I am here to share my story and get advice, but I come from the complete opposite direction. I had my vas about 8 years ago. Unpleasant surgery, left side felt fine, right side needed more anesthetic but I healed uneventfully.
Time passes, divorce, remarriage and now a vasectomy reversal for fertility reasons. (Discussed IVF but wife wanted me to be put back together). Surgery May 2018 with two urologists working in tandem. Left side felt great, right side felt like I was stitched up by someone with two left hands. Recovery was tough but 6 weeks out doing ok. Then 8 weeks out intense burning pain on right side. Urologist says, surgery a success since SA came back with sperm. Doesn’t think much of my pain, prescribes a course of prednisone which did nothing. NSAID’s don’t help. Pain is worse when sitting and increases during the day. In fact, I wake up and feel fine. By the end of the work day I am at a 7-9/10 for pain. He starts me on Gabapentin 300mg tid and I notice a slight relief. Does an in office ultrasound on a machine from the 70’s, all normal. Tries a spermatic cord block, ie. injects 5 cc marcaine into my sack and of course pain diminishes by about 50%, but that doesn’t surprise me.
I go to my GP, she refers me to hospital urology group. Have doppler ultrasound and they find bilateral varicoceles and some minor fatty tissue on right testicle (they assume prior trauma) and small nodule on right epi they say is commonly seen in men with vasectomy. New urologist also has testosterone and other labs run, finds testosterone is low for man my age trying to conceive. Based upon my symptoms, recommends varicocele embolization and clomid. I should say on physical exam, my testicle, epi and spermatic cord can be palpated etc. with little discomfort. They just feel sore, like they ran a marathon. Look up varicocele pain and I had almost every symptom. At this time, I suspect the nerves are trying to recover but pressure from varicocele is keeping them from doing so.
November 2018, varicocele embolization. Easy procedure and recovery. However, deep dull ache is replaced with an intense burning pain in right testicle 4 days post op. Emergency room, nearing a complete nervous breakdown (suicidal?) Ultrasound, normal, Rx Percocet 7 pills (first narcotic I have taken this entire time). I take 1 that night because. Since I have taken ¼ of a pill as needed. I still have 5 pills left, they are my safety net. Urologist starts me on 50mg clomid 3 times week.
My GP starts me on:
Amitriptyline 10mg daily
Gabapentin 300 mg TID
Klonopin 0.5mg BID (yes, I know all about this and have successfully tapered before)
Klonopin relieves nerve pain, why, who knows but I will take it. Amitriptyline is 3 weeks in on a low dose so jury still out. Gabapentin, helps, but I am thinking of increasing the dose. Have applied menthol, cooling creams to right scrotum which occasionally overwhelms dull ache signals to brain. My only other symptoms is slight weakness in my right thigh and lower back, but that could be job related.
Now 6 weeks post op embolization. I wake up and feel fine. I take my pills, do light cardio, pelvic therapy stretches I’ve garnered from books and internet, cold sitz bath and go to work. Pain increases throughout the day but I can work for the most part. End of day, crash and watch tv with wife in bed. Luckily, she is a homebody but I feel tremendous guilt during our first year of marriage.
Latest SA is good post reversal 50 million/ml with 21% motility.
I don’t suffer like some of you on here, but I am suffering in my own way and I need to get through this for my family’s sake.
My thoughts on my future:
- Conservative treatment. Started going to chiropractor, will see acupuncture soon. Nothing invasive until pregnancy at the earliest.
- Find the right medicine that gets me through the day. Maybe, the body will adapt to these painful nerve signals and someday I can taper off them. Applied for medical marijuana card at suggestion of my urologist
- Repeat ultrasound.
- Pain management? Do I want to get into one of those places? Not looking for narcotics, but my GP offered some tramadol which sure would help on those afternoons when the pain starts creeping up. I may take her up on that offer. My urologist says he has someone who is very good with pelvic pain at the hospital.
- Consider nerve blocks to definitively find out which nerve is the cause.
- If varicocele persists, varicocelectomy
- SCD? I’d have to be in a really bad place to consider this.
- Peripheral nerve ablation
If you have read this, then I thank you. If you have any comments or suggestions I’m all ears.