Post Vasectomy Pain Forum

Reversal for fertility nerve pain

Well, it’s been a while. I needed a break from the site and like most, I did it because I was feeling better. After my last post here, I was in a dark place. 8 days post op from the ganglion impar nerve block and I wasn’t feeling any better. Then, all of a sudden, the next day I felt relief. Over the next couple of weeks I was any where from 50-90% better. Then a little dip, and now I’m back to about 80% better. I’m still taking lyrica but I can say with certainty I was helped by the nerve block. I have another one scheduled next month since repeated blocks may have a longer impact. I’m glad I went to pain management and I wish I had gone 9 months sooner. If you are reading this, I do recommend it since my PCP and urologist had no clue how to treat my pain.

I met with the urologist and discussed potential options. He had never heard of the impar ganglion block! These nerves are involved in sympathetically mediated pain. I still feel that my pain is mostly from the re-connection but he thinks my epidydimis is also affected. It is slightly larger on the ultrasound. When on Lyrica, the pain is diffuse. If I go off it, it gets localized so I will attempt to go off this fall to see if I have improvement and if not I am going to have the re-connection cut out. I may opt for an open ended vasectomy to relieve potential pressure on the epi. Let’s hope no more surgery is necessary!

Summary: inquire about the impar ganglion nerve block. Hope this helps, even temporarily.

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Update in case anyone is interested. The impar ganglion blocks provided a temporary relief from the pain but ultimately they were only a band aid. I decided that I had two main pains, one in the reconnection site and the epididymis. My urologist offered three options

  1. Vasectomy of the right side removing the reconnection
  2. Epididectomy that would also remove the reconnection. Done under general anesthesia with the davinci robot. He says he has great success and recovery time is quick.
  3. spermatic cord denervation. He felt this was like a permanent nerve block and would only mask the problem.

I chose to have the reconnection removed (yes, essentially a very aggressive vasectomy on the right side only). Part of my reasoning was I could always remove the epi later on and the other reason was I could get this surgery done immediately rather than waiting 6 months for an OR date. The surgery was tougher than my original vasectomy. I had significant swelling two weeks later and they put me on cipro. Ultimately, the main pain (a tightening muscular nerve pain) is gone! Yay! My epi is still inflamed but I have a reduction in pain of about 50-75% and I can say I am elated. I think that a nerve got trapped in scar tissue in the reconnection. It goes to show that surgery in this area is prone to nerve problems whether it is a vasectomy, reversal, hydrocele etc.

So, I meet with the urologist soon to discuss my options. I plan on giving the epi another six months to see if it improves and then I might consider removal.

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Final note, why did I develop chronic epididymitis after the vasectomy reversal when I had no problems prior? It seems that this condition will burn itself out, according to most urology articles I’ve read.

I would also like to note that I did start to have back pain, leg pain etc. My theory on this is that the body is guarding itself and we change our posture, muscle use etc. I made a great attempt to walk normal and fight these instincts and those pains fortunately faded away for me.

Thanks for all the great information here and the updates. If you still pop in here from time to time, would you mind another update?

Hope you are still trending well.

replied in another thread but I’ll update as necessary. Just dealing with the epi pain (sucks that I developed two distinct pains after the reversal). Contemplating an epi removal if pain persists. (Epi pain has been there since shortly after the reversal, but it was massively overshadowed by my reconnection pain).

Had my right epi removed six days ago. Healing has been uneventful so far. Luckily, the surgeon appears to be very skilled unlike my reversal surgeon. Right now only dealing with post surgical pain. If I sit still, the dull ache is gone. Will be interesting to see how I progress over time. The epi pain was so erratic, there were times I wasn’t sure I was making the right decision. The pain would radiate to my right leg and it would feel weak. That has disappeared for now. I know this is a polarizing subject on here but ultimately I had to go with my gut, my urologist and a consult with Dr P. I’ll keep everyone updated. One side note is that after I had the reconnection removed 6 months ago on the right side, during sex, I feel small twinges of pain on the left at the reconnection. Nothing serious, but I think as much as we are put back together, it really creates a large amount of scar tissue. Best of luck to all those who struggle.

