Post Vasectomy Pain Forum

Spermatic cord nerve block causes swelling?

I got a spermatic chord block seven hours ago. Two shots: one near my left pelvic bone and one into my scrotum right by my left testicle. I notice my left testicle area is swollen to about twice its normal size. It feels like a bag of water surrounding my testicle. Is this normal? any advice? I did spend some time walking around after the procedure and the doctor gave me no special instructions. thank you

Blocks are fairly low risk and benign. On rare occasion you can get a hematoma (pooling of blood) if an artery or vein is punctured during the block. Generally this is self limiting and should resolve over a few weeks. Just keep an eye out for increased pain, drainage, fever/chills as this may be signs of an infected hematoma (extremely rare). Ice packs and scrotal support may help.

Jamin Brahmbhatt, MD

Thank you Dr Brahmbhatt. I am left thinking that I might have an allergic reaction to the anesthesia. The reason I am thinking this is that the pain I am now experiencing is very similar to pain I felt on the right side in the hours, days, week and months following my original vasectomy. At that time I had what I thought was a hematoma-very sensitive to touch, ached with each step, ached when I coughed or did anything. This is not quite as bad but very similar to what I am now feeling on the left side. I am now 20 hour post nerve block and my left testicle is swollen to about twice its normal size- I think the testicle is ok but the epididymis and the spermatic cord and super sensitive to the touch and ache with every step, cough etc. that I make. The only odd thing to me is that my left side did not hurt like this after my original vasectomy. I’m trying to find a silver lining and am thinking maybe I am allergic to the anesthesia? I can’t find any info online about this swelling and pain post nerve block. I am just praying that it does not last 5 months like the right side did…

I had a nerve block done in my right epi. After a couple of hours it started to bleed and then bruise. I was in pain for 10 days and then my situation resumed back to “normal” PVPS stuff. …Good luck. I hope the swelling goes down soon.

Thanks Tim, I just came from the ER my reasoning being that an ultrasound can’t hurt. The report says epididymitis and hydrocele. The doctor looked at me like I was crazy when I told him that these just happened yesterday from the spermatic cord block. Of course he said you have some good questions to take up with your urologist. My much more involved ultrasound in late December did not show any abnormalities. I can not find any evidence of spermatic cord block causing these but it did in me and it causes the exact same kind of pain that plagued me for months following the vasectomy. In both cases my epididymis went haywire and swelled like crazy. Its strange to be wishing I could just go back to the PVPS evening daily ache…

Did your original testicular pain get any better after the block?

Jason, after almost 2 years I’m still not adjusted to this new reality of PVPS and all its related issues. Hopefully, your reaction to the spermatic cord block will be indicative of something and will give a good doctor, like Dr. P, some ideas about the best treatment steps for you. Back in August I did a nerve block with Dr. P, which unfortunately wasn’t therapeutic, but my response helped Dr. P suggest what I might do next. That said, I’ve been trying to wait it out. I’m afraid of surgery. Hang in there.

Thanks Tim and Dr. Parekattil. I feel like a fool because I actually spoke with Dr Parekattil on the phone a couple weeks ago and he warned me not to do the nerve block because some men have bad experiences with them. Once again I let the doctor and my wife talk me into something that I knew could hurt me. My original pain seemed to go away from my spermatic cord with the block but my testicle still hurt. It was actually kind of tough to tell because most of my pain comes on in the evenings and this was around noon. I also noticed with an hour or so that my scrotum was swelling so that became my focus. I still kind of thought “well that anesthetic has to do somewhere” but as the day progressed it was clear that I had problems. I am left with swelling around the testicle but the bigger issue is that my epididymis is now enlarged and much more hard to the touch. I got the ultrasound to rule out hematoma. It is the same issues that I had after my vasectomy but now on the other side. I talked to the doctor on the phone and he said it sound like an inflammatory response. I take ibuprophen etc but it does not seems to help. It took months before I could walk normally and resume activities after the vasectomy and now I am feeling the same kind of pain on the left. It feels like a large hard lump about the same size as my testicle above my testicle (my epididymis) It does not seem to get any better. Each day it aches and hurt especially when I stand up and walk. Hopefully I can heal up over the next couple of months and then go see Dr. Parekattil. I am trying to hold out hope that by some miracle I will heal up and be functional again.

Wow, this thread alone is very representative of two things…1) the widely varying response that men have to having the same procedure, and 2) the different ways that doctors approach the same procedure.

