Post Vasectomy Pain Forum

PVPS and Prostatitis

Thank you for sharing your very valuable experience. I am not sure if I have nerve pain since pain is still changing. I will give it 4-6 more months to see if there will be relief and if not then I will start thinking about reversal. I will post any progress that may help people on this thread.

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I sincerely believe in waiting if you can somehow manage or press through the pain. 4-6 months sounds reasonable.

Good luck with the testosterone therapy. That sounds like THE right interim step. You’re fortunate to find a doc willing to try it. I believe Werthman is one of the foremost experts on PVP treatment. Never met him, but assume he’s terrific. I am SO grateful for the handful of urologists in the US that “get it” and are willing to and capable of treating guys like us.

When I started my PVP journey back in 2005, I think Werthman, Witt (Atlanta), Thomas (Cleveland), a few of Thomas’ understudies that left the Cleveland Clinic, and Marks were all we had to help us. Maybe more but they were really hard to find without forums like this. Just googling Post-Vasectomy Pain back then brought you more articles on GETTING a vasectomy than dealing with the related pain. I don’t think there was a Wikipedia page for PVPS until 2008-09.

Seems like you’re in good hands.

Best wishes.

You will destroy your gut with antibiotics. I believe it’s possible your problem won’t be solved with antibiotics no matter how many or long you take them and as you said it will just damage your microbiomme/health more.

I had horrific prostate problems for years after my vasectomy. They vanished instantly when I got a reversal. Like that, poof, gone.

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Same here. My prostate problems went away within days, maybe a week or two after my reversal. I was off work 2-3 weeks (OK, working from home) after the reversal, and I remember once I went back to driving, they were gone. It’s part of the reason I’m glad I had the reversal even though I still get bouts of nerve pain. I have no doubt reversal solved some of my multi-faceted problem.

Thank you MikeO and raising4girls. To know that there is a hope with reversal is giving me so much strength to cope with this. Pain is affecting every aspect of my life, everything is hard, intimacy results in significant pain for 3+ days after. Best Regards.

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Best wishes. If intimacy results in pain afterward, that sure sounds like congestion.

Hi there all,

I just read this thread and I wonder if there is more data about the bio wrap. The assumption that, as stated by dr. P, during a reversal more nerve tissue is damaged and this is the cause of pain relieve looks to me as this gives the doctors some time to prospone the autoimmune issue. Imo based on what I feel, and felt before reversal, the referred pain is solely due to autoimmune reactions. As I see it, backpressure is not the direct cause but initiates a cascade of AI reactions giving the pain. Interesting is reading fundamental research from the early 80’s where irreversal tissue damage occured in the lumen of the epididymus as early as two weeks after obstructing the vas defferens this happened in both animal and human studies. The irreversal damage was caused by inflammation after healthy tissue was disrupted by the builded pressure. I had muscle ache in my hamstrings, glutes, and even calfs. Could’t drive my car without painkillers. No biking, swimming or even hiking. Kidney pain when my blatter was half full. Well and a ton of other things we all know about before my reversal but still have some degree of pain. I wonder when there is gonna be some good research on T-therapy but this only will be done when doctors first admit the main cause is AI issues. And that is something they rather do not. It’s just hard to admit sickness is introduced by there intervention so first all other theories are greatfully embraced. So is the biowrap the thing? My guess it’s not. Finaly they will run out on options, I 've seen a lot of doctors but most of them really don’t give a shit and for them the pvps or chronic oralchia patient is just a pain in the ass.
So guys, i try to get T-therapy and when I do I will post again.

Sorry for the grammar, I live in the Netherlands.


Dr P no longer does the bio wrap. Unless requested. They didn’t really get the results they were looking for in there data. I didn’t ask this but I think if they still believe it min scar tissue they should continue to use it.

I will tell from my T experience. It relieved the sore achy pain I had in my testicles and the fullness that was there.
That being said I traded one pain and discomfort for another.
My balls shrank a bit and my sack tightened. My sack would not relax once tightened. I only assume(theroize) less blood flow to the area cause this. Everything rose up and put pressure on my cut site and cause a lot of discomfort and nerve pain and burning.

If you have done a reversal even if your T is low. You can’t do it because it will lower your sperm count which when you ejaculate it helps keep the vas def from closing up. You will need to look for natural ways to boost your T.

There’s also a lot of research showing biowrap can be part of the problem. The stuff is nothing new and Dr P didn’t pull it out of his cupboard in Florida. They’re putting more garbage in you and the risks outweighed the benefits. “It just wasn’t as successful as we hoped” is just one way to portray this relationship.

Lol yea he definitely didnt phrase it that way

Hello everyone I am new the the form. I came across this post and want to share my experience and see if anyone had some ideas. I got diagnosed with so called prostatitis a few months ago. I returned back to the urologist that did my vasectomy he gave me cipro for a month. That did not work. I asked him if it could be from my vasectomy he said there is no way of course. I since have gone to many different uros with no luck. University of miami and headed to the Cleveland clinic next month. My symptoms include pain in the urethra sometimes, pain in testicular pain, prostate pain and pelvic pain. Constant pressure. I have tried here is the list
Cipro, Doxy, Rocepin, Zithromax, Invanz shots, bactrim, flagel, there are many others. I also tried direct injections of 6 different mix of antibiotics and a steroid strait into the prostate. (This helped for a bit but I think it was because of the steroid that is in the mix. It takes the pressure off the prostate.)
At this point I do not think it is bacterial. It is a possibility that it is some sort of e coli that is resistant but I am starting to believe that not having the flow to my testicles if a part of all this. I always have had some pain in testicles after the vasectomy but this has really taken a toll on my life. Somedays I just count the hours to when I can go home and take my elivel and go to sleep. Im sure many can relate. I think I’m going to go though with the reversal at this point. I was wondering if anyone has had total relief for a period of time? I live in Florida. Has anyone used the Dr p that is on this form? Would he be a good person to go get this done? Any advise or help would be awesome. If you have any question for me please ask. Things I tried so far
cystoscopy to look for strictures. none found.
Prostate ultrasound
test ultrasound
mri on prostate
many prostate exams with result in saying it feels boggy
I will try anything and will not give up will I find something that helps me.