Thank you for continuing to post updates @Reversalpain. I hope you’re positive trend continues.

We see more negative reviews about epididymectomy here than positive reviews. You are not the only member to post something positive about this procedure, and that’s a good thing because it’s said to work ~sometimes.

If you don’t mind me asking, what kind of success rate statistics were you given on the epididymectomy beforehand if any?

Also, was there any reasoning as to why you ended up going the epididymectomy route -vs- any version of denervation of the spermatic cord (SDC)?


Good luck brother.

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Well, I cannot say it is a success or failure, yet. For me, success would be back to the same levels or better. Dr. P said expect about a 10-20% chance of getting worse. My surgeon has been doing this operation for well over 30 years and said that he has a very high confidence level, based upon my specific symptoms, that I would find relief. He didn’t give me a number and quite frankly I don’t think one really exists. I do believe that surgical skills play a significant role in all of this. My recovery at 1 week from this surgery is so vastly better than the reversal.

We chose to proceed with the epi removal over SCD because we were confident my pain site was the epi. My surgeon also felt that SCD was just cutting the nerves and masking the fact that something went wrong with my epi. He also felt that if this surgery did not work, you could always do SCD. As of now, I am grateful as I am definitely trending in a positive direction, but I think another couple of weeks to truly tell if this will be effective for me.

Interesting. There are many published studies regarding success rate statistics with epididymectomy, and to be quite honest, they vary all over the board. That said, it’s hard to know what to believe.

There is definitely truth in that statement, but this testicular pain stuff can get so complicated that I cannot agree with you 100% as to wth really went wrong.

Agreed. Time will tell.

Keep us posted.

On the epididymectomy sucess rates I was given by two senior urologists the same answer. 1/3 chance of improvement, 1/3 stay same and 1/3 chance to make it worse.

I’m overdue for an update. The first three weeks were tough. I would have a good couple of days, then a flare up. The flare ups have subsided and I have now put together over two weeks of very good days, to the point that I barely think about it, hence the lack of updates.

I had pain in the back of my testicle and in my cord after the surgery. The burning pain in my cord worried me since I never had that before, I thought I had made a mistake with the surgery. My urologist told me Advil and hot baths. I went out and bought a hot tub (cheap inflatable one on Amazon but impressive for $350) and cranked the temperature up to 104. I soaked an hour twice a day. Took 800mg of Advil three times a day with omeprazole for my stomach just in case. My symptoms rapidly improved. Cord pain completely gone.

I still have a minor discomfort in the back of my testicle. This discomfort gives me a little pain after sex but not enough to prevent me from enjoying it. Overall, I’m ecstatic! I endured 21 months of the most intense, life disrupting, pain any man should have to endure. I thought of suicide more times than I care to admit. I pushed through it all and persevered and I am glad that I did. Please note, I am in no way endorsing this surgery for anyone, but for my specific set of symptoms it worked. I’m in no way back to normal but I am back to a new normal that I have accepted and can live with. I realize I still have a long ways to go, with possible flareups down the road, but I am really enjoying this moment! I’ll post again about the things that worked and didn’t for me and answer any questions.

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My current regimen. Pain management doc recommended I do this for 3 months after surgery. He feels it will help calm the nerves down as I recover. I’m not sure I still need it, but I’m doing it anyways, I don’t think it can do any harm:

  1. Advil 800 mg three times a day
  2. Lyrica 150mg twice a day
  3. Nortryptylline. 25 mg once a day
  4. Tramadol as needed
  5. Hot tub!
  6. Gradually introduce exercise

I should note while Lyrica makes me very forgetful, it improves my mood and sleep dramatically. As someone prone to depression, this is a nice side effect.

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Throughout my 21 months I tried a lot of things, here are my thoughts after spending a lot of money.

