Post Vasectomy Pain Forum

Reversal Recovery queries, please help?

Hi there,

I’m new here. I had a vasectomy in June 18 and for 18 months suffered left sided testicle and epi tenderness which I was advised by urologist was likely congestive epididimitis.
I proceeded with reversal in May this year in the hope that it would resolve or improve my issues.
I’m now approaching 4 months in my recovery and it’s been tough. Physically and mentally exhausting as I’m sure many of you know.
I expected to have pain for some time post op so I’m trying to stay positive about my recovery however there are 2 specific issues I’d like to hear of people’s experience with as my urologist doesn’t say much. I’ve looked around the site a bit but can’t find much on these.
Firstly, my left epididimus is now really swollen and tender at the head, so much so that I can see it protruding against my scrotum. This is new since reversal, my pain pre reversal was more in the tail of the epi. Has anyone else experienced this? Is this just a normal inflammatory response after a big surgery that I just need to be patient with? Any treatment that’s worked for anyone? ( I tried a course of antibiotics to ensure no infection but they didn’t help)
Secondly, I am getting this stinging / burning pain radiating from behind my testicle and what feels like up the cord and along my perineum. It comes and goes a bit and tends to be stirred up when my core becomes engaged. Is this a normal neurological response to surgery that will also settle down over time as recovery progresses and inflammation settles? Any treatments for this that have worked?
Other than that it’s really just the aches and pains that are to be expected after surgery. My concern with these two symptoms is that I didn’t expect them and they are new since reversal.
Any experience you could share would be greatly appreciated as they are really playing on my mind!
Oh lastly, I feel I’m still nowhere near back to running or gym. Any experience on how long it took until you could get yourself back running or in the gym would be great.
Thanks so much guys.

Welcome to the forum @Downunderben. This sounds pretty awful.

Do you know what kind of reversal you had? Vas to vas?

Your symptoms changed significantly and seemingly for the worst and your urologist doesn’t say much? That sounds terrible. Can you elaborate on what they said?

How many times have you seen or contacted your reversal surgeon since you had your reversal? Do you even know if you are fertile? Did or does your reversal surgeon or urologist have you on any anti-inflammatory medications (NSAID)? Are you even working with your reversal surgeon anymore?

Typically, the same or similar NSAID’s, same antibiotics, same meds, same/similar post surgical concervative protocols apply to vasectomys and reversals - especially for pain patients.

I have experienced some post reversal complications, but nothing like you are describing regarding the swollen epididymis. Considering you had the reversal in may - this doesn’t sound like a typical inflammatory response to me. IDK.

Yeah, a lot of men do get better in time, but it can be a very long road. Sounds like you might need a better urologist.

I just had a standard vas to vas micro surgery. Was told everything went fine. Had a test recently and I have sperm flowing through within expected range. I’ve tried nsaids. If I think about it, it has improved slowly over the 4 months. It’s just very very slow! I’m mindful of not taking too many nsaids also as they can cause its own issues. My urologist just tells me it’s inflammation and I just need to be patient. I have an appointment for a second opinion next week.
It just feels like my entire left side is inflamed all the time. It actually does feel like an inflammation feeling. Rest seems to help but that’s hard to get with a job and 2 little ones, not much lying around time!

Personally I doubt the efficacy of NSAIDs. I would try hard on steroids. 40 mg prednisolone tablet each morning for 7 - 10 days. That should dampen inflammation. They say corticosteroids mask any symptome but death. I tried it for a week, until I couldn’t cope with the side-effects any longer (insomnia, feeling of dizziness, general out-of-shape), but I do believe it did a little bit with the pain 10 weeks post vas. Most dr’s won’t recommend it though, I belive, and it’s somewhat risky since it wacks out your immune system.

Ok thanks I’ll ask the urologists views and give that a go. Anyone with any advice on the neuropathic pain that comes and goes since reversal?

Well, I guess that sounds like good news, but no post op findings to speak of is rather unhelpful to you or anyone else. It’s always nice to get a full report afterwards - ie - if were sperm granuloma present on either side, if the surgeon noted that you were cut to high or to low during the vasectomy, if he/she removed any hemoclips if present, if anything else unusual or abnormal was noticed during the procedure - the level of scarring, etc.

I always prefer to hear a mans actual sperm count and motility is myself. There’s no telling what within expected range means exactly. Those statistics tend to vary place to place, country to country, etc. But I suppose it’s good to know that you are fertile post reversal.

