Post Vasectomy Pain Forum

Reversal booked 26th August

Hello all,

Just making my progress post to give the experiences since the vasectomy and after reversal, which all being well assuming no cancellations and no problems during the procedure - will be on the 26th August.

Vasectomy was 24th October 2020, from what I’m aware it was a standard open-ended vasectomy following NHS protocols done by a GP trained in this one procedure - No major issues after the vasectomy other than my left testicle was very sensitive if it was knocked, would be much more sensitive and sore than a healthy nut that was knocked

Feb/March 2021 - Epididymitis in left testicle, whole testicle and epi were swollen and red - A&E urologist prescribed ciprofloxacin, this seemed to clear it - Back to testicle just being sensitive if it was bumped

April 2021 - Mild left kidney pains last 1-2 minutes at a time, 1 week later Suspected gastric flareup(first time in my life), burning under left rib, during hospital visit doctor inspected my testicles and moved or poked something that didn’t feel good - severe pain in my left Epi/Cord, another course of ciprofloxacin seemed to alleviate it but I did also spend the majority of 5 days in bed with no activity around my testicle going on

May 2021 - Severe epi pains again in left testicle, seen consultant urologist who checked my tests so far(basically every organ ultrasounded and CT of kidneys, multiple bloods, stools and urine) and diagnosed me with PVPS and suggested reversal or epididymectomy, naturally I opted for reversal, unfortunately it has since come back that despite it being for pain and not fertility, the NHS will still not allow reversal.

Pains have never fully subsided since this last flare up - usually for the most part I get random bouts of minor dull ache in left epi and left kidney(not always at the same time), I receive the same pains in the right testicle and kidney but so minor you wouldn’t even consider taking pain killers - I am usually able to these issues by simply not poking around my testicles and taking paracetamol(tylenol) and reducing movement/ warm baths, however since the last flare up ongoing still now seems to be from when I over-inspected my epi and testicle in the shower 6 days ago, this has led to a constant dull pressure tooth-ache like feeling in my left epi/cord area that has yet to fully subside.

During these major flare-ups my pelvic floor goes to shit, walking during this will give me lower back ache and I have to keep the testicle well supported as if the epi bumps off my trousers or anything such as when bending over it will obviously increase the dull pressure ache - These flareups typically subside in 3-4 days but I guess I went too far with my inspection this time.

So, long writeup sorry want to be informative for people googling in future with comparable symptoms and hoping I can provide a cure with reversal a few weeks from now, overall issues that I can pinpoint directly to the PVPS:

  • Dull pressure-like ache in my epididymis area, the location specifically of this is it you put your finger under the base of your penis above the sack, then run your finger about 2-3cm from the base of penis towards testicle/epi on the left side, the dull ache is here, it can also be felt on the back of the testicle side of the epi, I rarely experience pain in the actual testicle from what I can tell, though it does seem slightly engorged(but not red) when these flareups happen. edit - To add, the pain moves from the head of epi/cord area to the tail of the epi around 1-2 hours after ejaculation, the epi feels around twice the size and goes hard - further edit, when abstaining from ejaculation for 24 hours, the epi is no longer hard but still semi-swollen and tender - but the dull ache moves in to my sperm cord/vas and it is, “thicker than a bowl of oatmeal”

  • Kidney dull aches, these seem to be worse on days where I have ejaculation, but I have no pains actually during ejaculation, they seem to begin roughly 1-2 hours after

  • The pains can sometimes go up the inside of my groin/hip area and lower abdomen but this is very rare for me personally and never causes much issue or stress

  • General heightened anxiety and surges of depression in burst windows as the PVPS seems to have settled in - Perhaps this is just me now as a result of the pain and worry for the last year though I never experienced mental health problems before this, but at the same time I never experienced severe chronic pain either, or perhaps it is to do with fluctuating testosterone, never had testosterone tested before or since vasectomy - I do not have hair loss and things, if anything I have hair growing out of weird places now

  • Low libido and poor orgasms even when I do not have pelvic floor weakness during bad flareups

Pain is directly related to the touching of the epi/cord area, the only other odd thing I notice is my issue testicle(left) is at a very horizontal angle, however multiple GPs, urologists and ultrasound has ruled out torsion - perhaps it was always at a bit of an angle and inflammation from the epi or congestion in the cord can be pushing it further.

So yes that is me, my life* has been ruined since this procedure, unbearable pains and discomfort, mental stress and anxiety etc.

The surgeon who has agreed to the procedure seems very qualified and certified with the relevant urological board, also carries out between 10-20 reversal per month including ones for pain and uses a multi-layer technique, I am confident and happy with my choice based on reviews and his experiences - I will not name him as of yet as I would like to get the procedure done first. Specific details of what will be done really is general reversal:

Expose the vas, remove scarred tissue, remove granulomas, check vas and epi for healthy structure, plumb vas-vas as long as there are no problems(not expected given my short time snipped), plumb vas to epi as a last resort if too many blockages or damage to vas - if epididymis is mince meat for whatever reason it will be detailed in report but not removed during procedure.

Surgeon has calculated roughly my success for total pain relief/improvement in pain is around 70%, and around 90% for regaining fertility.

