Post Vasectomy Pain Forum

Testicle and Leg Pain

Hi I am new here and was hoping to find some help and support regarding testicle pain.

I was diagnosed with chronic testicle pain 14 years ago and have undergone numerous tests, scans, nerve blocks and surgery, but nothing has helped.

My quality of life is extremely poor as I cant do the simplest of tasks because of the pain, the pain is in my right testicle and goes down my right leg. I cant stand or walk for long, I cant even sit down for too long as the pain gets so bad, I cant even wear jeans or trousers as the seam of the clothes triggers the pain as it rubs on the testicle.

The pain is located at the top and bottom of my right testicle, seems to be the head and tail of the epididymis, it’s very tender and painful to touch. The pain seems to get triggered after ejaculation/having sex, can start as an ache in the right testicle and gets painful and goes down my leg.

My new urologist has recommended Orchiectomy of the right testicle, and I was looking for some advice regarding peoples experiences with loss of one testicle.

Have you guys had any long term pain from having a Orchiectomy?

Have any of you guys gained weight, or lost muscle mass from losing a testicle?

Thank you in advance for any help.

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Did you have a vasectomy or other trauma? Have you considered epididymectomy?

Hi Sentosa, Not had a vasectomy, but I’ve had a varicocelectomy which hasn’t really worked.

14 years ago my pain just started all on its own, it started as a dull heavy ache from standing on my feet all day, plus my job involved heavy lifting. The ache gets very painful and always starts in my right testicle and the pain radiates down my leg, the top and bottom of my testicle is very tender and painful, feels like its the epi at fault.

The surgeon said removing the epi can often make the pain worst, so they rather remove the testicle as it has better results for scrotal pain.

My personal opinion and anecdotal evidence on this forum jives with your uro…I’d have the testicle and epi removed together, not just the epi. No doctor has ever been able to explain to me what happens to the sperm produce by the testicle if it’s receiving epi has been removed.

You mentioned surgeries. Have you had spermatic cord denervation? Are you in the US? Have you spoken with or seen either of the physicians at the PUR Clinic?

Cord denervation was, theoretically, invented to solve scrotal content pain without removing contents. It has mixed reviews on this forum, so by no means am I recommending it. I’ve been able to beat my 3 bouts with post-vasectomy pain with meds and injections without resort to it. Several of us have commented that cord denervation MAY be a better solution for those with scrotal pain from something other than vasectomy.

Before removing anything which is irreversible, I’d urge you to speak with one of the docs at the PUR Clinic. If you’re near Cleveland, Dr. Shoskes at the Cleveland Clinic is the only one in Ohio doing cord denervation, and he appears to do many. He’d be worth seeing, as well, depending on where you live.

Chip5, could you clue us in on the things you have tried? I don’t want to spout off a bunch of stuff that already didn’t pan out for you. But when I read you are considering orchiectomy, I wanna say pump the breaks have you tried x,y, and z first!?!?

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Hi mate, 14 years ago I was diagnosed with small varicoceles and cysts both sides, my first urologist said that my epi was the problem and that he could remove it, but also said the operation can be complicated and most often removal of the epi causes more pain. I was told to take meds such as amitriptyline, and then gabapentin which didn’t work. I carried on living in pain with my quality of life deteriorating each day, suffering what feels like a living hell.

Fast forward years later I then had an ilioinguinal nerve block which didn’t really work, so they agreed to give me a subinguinal varicocelectomy which was 7 weeks ago. I don’t think it has worked because I still have the same pain as before, if anything the pain is somewhat worst.

My 6 week follow up my surgeon has said I would stand a better chance of being pain free with having the testicle removed, he said there is no point in removing the epi as this will just cause more pain, the procedure rarely works. He reckons removing the testicle and cutting the cord high up gives a better chance of the procedure working, cutting all the nerves and removing everything works better for chronic scrotal pain he said.

I asked about MSCD and again he said it rarely works, not enough in known about the procedure here in the UK, he said we cant see all the nerves, so some get left behind. He also said that I had a spermatic cord block during my varicocelectomy procedure and it didn’t work, I still had the same pain when I woke up from the anaesthesia.

I live in the UK and having these procedures done on the NHS, the NHS works really slow in non life threatening conditions, I am now waiting to have the testicle removed; but ideally would like to try another spermatic cord block and go on to have MSCD. However I am more than willing to have the testicle removed as I do agree with the surgeon in cutting and removing everything I stand a better chance of being pain free.

Hi mate, thank you for your reply. I have posted above my bit of history, see what you think. Cheers mate.

Did you ever give pelvic floor physical therapy or general PT a shot? I had pains in my testes and epis that sent referred pain into my hips and down my thigh after vasectomy. PT didn’t fix it, nor was the pain in my testes caused by some dysfunction else where (well 90% sure anyways), but it did beat back the referred pain and greatly improve my quality of life. A guy I work with had groin and nut pain start out of nowhere, and it ended up being totally fixed by PT. I forget which nerve and muscle was the root of his issues. But it does sound like you have evidence of testicular issues most likely at the root of your problem.

Hi mate, I was told to perform pelvic floor exercises for six months, this made my left nut hurt and didn’t help my right nut at all; the right nut is the worst side. I was never referred to a pelvic floor specialist though, just told to perform excises at home.

Since I had the varicocelectomy surgery on the right nut, my left one is hurting more, can pain cross?

Did your pain start after the vasectomy?

Maybe? Probably not by nerves directly but muscles spasming and pulling things out of balance across the body. My left psoas and right lower back exhibit this at at times. But I had pain on both testicles from early on.

Yes. I believe congestion and epidemitis were there root of the problem. That constant pain and irritation set off all the other problems. I’m recovering from reversal right now, so I can’t say 100% yet.