Jason, from reading your initial post in the thread, it sounds like you were fully conscious and were watching the block procedure, based on the locations in which you described the blocks took place. And Tim, we had our blocks with Dr. P right about the same time, mine was in August of last year as well. But the response was totally different for the three of us. First, for Tim, you say it had no effect therapeutically for your testicular pain. Jason, you state that the block was possibly detrimental, and my experience was just the opposite…giving me complete and total relief from pain for several hours. At no time, even after the block, did I feel any worse, and except for the slight evidence of the puncture wounds left by the needle, would have had no idea exactly where the block(s) took place. But, one big difference might have been the way the blocks were done.

As many here know, Dr. P uses sedation anesthesia while doing the block, and while that alone might not have anything to do with your results, it might. But it just makes me that much more amazed at how Dr. Parakattil & Dr. Brahmbhatt can manage to stay on the course to finding some answers to the chronic pain that we all have suffered with. I often feel like throwing my hands up in the air and just giving up…but then what is my recourse? I will still have the pain. This and the previous forum helped me immensely in researching the experiences of so many in similar circumstances. Dr. P mentioned that it is sometimes hard to keep up with the men who have had successful outcomes from the procedures that he has performed on them, as they tend to “disappear”, and probably rightfully so. But I often wonder where the men are who have not had successful outcomes. The ones presently on this board cannot be the only ones of us out there.

Anyway, Tim…don’t give up on the possibilities that surgical intervention could help, and if anyone can make you less apprehensive about surgery, it is Dr. P. I also share your fears of surgery, but so far have not given up. Jason & Tim, I wish you both the best in your recoveries and whatever future treatments you may seek.

Just a quick update. I noticed last night (5 days post nerve block) that I have a rather large (1 inch by maybe 1 1/2 inches long) purple bruise on my scrotum where the needle was inserted. I still feel substantial swelling around my testicle, a hard epididymis, and pain that shoots down that cord from near my stomach (were the first injection was) into my testicle. Pain is worse when I stand up-I feel like things kind of fall down and it hurts. It really hurts when I bend over too. Then I noticed that when standing up, I can literally see my scrotum undulating slowly on that left side. It seems to go out and come back in and move slowly but constantly-my wife actually noticed this while checking the bruising 6 days post nerve block. My advice for anyone in the future reading this- do not mess around with local doctors (mine was one of about 7 I have seen and he was 1 1/2 hours away in Columbia Maryland and he has done many a reversal, denervation etc), and take yourself to the pros like Dr Parakattil and Dr Brahmbhatt.

Sounds like you formed a small hematoma after your nerve block. That can happen to the best of us if a small blood vessel is punctured during the blocks. The good news is that hematomas generally resolve on their own over time. After our blocks we generally recommend ice packs and scrotal support to decrease the odds of hematoma. We also take a whole body approach with anti-inflammatories to decrease any potential inflammation or reaction from the block. I wouldnt say we are any better than the local docs–just maybe a bit more experienced with the procedure and the testicular anatomy. Hang in there and keep us updated on your statue. Thank you for the support.

Jamin Brahmbhatt, MD

Just to update my story-its been five weeks since the nerve block and mostly I am back to where I was before it. Most of the swelling has gone down and I am pretty much back to my regular level of pain. That left epididymis still feels kind of hard and enlarged. I have not exercised (weight lifting) etc. over this time but I am thinking I can start again soon. The only difference in my pain seems to be that it hurts in a minor way most of the time now. Pre nerve block it always seemed to hurt more in the evenings and less in the mornings. I still feel that the pain is in my (primarily left) testicles and not really my spermatic cord. I just wanted to update for the benefit of anyone reading this in the future.

I have a question regarding my cord block. I had it done back in November and I still have pain in the injection point of where the needle was inserted. My Dr. was horrible, it was a wham bam procedure with no instructions on what I should expect after the procedure. Wish I never had the block. My chiropractor has gotten me back to where my testicular pain is gone but now I’m dealing with this pain from the needle injection. My chiropractor feels it will take 9 months for the scar tissue to heal the injection spot. Do you agree or could the unhelpful Dr damaged something? Just an fyi the Dr told me that there was nothing he could do for me and sent me to a pain specialist.

Hey man. My situation is very similar to the one you posted some time back. How are you doing now? I had pain in both sides following vasectomy. Right side worse. After a year I was doing ok but not 100% so I saw a dr who said “let’s do a block and see if it takes away pain from vas sites. It did but after a day the good side started hurting like the bad did the fist couple months post vas. Wish I would have done it. I’m wondering if it was the nerve block or me pushing around on vas site when I was numb.