Post Vasectomy Pain Forum

Post Vasectomy Pain Appearing 3 years AFTER Vasectomy

Hi Everyone,

First of all, THANK YOU to all the guys who are posting on this topic as I am new to this site. I’ve been reading a lot of your posts and figured I would share my story in the hopes that I can finally get resolution of pain to my problem (don’t we all) and maybe my story will help someone else out.

Here’s my story thus far. Had a vasectomy back in Jan. 2018. I seemed to heal up just fine. Pain was significant, but I rounded a corner on day 8 after the vas. Pain subsided after another couple of weeks. Had no problems whatsoever until Jan. 2021, although in hindsight, problems may have been brewing for several months before (maybe even a year before). I am going to be as detailed as possible because I think a lot of guys explain their story and forget about how the onset of pain started.

So, about 2+ years after my vasectomy, I started feeling this very mild . . . and I mean very mild pain in my butt bones, as if I rode a bicycle for the first time in a while and my butt bones felt a little bruised. Yet, this was happening even though I had not ridden a bicycle in a while. The pain was so mild that I forgot about it for a long time. Fast forward to Jan. 2021 (several months later) and I all of the sudden started getting a strange stiffness in the inside of my thighs after exercising even though I was pushing myself anymore than I normally do. The pain still wasn’t enough to really concern me and I continued to work out like normal.

After a couple of weeks of this, one day, I did my normal routine on my stationary bike, then did some hip stretches. Then, went to take a shower. While I was bathing myself, that is when I realized the shit had hit the fan as I noticed my left testicle was sensitive to handling and was swollen (and a little red).At this time is when I also started having significant groin pain on both sides. I paid a visit to my urologist who diagnosed me with epididymitis in the left testicle, which is still visibly swollen as of this writing (sort of golf ball sized).

That’s when I started wearing the scrotal supports (compression shorts 24/7), taking NSAIDs and warming and / or icing my cojones. It is now about 5 weeks after the onset of testicular swelling with no improvement whatsoever. When I say 5 weeks, I feel like a newborn baby in this new journey that I am on based on what I have read in many threads so far.

I just ordered some papaya seed powder (organic) as I have heard this has helped some guys along with the omega-3’s. I’ll try this for a few weeks and let you know how it goes. I have seen my urologist a couple more times since my original diagnosis. At first he said heat, ibuprofen and scrotal supports were the way to go and that sometimes the epididymitis “burns itself out” and to give it time. The second time I saw him, I brought up the possibility of an epididymectomy and he said that was an option. However, the more I read about that, the more I want to RUN from that as an option. The third and last time I visited my urologist was a week ago and I mentioned to him that I am experiencing groin pain on both sides. At that point, he said he was going to refer me to a guy who was good at doing vas reversals. As a surgical option, this would be my first choice as I like the idea of being put back together inside of having more parts removed.

I have read several posts so far by many of you regarding your vas reversal experiences and it seems quite obvious that the recovery from that could take years for full pain resolution (if it even happens), which scares the crap out of me. I feel like I’m in the first inning of an extra-inning ball game here . . . a long way to go.

So, my questions for anyone reading my post to start off are:

  1. What were your initial symptoms? Was it just scrotal pain? Did it include testicular swelling? Did it include groin pain? My groin area on both sides is a bit puffed out clearly visible to the naked eye in addition to the left testicular swelling along the back of the testicle (swollen epididymis).

  2. Do you think after 3 years of being okay that it is more likely that I have congestive epididymitis vs. nerve pain? If congestive, I would lean towards getting a reversal if the supplements don’t do the trick.

  3. For those of you who have had success with the herbs, etc. did it make your swelling go away?

Thanks for creating this community and I look forward to any feedback. Tell me your story if possible, in particular, how your symptoms first manifested. Maybe, there is a pattern we’re just not seeing just yet. I’ll keep posting about this for what it’s worth.

1 Like

Hi there,

To answer your questions,

  1. Scrotal pain after only three months. No swelling included. No groind pain. Swelling means inflammation. Inflammation without infection to me can only mean some sort of autoimmune reaction. I could be wrong.

  2. I think congestive epididymitis. If it was nerve damage you would have experienced symptoms much earlier. Perhaps your congestive epididymitis got large enough to cause an autoimmune reaction.

  3. I have had success with herbs but that was more for testosterone of which diminished for me post vasectomy. I had a reversal at the 9 month mark and it 100% removed my pain.

Wow, lots of similarities here. I’ve had 3 bouts with scrotal pain since my vas nearly 16 years ago (3/5/2005), and 2 of those bouts began after bicycling. The first bout was 8 months post-vasectomy and, like you, I had a pretty normal recovery.

I had my vasectomy reversed in June, 2006, and after recovering, have had mostly pain-free living. I was NOT congested; in fact, I was leaking, and that I believe was the cause of low T and high PSA I was also experiencing. I also think removal of the granulomas at the vas tips and general scar tissue removal helped, so I don’t regret the reversal one iota. That said, I think I was lucky. Reversal can make matters worse.

