I have read this forum for years (basically just before my vasectomy, I should have trusted my gut), but here is my turn to come for help. First I’ll vent a bit with my story.
I got a vasectomy in 2018, it was intensely painful during the surgery and I asked for additional pain relief in the middle of it. The surgeon said it was not possible to feel any pain, but there I was crying and squirming. I always had a high tolerance to local anesthetics it seems.
I could feel a bit of the local pain, but also pain shooting up towards my stomach. I was white as a ghost after surgery, the nurse was very worried for me apparently. The pain was intense and disabling for months on end, it was hard to walk more than a few hundred feet even after a number of weeks of recovery. Recovery took many months of waxing and waning pain, easily 6+ to feel a bit more normal.
Then I had a few ‘ok’ years of much less pain, much more like sensitivity and an occasional set back.
The biggest difference was I just never felt the same again since that surgery. Immediately afterwards and to this day there is a tightness around the base of my penis, it feels strangled at times. My orgasms are different, sex is different. All of the things that I was promised to remain normal…
Roughly a year ago now, some pain started to come back, slowly but surely things really didn’t feel great. Shortly after that, one night during sex I had major discomfort and nausea set in. I lost my erection almost immediately and pain started to set in the coming days.
Immense, life changing pain. I literally could not function, hold conversations, eat. It was terrible, finally after a couple of urologists I got on a strong dose of gabapentin which helped me at least get to the point of minimal viability as an adult and father.
I’ve been in this limbo of pain and uncertainty, and I feel like sometimes that I am a disabled person. It’s hard to go for walks, I can’t do anything athletic except maybe occasionally swim. Forget about trying to be an active father. Plus sex is really just sad now. I actually find my self now trying to not think sexually at all, because it’s simply more pain free.
I’ve tried the regular kind of relief stuff, antibiotics and NSAIDs.
Then cord blocks, oh boy were those crazy painful during the injection process. I am just so tender down there. The first did seem to help with pain maybe to the point of 80% for about an hour-- but sometimes I wonder if it was simply me being super enthusiastic. After it wore off I had increased pain for 2+ weeks.
I then tried a second block mixed with a steroid and it went awry it seems, caused tons of pain and never any relief. More pain ensued and easily lasted 3+ weeks.
Really any examination, or touching, causes 8-10 pain for days on end it seems, but the cord block after effects were just not worth it at all.
I also tried things like pelvic floor exercise (no relief), alternative medicines (some of which I found on here, sometimes very tiny relief but never consistent for me to suggest using), and acupuncture multiple times a week for months (a waste really).
After tests and attempts, I’m at the point of reversal, denervation, or maybe both…
I have local pain which I attribute to congestion, I also have sharp shooting pains up into my abdomen (often) and to my anus (less often), leg (rare), and penis(also rare). I know it has flared up bowel issues, and I’m trying to figure out how to basically supplement what I am now losing in nutrients.
I also have vague but strong pain on one side that causes me to feel nearly disabled because I now literally hobble around and walk with a weird gate to prevent any additional discomfort. I am literally in 24/7 pain for nearly 10 months now, plus good ol’ nausea and often IBS too. I find my self tearing or straight up crying sometimes. Occasionally, I find my self almost doubled over in pain and I think it’s just getting worse some how. At least a few times I fell to the floor in sharp pains.
I have seen multiple urologists/surgeons at this point.
Denervation is a common topic it seems, not without risks obviously. I’m basically terrified of the idea, it seems extreme and I feel like it doesn’t really fix the underlying issues which are constantly brewing.
One surgeon in South Carolina is absolutely adamant that reversal is the only way to truly alleviate pain. He in particular performs a handful of reversals a week and 1-2 in a month tend to be for pain relief. He’s been operating for the last 30+ years with 100% success rate at reversal (offers no post op care).
A point he made during my call with him is that sedation and local anesthesia is better during surgery than general since a ventilator would technically move my testicles under while operating which is less than ideal.
I was a bit gun-ho to go for it, just based on his confidence, but I just saw the most highly regarded urologist/ surgeon I could find, based in NYC. He was very knowledgeable during exam (but said I simply have congestion and nothing out of the ordinary) and his suggestion was start at denervation. He did also offer up a reversal and that he would also perform denervation at the same time in my case (his idea).
He was highly confident that there would be zero issues from the denervation as he is highly skilled, but there is a chance of permanent minimal numbness at the area and surrounding area (including a bit of my leg).
He had statistical rates of pain-relief success that was just around 70-80%, which I think is simply the rates everyone seems to refer to at this point. He performs 1-2 reversals a week with 100% success rate of connectivity, also been doing it for 30+ years.
I was in so much pain from the examination that I couldn’t think straight, but I’m going to inquire about his denervation success rates versus complications soon as I get a chance.
Obviously I want the best course of action but I’m at a bit of cross roads and it all seems a bit like a crapshoot.
I lean heavily towards the guy in SC, with the reversal; simply because his confidence was so high at my overall recovery, it also seems the least likely to cause permanent irreparable damage.
Part of me thinks that the vasectomy is going to have long term effects like testosterone issues, or maybe something else, and that denervation may not alleviate my issues of stomach nerve pains or bowel issues-- maybe nothing from a urologist will though…
I’m also a bit nervous about long term effects of denervation. The NYC guy told me no major effects, but that the nerves can grow back and a second round may be necessary. He was highly confident about removing nerves one by one, and that the process is easier and faster to heal from than a reversal.
Has anyone knowledge of a reversal WITH a denervation performed as well?
Appreciate any words of wisdom (any at all, general or specific) or ideas I need to further research!