisone, I went ahead with an epidural cortisone injection in the hopes it would take care of both the back and nut pain. But cortisone shots in my wrist, toe, and even a trigger point one in my back, had always seemed to give me zero or very, very brief relief, only for the issue to feel WORSE after the effects wore off. I still can’t bend my left big toe after two shots. But, my docs thought it made sense and I was desperate. I regret it. The two weeks following the shot, everything was worse, including the nut pain. It settled down over the next couple weeks, but I never got any real relief for either my back or my nuts, and now everything just felt worse. So much stiffer and so much more pain in my pelvis and nuts. I went back to doing core stretching and strengthening, but everything seemed to make the pain worse. I went back to Orlando Ortho to see the surgeon instead, but he felt surgery would make it worse, and he reiterated that the herniated disc was not related to the nut pain. Also suggested swimming. Which I did, and still do. But the stretching just kept yanking on my nuts…stuff that was supposed to stretch my psoas muscles or hips or lower back would usually spike that stabbing pain, and it would sometimes feel like things were being yanked.

June 2016-March 2017
The swimming did seem to work my core with minimal discomfort, but I would still get some nasty flare-ups. I still wasn’t able to do any good stretching without aggravating either my back or my hip or my nuts. And one of my favorite things to do, walking, is one of the worst triggers. Within 10 minutes, my back my start to hurt, and my nuts definitely will. Sometimes it’s just some achiness and a few stabs and then it’s not too bad, but usually it stays triggered with the on-going stabbing for a few days, if I push the walking enough. And sex? Yeah right. It would make my back spasm, and the stabbing pain would start in my nuts too. But the nut pain didn’t usually happen right away, not immediately as I ejaculated. It usually crept up over the next several minutes or hours. And could stay triggered for days or longer.

March 2017 - Feb 8, 2018 - Maybe an ablation? Fuck it, I quit - Dr. Dycus/Dr. Brooks/Dr. Radahd, Orlando
I seemed to be getting more and more triggers, so I went back to my primary care. We talked about maybe it was time to consider a nerve ablation, or some other form of killing the nerve (he wasn’t sure what the current techniques were).
Before going to the new pain doc, I wanted to see another uro, since it had been years. But I went in with an objective: to get him to agree I should try the nerve block. That’s not to say he just went along and wasn’t thorough, but I immediately discounted that it could be the vasectomy, because that’s what I have been saying for years…the stuff I read about it didn’t seem to fit my pain, and I didn’t WANT it to be that. I loved getting rid of the chance of mistakenly procreating, and with no docs pushing for that idea over the years, and my own insistence it couldn’t be that, that’s just the narrative I stuck with. I wanted to be able to help my back pain and my nut pain at once, and it seemed plausible, and just less scary, than it being specific to my nuts. Still…it seems like one of these uros would have at least questioned me a little harder on it, but as I’ve seen from reading through posts on here, it’s a bit of a mystery to many docs anyway. He did seem to think it was something musculoskeletal and said to try that nerve block.

Dr. Dycus then called and consulted with Dr. Radahd, and I went to meet with her. She offered a nerve block for the ilioinguinal nerve, but said outright she wouldn’t do an ablation. That, along with the GF and Pudendal nerves were familiar to me, so that made some sense, but once she explained that it would include cortisone, I said no way. Every single time I’ve had cortisone, my issues got worse. She didn’t seem to think my concerns were legit (with an eyeroll to go along with her shitty tone), but she did offer to do the shot with just the anesthetic. This obviously wouldn’t give more than a day (if that) of relief, but could at least tell us if that nerve was involved. But considering she seemed so averse to doing anything beyond that, I didn’t see where it could go. I got frustrated and just sort of quit.

Feb 8, 2018 - Now
Woke up on the morning of the 8th around 3am, in pain, and super tight and stiff. Pissed off, and motivated by it, I got up and decided to see if my body could handle stretching my core yet. To my pleasant surprise, it could. This little act helped kick start me into getting back on the FIXIT bandwagon. I’m not done yet, you bastard pain. I had also recently found an incredible massage therapist, and she is excellent with disc and nerve pains. I worked with her to design a super intense and targeted massage routine to keep my back/hips/pelvis loose, to possibly help the nut pain, or at the very least help me better ascertain which pains are which. My back/hips/pelvis feel looser and more stable than ever, after the last few weeks of daily stretching and a couple intense massages (every 2 weeks), yet the nut pain persists. The past month or so, it’s been more persistent than ever…as in I’m feeling the base throbbing/achey pain almost 24/7, and on top of that I also get the random stabs that make me stop in my tracks (or jump in my seat) and scream. I guess that’s what lead me to this site. I needed to do some research to figure out my next step. It was here that I started to reconsider that this all could really be from the vasectomy. I’ve seen many posts describing pain and triggers that sound very much like mine. I feel like it could be nerve pain caused by the slicing and dicing. I don’t seem to fit the experiences of the congestive type pain, but the neuropathy one fits. And that would make sense as to why the same activities aggravate my back/hips and my pelvis/nuts. I just made an appointment to see Dr. P at the PUR Clinic, but I’m still really anxious about the whole ordeal. I still don’t have a clear idea if this is from the vasectomy, or from something in my back/hips, but I do know that I can handle the back pain, but not the nut pain, so I’m making that my focus. Hopefully Dr. P can help me make sense of this…we’ll see.

That’s a really detailed synopsis. Maybe you can condense it in your profile and/or include a link to this post. I’m sure there is a way to do it. I got my vasectomy in 2007 as well btw. I saw you have bad reactions to steroids as well. We have a lot in common. I’m at work right now but I will read this when I get a break. When you’ve been suffering with this a long time it can be a pain in the ass (and emotionally taxing) to lay it all out in a timeline like that. I think it’s good to document it though. If this place is nothing else, it’s a good archive/artifact of men’s experiences with bad vasectomy outcomes. The narratives kind of speak for themselves.

