Hi my PVPS brothers! I am writing this for my own notes as well as anyone else. So, I had my appointment with Dr. Spitz and he basically spit on my notion that my pain is even vasectomy related. Based on his physical examination, he basically thinks that my problem has more to do with pelvic floor issues rather than PVPS. So, he is referring me for physical therapy for several weeks. Personally, I would be shocked if he is correct in his diagnosis, but I suppose it is better to try something conservative first even if it doesn’t work. If my scrotal pain improves, maybe he’s onto something.
When he manhandled my balls today, it actually didn’t feel too bad. He even squeezed by hydrocele/vericocele and it was a little uncomfortable, but that was all. He was also pinching around where the vas sites were. Again, . . . no real pain.
My groin and crotch pain he says could be related to general pelvic inflammation. I have struggled with lower back pain on and off for the last 8-9 months (this whole Covid thing has had me sitting a lot more than ever before and maybe this is f**king me up). I don’t know though, I still find it hard to believe that general pelvic inflammation would be causing my epididymitis.
When I mentioned that I had my vas three years ago, he seemed to dismiss it as a cause for my scrotal pain. He said if I had just had my vas, then that would make sense. I told him though that I have heard guys tell similar stories to mine where pain shows up some time later. I truly believe that because it is rare that guys have pain years later (<1 % by most accounts), most urologists don’t want to believe that this happens.
As for the physical therapy, this is how I look at it. If it works . . . great. I’ll come back here on this forum and would love to tell you that it worked (and also feel like an asshole knowing what most, if not all, of the guys on this site have been through). If it doesn’t work, which I don’t think it will, then it’s at least one more thing to check off the list of conservative treatments. I agree with many of the guys here that panic surgery is probably not the best option and taking it one logical step at a time probably is the best. In a way, I am happy that Dr. Spitz is not willing to jump to a drastic measure . . . I get it. I believe Dr. Marks has also said the same to other guys on this side who have consulted with him. My worry is that if the PT doesn’t work, then they will recommend something else rather than a reversal. After reading lots of posts here, it just seems like doing the reversal should be the first surgical option (even more so that using denervation techniques). I don’t want them f**king up any more shit down there. I only want reconstruction.
Has anyone had success with physical therapy? For how long did you try it, if so?
Something else that just popped into my mind. I did have a bought with prostatitis about 5 months before my vasectomy and know prostatitis can cause pelvic pain as well. Upon physical exam by my original urologist, my prostate felt fine to him. I think I am going to ask my primary care physician if she can order up a PSA anyway, just to get numerical confirmation. When I had prostatitis before, I had excruciating pain on my nerves related to the urge to go pee. My PSA was up to 11.8. After a month on cipro, I felt much better and my PSA was back down to 0.8. I am not experiencing this pain now though, which would make me question my prostate being the cause. I’m just trying to figure out how I can have so much pelvic pain if prostatitis or PVPS is not the issue.