That said, I’m pretty convinced I have a damaged left GF nerve. That’s been confirmed by numerous diagnostic injections.

Dr. Parekatill in Orlando has treated many forum members. He suggests that many of us suffer from Wallerian Degeneration of the scrotal nerves brought on by injury from the vas and/or subsequent reparative surgeries.

Your bicycling may be the “inciting event”, like mine, that triggered damaged nerves from off to on. It took me 30 months of treatment from April 2016 to October 2018 during my recent bout to get my left GF turned off again. Treatment consisted of supplements like Nerve Shield and Zyflamend (which I take prophylactically now), meds like amitriptyline, gabapentin, and targeted injections to the cord, GF, and pudendal (perineal) region. Prior bouts weren’t as stubborn.

I began bicycling again in 2020 but use the Moon Saddle. Look for it or one like it.

Read up on distinguishing between congestive pain and neuropathic pain. Given your story, I’m GUESSING neuropathic, but it’s important to do your homework and get medical diagnosis. If you have nerve damage, reversal might not work and might even make matters worse. Instead, injections or denervation surgery may be better approaches.

Best wishes. This is rough, but a lot of us have been there.

Hi raising4girls,

Thank you so much for your feedback . . . good vibes man. Your response reminds me that it’s all about the DETAILS. So to clarify my original post above . . .

I don’t believe the biking was an 'inciting" event given that my stationary bike is the recumbent type rather than the upright variety. So when I get on it, I’m not sitting on a seat that goes up into my groin area. Great point however about the Moon Saddle. When I feel ready to resume outdoor biking (which I had not done for many many months before I started having issues), I’ll look into it.

I have to you another question though, did you have a lot of swelling in the epididyl / groin areas upon having your relapses after your reversal? Was the groin swelling on both sides? For me, my left is worse than my right side, but I am clearly having epididymitis on both sides. The pain is clearly emanating from there and radiating up into my groin on both sides and swelling in both groins as a result. If this was nerve pain only, would I be getting this much swelling / inflammation?

Another question, sorry as I am a newbie . . . could you point me to any resources that would help me decipher between congestive vs. nerve issues? Again, I really appreciate you input as I know you have dealt with this for awhile.

One more detail that I think I should mention and I have not heard anyone in this forum mention it before, but may lead to a correlation. I have had somewhat high blood calcium levels (either at the upper end of normal to slightly above normal . . . about 10.7 mg/dL has been my highest reading vs. 10.3 mg/dL being the cutoff) for years and years now. I’ve had many thyroid panels done already and nothing abnormal found. Just wondering if anyone else has had high Ca levels and how this may be related to uptake of dead sperm, etc…

Okay, more details . . .

I tried taking Prednisone for a couple of weeks . . . no luck. Ibuprofen (2000 mg / day) . . . no luck. Heating and / or ice . . . no luck so far. Took cipro for a week . . . no luck.

Thank you for your reply Nylem,

How long was your recovery from the reverse vas to the point where the pain was less than before you had the reverse vas?

I keep remembering more details so here’s another one . . .

I have had two ultrasounds one showing a “moderate” sized hydrocele in the swollen left testicle. The other one was done in the ER (cause I was freaking out about the swelling) and that one they diagnosed as a “mild” vericocele, but this was after I was icing my balls all morning. Frankly, I don’t think they know what they hell they’re doing when diagnosing one from the other. I was say hydrocele was more accurate. When I discussed this with my urologist, he said “hydrocele” is something that you get from having epididymitis anyway.

One other thing, I also have had a small inguinal hernia on the left side as well. If it’s small, I doubt it has anything to do with my PVPS.

Hi man, is there a possibility that you caused the hernia from working out or bike riding?

Hernia’s can press on the nerves that lead to the scrotum, what did the docs say about the hernia.

1 Like

Scrotal inflammation was never a problem for me. Tenderness to the touch, yes, but I never felt like the epis or testicles were swollen. I recall my reversal doc stating the epis seemed normal and flat, not full, and that was likely due to them leaking which he found during the reversal procedure.

Not sure there’s a particular resource. Maybe just the wikipedia entry on PVPS. Generally, those with congestion seem to report an increase in pain after ejaculation. That’s something every urologist has asked me about so it appears to be conventional wisdom, if not proven fact, that congestion is congruent with pain after ejac.

Neuropathic pain appears to be constant, those not necessarily constant in degree (can be made worse or relieved by position, pressure, etc.).