So yes that is my story, again sorry for monstrous writeup - I will follow up again in this thread once the procedure has been carried out. Now roll on 3 weeks of hoping and praying for no spontaneous cancellations, the reversal being done with no complications, and it totally curing me of this life ruining condition, or at least vastly improving it, my odds are good but there unfortunately is never a guarantee.

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Thanks for the detailed write-up! It seems you have done your homework and due diligence, as well as you seem to be a good candidate for the surgery that you choose. I wish you good luck and hope you find relief!

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Moved the reversal forward 1 week and was carried out on the 19th:

On my bad side, the fascias all adhesed together and hardened, he divided it and although it will grow back he said the reason it got hard and stuck to the tunica vaginalis(likely causing the weird position of my nut) was because of constant inflammation due to sperm leaking which should no longer happen, the left side of vas had also became its own kind of granuloma so he cut about 2cm off it to fresh vas, granulomas 1cm on both sides in the tube and also intense pressure in the epididymis, so much so that when he cut it, a splat hit the screen in front of me and the nurses burst out laughing and he said " well, that was a lot of pressure"

Day 1 - felt amazing getting out of the surgery, all the congestion feeling in back of nuts was gone, had my first normal shit in 6 months, no more IBS, spent the guts of the first 24 hours lying on my back in hotel bed other than to use the bathroom

Day 2 - Lots of travelling to do unfortunately, spent around 8 hours travelling but was passenger in car, wheelchair in airport etc, very low amounts of walking done, some random shooting pains in the original epi areas but these lasted a few seconds and have yet to return

Day 3 - Lots of bruising and swelling has set in so lots of tender type pains, the main pains are strained and tender pains in the pubic bone above base of penis, likely due to all the pulling - the scrotum has swollen a lot so get lots of nipping from the skin in between my legs when I walk, imagine your scrotum sticking to your leg on a hot day multiplied by 5.

Day 4 - I do get some dull aches in sort of my epi area, its hard to tell because I don’t really know where my epi is right now due to the swelling, its likely there is or was a bit of a hematoma in the bottom of the sack, feels kind of pouchy and liquidy, possible hematoma that is now dissolving.

Scrotum is maybe 2.5 times the size of normal with swelling. Worst pains have been dull ache on the back of scrotum area as mentioned above but these tend to pass with adjusting position e.g. standing up to walk a bit, they also go away on their own where as before this was a 24/7 constant “feeling” in my epis

Worst of all day 2 on the journey home I picked up a brutal cold(tested negative for covid) so lots of coughing and sneezing increasing discomfort, surgeon advised that although it will be tender and painful due to the muscles contracting it is unlikely to be detrimental to the vas connection.

Both sides were connected vasovasostomy and noted there was no tension on the vas at reconnection.

I will post an update further down the line, it was a transverse horizontal cut with scrotal exploration rather than just straight up reversal, the wound seems to have stopped bleeding completely, currently lots of swelling and some dull aches just but optimistic, no shooting pains down legs or up torso etc so hopefully avoided nerve damage

Co-amoxiclav for 7 days to prevent infeciton
Naproxen 250mg for 6 weeks

Left side(worse side for pain) was highly congestion showed multiple clusters of motile and non motile sperm
Right side was also congested and showed full sperm but non-motile

Going to be a long road to recovery, pretty anxious for the days to end so I can wake up with possible improvement, rather than before reversal it was going to bed with an almost guarantee that the pain was going to increase

Take it easy. Do not do anything if possible for 2 weeks but rest and ice. Its very easy to bump the area and cause a hematoma which will screw up healing.

I gave myself a hematoma by bucking my hips up into a laptop tray on day 9.

The first couple weeks after a reversal are the most important. Congratulations and good luck.

Cheers mate, hard to not get anxious over the dull aches that come go, need to remember it takes time for the epi to deflate back to its normal pre vas size, I imagine all my coughing could have caused hematoma to be honest, looking forward to day 7 when I finish antibiotics, will be over this cold and can take baths again. How are you doing these days?

@lundy - how you feeling?

Hey mate lots of ups and downs I was warned about, some original pains come and go, some new pains come and go. The 24/7 constant “feeling” in my epididymis on both sides has gone which is great, I do get some tingling feeling in the left epididymis. Everything down there is very tender and achey, I wouldn’t say it’s dull aches any more but feels very tender and bruised pains, nothing really brings it on I don’t think it just tends to happen.

So far its kind of been 2 days of being really positive, not too bad pains but mentally really good, then 1 day of pretty bad pains and anxiety about healing, then repeat that pattern - I guess it depends on how much I’ve done, I had a good day or 2 there just past very positive and knowing reversal is curing me, then today I’ve been pretty bummed out because of similar aches and pains but it’s possible I done too much walking and driving yesterday maybe, not sure, just get paranoid about the healing process really but I guess the ultimate test is in another 12 days with swelling and things down further, it really feels a lot of the discomfort might be cured by ejaculating, hopefully anyway . It takes a long time for epididymis to deflate and reshape back to it’s original size and I guess tenderness and things doesn’t go away until that happens.

Ultimately in terms of pains and things, even with current surgical pains I think I am probably still in a bit less pain that I was pre-reversal, and definitely in a lot better of a mental state. One other things is my IBS disappeared within 24 hours of reversal which is nice but obviously no scrote pain is the goal lol

9 days post-reversal

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