  1. Tumeric, serrepetase etc. did nothing for me
  2. CBD had no effect
  3. Marijuana helped me sleep but amplified nerve pain while awake.
  4. Lyrica helped my mood and moderated pain a little
  5. Tramadol. hated it at first, but now it is helpful. Increased my blood pressure
  6. Hot baths, helpful now, never tried them much before and regret that
  7. Advil didn’t help with nerve pain, helped with post surgical pain
  8. Stretching, always helpful, should do more of it.
  9. Visiting this site, very helpful at times, but other times it made me feel hopeless reading some of the stories. This site is very important overall!
  10. Klonopin helped when I was very despondent
  11. Video games, great distraction
  12. TENS no help
  13. Ultrasound machine, always felt better after my ultrasounds at the doctors office, bought a little home unit but have only used it once, not sure if it is helpful, just bought it recently and don’t feel I need it right now.
  14. Narcotics, was given a grand total of 12 pills throughout all of this. Kind of disappointed because when you need them, they really help. I get the sense that people think we are making this pain up. Spending my Friday night in the ER with my wife isn’t what I would prefer to do. Walking away with one percocet and pain of 10/10 was hard. I definitely see the need to regulate them, but boy did I suffer with all these new rules in place.

Three month update.

After my last post I had a flare up of pain right where the spermatic cord attaches to the testicle. All my cord pain has disappeared and has stayed gone. I panicked and called Dr. P right away. I also had an ultrasound done which showed a small infarction in the testicle from the surgery but otherwise good blood flow to the area. Dr. P. put me on medrol dose pak that made a huge difference. The pain returned after going off the steroids but it never reached the level it was before. For the first time ever, taking a tramadol has helped the pain significantly. Over the past several weeks, my pain levels have slowly trended downward. I have been increasing my physical activity with no adverse results. Overall, I’m pleased with where I am at three months post op. If things worsen then denervation with Dr. P is in my future but for now I’m good.

Today, I am getting GF and Ilioinguinal nerve blocks. This was set up several weeks ago as a palliative measure since everything is on hold due to the virus. I’m hoping these will provide additional relief. If my pain levels stay where they are now, I would not do anything other than take the occasional pain pill. I would like to see if I can get them lower but only with minimally invasive stuff. I had to find a new pain management doctor since my previous one would only do one specific block that had minimal help for me. I studied the embryology and innervation of the testicle, epi etc. and interviewed doctors until I found one that I felt comfortable with (had to bypass the guy who was googling testicle innervation during my consult!). I’ll keep everyone updated after my blocks today.

My bad news is that for the first time, I get some minor twinges of pain on my left side that never gave me any trouble. It feels like a muscle spasm after ejaculation. Lasts about 30 seconds and doesn’t happen all the time. Definitely, not something I would do anything about but I wonder if that side is closing up? I haven’t looked under a scope in a while.


Well, just had ilioinguinal and iliohypogastric nerve block. She wanted to do those first then later a block of the genital branch. I’m a little disappointed because I’m convinced that the gf nerve is involved. So far I seem to have some minor relief of the peripheral components of my pain but the surgical site did not go numb at all. So overall, not a poor outcome by any means but I think it is proving that I need that genital branch blocked. I still need to see how things progress when the steroid kicks in. Unfortunately, today was a low pain day for me. Looks like I’ll have to wait another month to get the nerve block done that I really want. Super easy procedure, they kept offering me sedation but I declined. I totally don’t think it is necessary and it will alter my perception of how effective the anesthetic is.

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So ilioingunal and iliohypogastric blocks gave about 10% pain relief. Helped with what I would call the background noise. I just had my genitofemoral nerve block about an hour ago. My testicle is definitely numb and when I press on the pain area most of the pain is blocked. I can feel a little bit. It’s way too early to tell but this seems promising. My entire pelvis is messed up. I’m restarting taking klonopin because my muscles are out of whack. I also plan on visiting a pelvic pt. The constant testicle pain has caused poor posture resulting in pains other places. I’ve been stretching and in a hot tub a lot and that has been helping. Depending upon how this nerve block plays out, the doctor may also try a superior hypogastric plexus block to help with sympathetically mediated pain and pain that has centralized over the last two years. Good luck everyone.