My understanding is that pain management injections will help with the diagnosis. If numbing of the nerve through injection relieves the pain, then the assumption is that the pain could be neuropathic. That might indicate therapeutic blocks with steroid or botox might work, and it is also used as an indicator that cord denervation surgery might be warranted.
[/quote]

Hey Chip,

I have an appointment with the doc who repaired my umbilical hernia a couple of years ago in about two weeks. I am going to ask him if what he is seeing with my left testicle and groin swelling is a common symptom he sees with inguinal hernia. I talked with him about the hernia back then and he told me that if it isn’t that big and not bothering me, then I can just let it be. I would be surprised if the hernia was causing this much pain. Especially when I consider that I have been having groin pain on BOTH sides. I do have an ultrasound scheduled for this coming Tuesday to check for inguinal hernia on the right side as well. If they do not find a hernia on the right side, then I think that eliminates the pain coming from a hernia. As for the left hernia that has been spotted, I do not think that it is that significant. I say this because when I had my last ultrasound on it about two weeks ago, the technician had to press pretty hard on the area for it to show up on the ultrasound. I am now considering asking for a CT or MRI to see if they can get a more detailed image of the entire groin area just to see if they can spot anything more conclusive. I have to say that if all of this pain (and left epi swelling with right epi tenderness) was coming from hernia issues, I would almost be relieved. I hope God doesn’t strike me down for saying that. :slight_smile:

When I press on the upper back / side part of both testicles, that is where it hurts most. One thing I wonder is whether the vas deferens drops after they snip. Or, is the vas held by muscle, etc. to where even after they snip, the epi end of the vas stays pointing upwards. It seems the most pain I get is right near the site of the vasectomy (maybe just above there by a few mm). Just thinking out loud here.

Thanks raising4girls. I can’t say I am in constant pain. It feels more like a constant heaviness (probably because of the inflammation). I am able to sleep at night as long as I have a thick pillow between my legs. Occasionally, I’ll get a sharp pain that radiates towards the hip from the left epi area (my worse side), but not too often. I figure this is just inflammation pressing against a nerve. When I try to walk too much though the groin pain builds.

Where are you located?

Los Angeles / Orange County area.

A number of guys have seen a Dr. Werthman in the LA area. One of the original voices about PVPS, Kevin Hauber, was treated by him. He’s mentioned in Kevin’s book If It’s Not Broke, Don’t Fix It.

I am generally not one to recommend anyone to anyone, but this guy is in your area and I have heard some positive things about him over the years. Might be worth looking into.

https://www.orangecountyurology.com/our-team/aaron-spitz-m-d/

Spermatic cord blocks

Where the urologist injects numbing anesthetic medication (lidocaine and/or bupivicaine) into the tissues in and around the spermatic cord, high in the scrotum. The hope is that, if this works, this will block the delivery of the pain message from the nerves in and around the testicle up through the spermatic cord up to the brain. Though this may work for some, usually it only lasts a few hours to a day or so and has the added risks for causing more bleeding with more problems and pain to include damage to nerves or blood vessels. Cord blocks are controversial. Some doctors us this as a test and think that if this blocks the pain, then more definitive surgeries will help such as nerve stripping or neurolysis. Over the decades, I have seen many men that did not get a good cord block results yet had dramatically positive results with a vas reversal, so in my practice we do not routinely require or even perform a cord block before vasectomy reversal. I always worry that a cord block might cause more inflammation and scarring around the vas, making a subsequent vasectomy reversal surgery more challenging with concerns over lower success rates

It seems many people downplay or whitewash these risks, but I assure you all they are as real as Dr Marks is.

Source

https://www.dadsagain.com/articles/treatments-pvps/


The thread below might be worth a read @keeping_faith

Hey Ringo,

I’ve read a lot of your posts in the past and I really appreciate your input (as well as raising4girls). You two always post a lot and I hope to be someone who can also supply useful information to others like us who fell into the vasectomy trap.

It’s funny you mention Dr. Spitz as this is the guy who my urologist has referred me to. I’m still trying to get the referral to go through. I’ll keep everyone posted.

Hi, your question on how long til pain was better is hard to describe but I’ll try.

Post reversal the removal of the ‘pain’ I was feeling after vasectomy was almost immediately. Next day after a night’s rest. I also got morning wood that night. Something I hadn’t had in some time after the vasectomy.
Obviously after the reversal op I had pain from that operation but it was different pain. The recovery pain was from cuts to the body. The pain that disappeared was the throbbing and stabbing pain that was in my scrotum. That is completely gone and has never returned. Once healed from reversal I was 100% pain free and have been ever since.

Hey Nylem,

Thank you for the response! Did you also have a lot of groin pain or was it just pain in the balls? I noticed the same thing as well about the lack of erections although I don’t seem to have a problem getting them when my wife is in the mood. But, it just seems like I used to get a boner sometimes throughout the day and now . . . I have to be stimulated to get one. Sorry for all the detail, just trying to compare notes.

So, I have an update to my situation that I am hoping someone can help me with. I mentioned earlier that I was diagnosed with an inguinal hernia on my left side. I now have been diagnosed with an inguinal hernia on my right side as well. Does anyone have any useful information on how to decipher between PVPS vs. double inguinal hernia? The hernias are “reducible”, which I think means that they only come out of the abdominal wall if I flex my abdominal muscles.

I would hate myself for getting a vas reversal only to find out that it was the hernias causing my groin / epididymitis pain. My gut is telling me this is still PVPS epididymal blowout. I have an appointment this Friday with the surgeon who repaired my umbilical hernia about two years ago to get his opinion. I also have an appointment with Dr. Aaron Spitz in about 1.5 weeks to talk with him about my issue. I’ll keep everyone posted for what it’s worth. Getting answers is such a bitch.

2 Likes