Thanks Mike, I appreciate your feedback and sharing. It did feel kinda therapeutic to lay it all out like that. I know it’s super long, but I still feel like it’s missing a lot! Hopefully some people will get something out of this, even if they just skim it. Has yours been going on the whole time, or on and off? For now, I think I’ll just put a link to this in my profile. I’ll try to make a short version at some point.

I have had two periods, pre and post reversal.

Post vasectomy the issues were continuous but the intensity varied with it getting worse over time. My vas was a non-event, nothing special or traumatic. I was fine. After that my symptoms can best be described as a frog in a pot of boiling water. I had continuous discomfort, pain sitting, sleeping, nonstop urological urgency until it got to point where I could not take long car rides, watch a kids play, movies etc.

Post reversal I had recovery from surgery, which sucked, then a period where things gradually improved to where they were really good then some pain returned. I’m kind of stuck at that level now. I still have some issues with sitting but I can at least do it now. The problems are nowhere near as bad as prior to reversal but not at a level I’m happy with. I am at work typing this. I can sleep through the night now too. I get issues if I sit too long. No testicular pain at all. Just groin pain where I was cut and fixed.

Like everyone else my situation, my symptoms, the path I chose are unique to me so don’t take what I said as advocating one way or another what you do. I tried a lot of different things in the first 5 years. Many different therapies, remedies, cushions, kneeling chairs, recliners, acupuncture, nerve blocks etc… I exhausted a lot of different avenues before more cutting which is the way to go.

Well I’m glad you’re better than you were, and I sincerely hope you continue to improve. Thanks for sharing this, it’s helpful to read these.

Ryu, I know it’s been a couple years, but can you provide an update on your current situation. Did you have any luck with Dr. P at the PUR clinic?

I actually just saw Dr. P back in June 2019. I don’t recall what I shared, but I have a herniated disc/pinched nerve in my low back, and I’ve always thought the testicle pain was either directly or indirectly linked to the back issue. At the beginning of 2019, my back pain destabilized after doing well for a while, and sure enough the nut pain came with it. But I didn’t have much luck with the one epidural cortisone shot I did for my back years ago, so I felt like there was nothing I could do for my back, sans surgery, which I do not want. I decided to try focusing on the nut pain and that’s when I visited Dr. P. I thought he was great. Explained things in detail and answered all my questions. But I just wasn’t down with dropping $700+ on the spermatic cord nerve block, just to see if I might then be a good candidate for the who-the-hell-knows-how-expensive surgery. Even with good insurance, this shit would leave me in a huge financial bind. So, I switched focus back to my low back and went ahead with a series of 3 epidural cortisone shots to try stabilizing my nerve pain. This time it worked fairly well. My back is kind of semi-stable, and stays bearable unless I tweak it. And as long as my back is stable, the nut pain stays away. So that’s where I’m at now.

Thank you for the update. Did you have back problems prior to your vasectomy or did the back issues happen after?

You can check my story Another Personal Journey here

But the latest is I saw an Ortho PA yesterday and he said my X-rays show arthritis in my back that is casuing the issues (Or a possible herniated disc, havn’t done an MRI yet).

I have had some minor (minor because I never went to a Dr. for them, but maybe should have) back issues in the past, I injured my back about 10 years ago when I was 24 chainsawing logs, and I never went to see a Dr. about it. It was a pretty bad injury. I thought I just pulled a muscle in my low back, but I’ll never know. I couldn’t walk normal for months. Took a year for me to feel OK after that injury, but after that year I was back working out hard in the gym, but my low back has been gave me problems since that initial injury.

I wonder if guys that have low back problems are not good candidates for Vasectomies because the nerve pathways that can get irritated or damaged during the procedure. I would like to know if I would have developed this pain in my scrotum without the vasectomy because even when I hurt my back 10 years ago I never had scrotum pain.

Thanks again for the update.

No problem man. Yeah, I’ve always had back problems. Or at least as far back as my martial arts days in high school. I didn’t have the actual herniated disc/pinched nerve until 39, but yeah, plenty of low back pain on and off, depending on what activity I was doing. Dr. P did say it was possible for back issues and scrotum pain to be linked, which was another reason I gave the epidural series a chance. I think you’re absolutely right about the link between back pain and vasectomies. Nerves are fucking weird, as doctors love to keep telling me, and I do think people with low back issues should be warned about vasectomies. My personal opinion is that the cutting done in the scrotum caused some scarring or some shit, and that nerve is just ready to aggravate at the drop of a hat. So if my back starts up, that nerve joins in. I get a lot of referral pain, actually, through my pelvis and hip too.

Arthritis is a fucking bitch. That hasn’t been brought up in regard to my low back, but my left big toe joint has a ball of concentrated arthritis that takes up 20% of the joint. I was limping for over a year until I finally got a cortisone shot for that a couple months ago. I’d probably push for the MRI to rule out the herniation. I really hope it’s not herniated. You don’t want that shit.

I also have a neurosurgeon on tap should I decide to consider back surgery. I plan on consulting with him before June, since they want a recent MRI within 6 months, and I just had one in December. I really, really don’t want surgery, but we’ll see how the next few months go. I’m currently stable, but it’s SUPER easy to aggravate things, and I wonder if surgery would actually be a good option for me. My biggest fear with surgery, though, is that it will either temporarily, or worse, permanently cause more/additional pain in my scrotum. That link is a bit mysterious, and no one can really guarantee me the back surgery won’t spike the nut pain.