While I have no experience with Dr p, he is highly regarded here and many others have been treated by him.

I’m sure others will chime in.

I’ve also seen lots of others misdiagnosed with prostatitis when it is in fact pvps.

Welcome to the forum and I am sorry that you are here. Best of luck in your recovery.

Thanks! I have had the worst luck with Uros so far. No one wants to spend the time in trying to figure out whats wrong with me. I feel like I have to be my own Dr.

I know that feeling. Fortunately my GP is open to my ideas that I’ve read on the internet lol.

It’s alarming how common pvps is, but most uros are in total denial.

There is a directory of pvps specialists on this site, but if you’re already in Florida, the pur clinic makes perfect sense.

How long ago did you get the vas?

Who are you seeing at the Cleveland Clinic (in Ohio or Florida)?

Prostatitis is their catch-all diagnosis. Non-bacterial prostatitis has universally been rejected in favor of Urological Chronic Pelvic Pain because the prostate really isn’t involved. My vasectomist gave me the prostatitis diagnosis because it couldn’t possibly have been related to the vasectomy, could it?

It’s been 11-1/2 years since my vasectomy. I’ve had 3 bouts of pain that have taken up 2 of those 11-1/2 years. I’m currently having my 3rd flare up, though I’m not sure if it’s nerve pain remnants from the vasectomy or a new problem with the pudendal nerve from bicycling. Hard to tell.

If you’re in FL, I’d definitely see Dr. P. He trained under the uro at the Cleveland Clinic who did my reversal. I’ve spoken with Dr. P. Great guy. I like that he does denervation and reversal surgeries. Most urological surgeons do one or the other, so you run the risk of “if my only tool is a hammer, your problem must be a nail.” I think Dr. P. will be objective.

My bias is toward reversal. I think vasectomy does a lot of unforeseen damage I wish I had considered pre-vasectomy. Had I been fully educated, I wouldn’t have done it.

But, if Dr. P. doesn’t think you’re congested or leaking but have nerve pain, reversal likely won’t help and could make things worse by further aggravating damaged nerves.

Best wishes. Keep us posted on a separate thread.

I got it a little over a year ago. Have had tenderness in that area since but this really didn’t start up till 4 months ago. I thought it was bacterial due to Fellatio or sex. I am still not sure if its some aerobic bacteria that cannot be gathered in a culture. Or perhaps it went down my vas difference and now the antibiotic cannot penetrate that area because they are cut. I have many weird theories.
I feel like the pain moves around quite a bit. From the test to the prostate to the penis.

Thanks raising4girls
I am going to see Nicolas Muruve, MD I already went to University of Miami to a specialist. He was no help.

I have heard Ranjith Ramasamy is very good at the University of Miami. Did you see him?

I could also recommend talking to Dr. P or to Dr. Marks. Dr. P does a wide variety of treatments, and Dr Marks only does reversals but has seen a lot of pain patients.

Hello Markmc, I had a reversal at the PUR clinic a few months ago. The whole process was a positive experience.
I had always had abdominal and prostate sensations after the vasectomy, mainly an occasional sharp pain in the prostate after I stopped urinating. I had my prostate checked about a year before my reversal from a local Uro. Prostate was normal at examination, he felt it could have been an infection but he could not get a fluid sample to test. I was precribed antibiotics which I never filled believing my pains were from the vasectomy and not an infection. Congestion pains were my biggest issue. Congestion pains stopped immediatley after reversal, prostate issues have faded much after the first 6 weeks.

Raising4girls has a great point regarding caution with nerve issues. I definitely have some new nerve sensations, pain is a strong word, but had occasional burning feelings in the penis, scotum and legs 5-6 weeks post reversal. Most likley healing and from all the lying down the first month recovering. I am cautiously optomistic that things will continue to improve as time goes on.

The last few weeks have been as close to normal as I can remember since the vasectomy 5-ish years ago. Whether or not this works out in the long run, who knows. My opinion, nothing is guaranteed but it was the only surgical option I would ever consider. With that said, my heart goes out to anyone who chooses reversal or any other treament with little or no improvement. We literally go into any of these procedures blood, sweat and balls. Everyone has a unique situation, good luck to you what ever you decide.

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Xpander Thanks for your input. At this point I am willing to try anything. I know everyone here has felt this way at times.
Has anyone ever gotten a bacterial infection with a vasectomy? Maybe somehow the antibiotics can not get the the epididymis that bacteria has gotten into somehow and inflammation is causing pain and infection?
Sometime with cutting off circulation and flow seems to be the case.

Robert I saw Dr. Christopher Gomez there and he spent 5 mins with me and told me to go to physical therapy which I will try but know that won’t fix my problem. He told me to come back in 3 months. I was like I cannot live like this for 3 months to come back for another 5 min visit. Frustrated. Thanks for listening.