Post Vasectomy Pain Forum

Q&A with Dr. Sijo Parekattil

Just had a phone consult with Dr. P. These aren’t verbatim, but they are to the best of my recollection and note taking skills. Hope he doesn’t mind the post. I definitely recommend the consult.

Why do some unilateral orchiectomy patients experience pain migrating to the good testicle or side after surgery?

It’s a type of phantom pain. We have research that shows the nerves in the stump where the cut is made start firing. There’s cross talk between the two sides in the spine.

If I have orchiectomy, would a radical, inguinal procedure make it less likely that I would have pain or complications after the surgery?

Yes. Going through the scrotum is more likely to produce pain.

If I have unilateral orchiectomy, what are the odds I would need TRT?

Varies by patient. For me, it would be 50/50.

After unilateral orchiectomy, would long-term TRT shut off the remaining testicle?

Yes, with time.

I didn’t experience any pain relief from a cord block, which is why I haven’t done denervation.

You should also have a good result from a cord block before orchiectomy. If you don’t experience pain relief from a cord block and then have orchiectomy, I’m concerned you could end up with phantom pain.

How much of PVPS is psychosomatic?

All pain to a certain extent is psychosomatic. The goal is to break the cycle of constant pain.

Can I come to Florida by myself and have your procedures?

Yes, we have a butler service to assist people who come by themselves.

On the forum, it seems a lot of denervation guys have had more problems than orchiectomy guys.

You’re only seeing a small sample. People with bad outcomes are more likely to go online. I’ve done 2,500 denervations with many good results.

Do you think my hip problem could be related to my PVPS?

It could be. The pelvic area has hyper-sensitive nerves. They are cross-linked.


Thank you Sentosa, that is very interesting.

Oh crikey, not good news for me then.

As i learn, if you get HCG hormone with TRT you save remaining testicle

From the quick research I did, it sounds like hCG preserves sperm production. I asked Dr. P about testosterone production. He said testosterone production in the remaining testicle would eventually shut off.

Bad news…:triumph:
As i understand… Testicles are very complex…
İf testicle or spermatic cord has problem then every solution step has its own problems…
İ know many Man in testicle cancer forum with no testicle and have normal sex life…

my search for HCG;
Not only will hCG help to restore your fertility and sperm production, but it can reduce the testicle shrinkage. Using hCG with TRT can restore your testicles to their normal, healthy size and function.

Studies have shown that in healthy normal testosterone men selected to undergo TRT, it was shown that their intra-testicular testosterone levels dropped by 94% while on therapy. However, in those who received HCG injections along with TRT, their intra-testicular testosterone levels only dropped 7%.

Additionally, in men who received TRT and a higher dose of hCG every other day, had an increase in intra-testicular testosterone by 26% from baseline was observed. This proved that co-administering low dose hCG could maintain intra-testicular testosterone in those undergoing TRT. It was later shown that not only is intra-testicular testosterone increased with co-administration hCG but the sperm count is preserved as well at one year follow up.