Yes, they certainly can. I’m not sure what kind you have taken. Some work better for some men than others. I prefer 200mg celebrex myself.

This is actually quite possible. I’m not thinking there is anything that is 100% typical about reversal recoveries either. Many men have their own unique stories to tell regarding so many things. In many cases, recoveries are not linear. They can be a bit of a rollercoaster ride for quite some time for many. I have experienced it myself.

BTW - how long did your urologist have you on antibiotics post reversal, post all of the new swollen epididymis symptoms? Do you feel pretty confident that these symptoms are not related to infection, epididymitis, etc?

That’s good. I don’t like the idea of you suffering if your urologist is missing something and/or if something can be done to help you. Perhaps your current urologist is wrong. IDK. There’s nothing wrong with getting a second opinion.

Side note - I have heard of several guys that had a post reversal story like yourself. I’m sure I have heard many stories that I don’t recall off the top of my head at the moment, but just wanted to say that I have seen, or know of men that eventually made a near full recovery that had similar symptoms for the first ~12+ months or so post reversal. Anything is possible.

There’s also a few guys that have posted similar post reversal stories on this site, but unfortunately they never posted an update in time. Hard to say what happened to them.

Time, meds, proper support, physical therapy, stay active, keep your mind busy, and so on. There are some other concervative options to consider, but at this point, I think I would stick with the former.

Let’s see what happens at your next appointment.

Keep us posted brother.

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Thanks so much for the advice, I really appreciate it. I’ll let you know how I go with the 2nd opinion.

Hi, quick update post my second opinion. He thinks my pain left side is not the head of the epi but more likely some scar tissue from internal incision sites they make to access the surgery site. He thinks this will soften over time and improve and it has seemed to settle a bit over last few weeks so I’m just going to try to be patient with that. He also said my left testy is just generally tender and inflamed so has prescribed some Celebrex.
I also saw a pelvic floor pt for the nerve pain in perineum and some stretches she game me seem to be helping. She was fantastic. I’d also been feeling little nervy jabs and pains up through my groin and into my inguinal region. Her view was that this often happens because the whole area has been so hypersensitive to protect from pain for so long that all the nerves fire off over what would normally not cause issues. She got me just to think about my testy being knocked and the nerves fired up which showed that whilst the pain is not all in my head, it’s real, the mind plays such an important part. The plan is to try to settle the nerves down as much as possible through nice easy stretching and then once they are settled to slowly build back into normal activities. This will take patience but it makes sense to me so I’m happy to give it a go.
I also had another light bulb moment where I realised that I had been having a few moments where the pain was close to non existent and I was finding it really hard to just accept that and was just waiting for it to return and when it did, even if it wasn’t that bad, I would become really down because my glimpse at pain free life disappeared. What I’m going to try to do is flip that thinking and be positive that even small widows of no pain suggest healing and recovery is taking place and I just need to do my best to be positive and patient. I’ve only just gone 4 months post recovery and from looking around this site many seem to experience significant gains anywhere between 3 and 12 months so I’ve still got plenty of time for improvement.
If anyone has any insights to share on anything similar within the journey it’d be great as anything to keep the mind positive and focussed on moving forward is a good thing.
Thanks everyone

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Thanks for the update @Downunderben.

You certainly sound more positive and/or optimistic than in your previous posts.

Don’t forget to drop another update/s sometime. I am curious to hear how things progress for you in time. I’m sure others will find your update/s helpful present and future too.

If you have any more questions - don’t hesitate to ask.

Good luck

Thank you. I actually do have one more question for anyone with any experience with nerve pain meds. The PT suggested a low dosage can be a good circuit breaker just to assist in calming everything down while we do the PT work. For some reason I’ve been keen to stear clear of nerve meds due to many stories that I’ve heard about side effects. Her view is that a low controlled dose shouldn’t cause any issues and that she’s had great results with them.
Has anyone found them to be positive and helpful?

Based on everything I know, there is likely some truth in what she’s telling you. What she’s telling you isn’t unheard of by any means.

I’m guessing she’s referring to RX meds like gabapentin, lyrica, amitriptyline, cymbalta, and so on - which aren’t your typical pain meds. If you or anyone else is unsure of what I mean by that, look them up.

Some people do well with such meds and some don’t. I too have read and heard many bad reviews regarding such medications, but keep in mind that there are plenty of people in general - including some men on this site that did well with such medications. There are some men that didn’t as well. I don’t do well with such medications, and neither does my mother. Cymbalta makes my mother see halos.