For perspective, prior to PT the pain was debilitating. Afterwards it was livable to the point that it took me over a year to finally opt for reversal. And I should clarify when I say PT I mean it as an umbrella for medical PT, massage, chiropractic, and even acupuncture. A massage therapist actually was the most relief per dollar for me.

Hi mate, I was thinking, if my pain was coming from my pelvic floor or even a hernia or something, if one of those organs was transferring pain to my right testicle and leg, would it still hurt like hell when I press on the testicle, even though the pain was coming from somewhere else?

My testicle and leg pain doesn’t start on its own, it has a trigger point which is the top or bottom of the right testicle. As soon as I put on clothing or sit down the pain starts in my right testicle and travels down my leg. The pain is always located at the top of the epi, last night I touched the top of the testicle and got instant pain which shot down my right leg, this happens all the time.

I’m not saying a testicular issue isn’t at the root of it. Sounds actually likely in your case, as it was in mine. But for me there was a “feedback” from the spams and muscular dysfunction caused by the constant irritation. The PT stuff made both primary and referred pain much less for me. Like I thought I was nearly clear of PVPS at one point. I still had flare ups which eventually sent me to a reversal. PT techniques have been helpful past reversal recovery too.

Hi mate, It’s really confusing isn’t it, especially when different urologists all have their own opinions as well. When did you have your reversal surgery?

The surgeon that done my varicocelectomy said when he cut me open he found the surface of my testicle was inflamed, but he didn’t say anything about why it was inflamed, it must be inflamed for a reason. He also told me that he found a cyst on the head of the epi, not sure if this is causing my pain or not, again he didn’t say anything about what he thought, which I found very odd.

Hey Chip!
I too have non vas related Scrotal Content Pain. Left side. No related injury, trauma or surgery to account. I do have cysts, and a varicocele… all of which the docs assure me do not cause pain. I have called BS on the for years now! Something is causing this pain.

If you find my other posts, I have had the nerve blocks done, with time limited success. I have considered denervation, but haven’t gotten my mind around removal of tye testicle …

I find, that relief from the pain, when sitting in a hot tub, or bath or even when the weather is warm, and everything relaxes, and the scrotum hangs away from the body… I don’t know if you find similar relief. I have been doing research for awhile, and although not for pain, I have found research that Botox in the cremaster muscles of the scrotum, release The muscles allowing the scrotum to hang looser for as long as the Botox lasts… in theory, in my case, this sounds like it may provide relief… however, I have been unable to find a Doc, will to do this…

Just something I have been looking into.

There is so little out there regarding this, and Us men as a rule don’t talk about it… although I have been much more vocal in the past year, and have discovered two friends who have to a lesser, less debilitating degree , similar pain as mine…

Hope this is somewhat useful, if ya wanna talk about it, all ears!!! No need to suffer in silence…

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I have seen many patients that opted for an orchiectomy with continued, persistent pain. Phantom pain. Like when a diabetic looses a painful foot and it still hurts like hell. I am a firm believer in pelvic pain physical therapy. there are a few experts in the country and many men have had good results without burning bridges of surgery. I have performed hundreds of reversals on men with PVPS ( I only do reversals and do not handle all the other issues of PVPS) and when it works, it works great for most, but for others it sometimes doesn’t or it can come back. I’d say talk to Dr Sijo Parekattil in Florida. I have sent many men to him (and he has sent many men to me).

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Dr. Marks - thank you for coming here and chiming in. I spoke with you during my second bout of PVPS in 2008-09 but ultimately recovered. Had another, more stubborn bout 2016-18 but recovered following treatments (plural) with Dr. Parekatill. We’re fortunate to have men like you and him in our corner!

Thank you Dr Marks, I very much appreciate your reply.

What makes me confused is, if my pain was coming from my pelvic floor, would putting on a pair of jeans or touching my right testicle trigger my pain to start in the testicle and radiate down my leg, just by putting on a pair of jeans?

Hi Caperdave, You sound very similar to me, my pain started all on its own, started as a dull ache from being stood on my feet all day. Also ached after sex/ejaculation, this often made it worst.

My pain starts in the testicle and goes down my leg to my foot, do you get similar?

The only surgery I’ve had done is a varicocelectomy, which hasn’t worked as I still have the same pain.

My right testicle seems to be the trigger point, its always tender and the pain will start when I put on a pair of jeans. Surely this red marker must indicate that my testicle is at fault, it seems to be the trigger point?

I’m so confused.

From orchiectomy point of view i am in a very similar situation. My vas deference was damaged during inguinal hernia surgery. İ am in pain for three years. Sex is painfull. My sex life is destroyed. İ am in deep depression. Dr P. Ofered cryablation and one other uro ofered SCD. But there are persons in this form in more pain due to SCD or cryablation. So both actions are dangerous.
One other uro ofered removal of spermatic cord and vas deference and orchiectomy. So this May create phantom pain…

İn every choice or situation there is pain risk. But in current situation i am in pain😤

Hey chip,

Mine is left, and radiates up into my groin, hip and into my abdomen, and a little down the left leg.
Any vigorous activity, running. Jumping. Sex - solo or partnered can trigger. I often don’t get to the ejaculation stage, as the pain becomes too intense and is an instant boner/mood killer…
My Doc has suggested good supportive underwear, ( I am a loose boxer/freeball kinda guy). I do wear them more often, and don’t notice much difference.
Do you find much relief when your scrotum is hanging looser? Like in the heat, or after a hot shower, bath? I find this can reduce or eliminate the pain greatly. My wife says, I am trying to convince her to move to hotter climes… which is also the case…