Bottom line - only you can decide what is best for you and/or if you are going to give something of the sorts a try. I certainly would not recommend anything RX of the sorts to anyone without a proper warning beforehand. Such meds have the potential to put someone on a bad trip, could potentially lead to unpleasant side effects, and so on.

I did well with tramadol and celebrex myself, but keep in mind that what works for one may not work for another - and vice versa.

Hope that helps.

I’ve used gabapentin to that effect for limited durations after vas and reversal. I used 900mg daily, which I’m told is considered a relatively low dose. I don’t find it at all addictive and come off it without issue. Side effects for me are that it dulls all my senses and makes me a bit stupid. It may make me feel a bit depressed, but that may be a result of the general numbing effect. Nothing lasting though once I stop. I’d say it’s worth a shot in the way your PT is recommending. I wouldn’t say it’s a good long term medication. It’s been around a while so it’s quite cheap and well studied. Lyrica and cymbalta from what I understand have the potential for more side effects.

I’ve had bad luck with pregabalin and lyrica. Made me doppy, forgetful and tired. Short term memory was awful. As was mentioned above all men will have different reactions and maybe no issues for you.

Thanks guys. My follow up is in a few weeks so will see how I’m feeling then and may give them a go if still needed.

Hi there, thought I’d provide a quick update.
I’m finding it hard to be objective today as I’m feeling quite down about the whole thing. The weird thing is I’m not down because I’m not improving or getting worse. In fact I have continued to see slow improvements over the last month. My chord pain and ingunuial pain whilst still there seems to slowly b getting better. And the inflammation I had been feeling seems to be settling and the nerve pain has also improved. I just get so frustrated with this process and sad at not being able to just get on with my life without this in my mind every second of every day. I’m sick of having to be careful with how I sit and walk and move so as not to hurt it. I desperately want to go for a run but just don’t feel there yet. I had thought as my pain improved my mind would also but in some ways on some days my mind is worse because I get a small glimpse of a pain free life but then it disappears again. Today is a great example where my pain is only annoying without being terrible but I just feel so down. I am trying my best to remain positive but at times it’s hard.
One issue I am having is a burning feeling right at the end of my scar on the left side where the op was done. Anyone that’s experienced this with any ideas that’s b great.
All in all though physically I am in better shape this month than I was last. I’m just trying to hang in there with any small improvements. My urologist had reminded me that scarring and nerves can take a good 12 months or more to settle and I just need to continue to give it time. Another urologist I saw told me in his experience whilst some can feel pretty good by 6 months there are still many that take 6 - 12 months to feel good again. I’m just coming up to 6 months soon so just hoping to see continued improvement through the next few.
I’ll continue to provide updates as I go. If anyone has a similar story that can show me some light at the end of the tunnel I’d love to hear it.
Take care all.

Sorry, I should just also say my expectations r not necessarily to b completely pain free again. I just want to at least be able to get back to the things I love. Running, some gym training, playing properly with my kids. I could go this after vas and before reversal even with the vas pain I had so I just want to at least get back to that. Again, any experiences on getting back to those things, timeframes, how u did it etc would b greatly appreciated :+1:t4::+1:t4::+1:t4:

The doctors or urologists you have spoke with regarding typical reversal recovery timelines are shooting you straight. ~6-12+ months is pretty typical. Every man is different. Unfortunately, there is no one size fits all answer.

There are things you could be doing in the meantime that might be beneficial. There isn’t a one size fits all answer regarding all that stuff. Those things are not mandatory either. Again, everyone is different.

Considering your first post on this site, you seem to be trending in the right direction. Don’t give up on time itself.

Hope that helps

Thanks, that encouragement really helps!

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Reversal recovery is much more involved and can be a long journey. Be patient. Be happy you have patency. Try to be healthy and eat right, get lots of rest and wear supportive underwear.

If you are having moments where you forget about it you are heading in the right direction.

I was a regular on this site for 7 years. 1 year before reversal and 6 after and It took me that long to break free from the 5 years of agonizing pain I was in. I owe it to serendipitous side effect of a medication taken to help me lose weight ->metformin. I took 500mg a day on my way to 1000 and after 4 days my nerve pain disappeared. It was like a switch was turned off.

You sound like you are in a pretty good place and getting better. If you have nerve type pain still maybe you could get a script for metformin and give it a try. I don’t take it now. There is research on Metformin for use in neuropathic pain. It’s not a complete fluke that it worked for me but that was not what it was prescribed for.

Good luck. We are always here if you need us.

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