Post Vasectomy Pain Forum

Was supposed to be easy!

Hello all - I have to say I’m both glad and sad this forum exists. I’m sad to see that we were all mislead about the possibilities of having issues but I’m glad we can all be here for each other and hopefully some of us can get better! My doctor said he has yet to have any patients with any long lasting pain because he is so quick to treat anything that comes up and is aggressive in finding out what the problem is. While he has been great in being responsive, seeing me on short notice, responding to me personally via email or text message… I’m still in a ton of pain. I’m going to share some of my emails and visit notes, for hopes that either someone has some sort of idea what might help, or maybe my experience will give clue to someone else.

My only other surgery that is somewhat related (at least to the area) is when I was younger, elementary age, I had gotten kicked pretty bad and it caused a Varicocele, which they repaired.

I know, I know… I’m only 3 weeks (today) post vasectomy but I was told that with 48hrs I should pretty much be recovered and the vast majority of patients don’t have pain over a week. My wife knows a few people who have had it done and they were all up and going within 2-3 days, still pain free months later. That’s my luck I guess.

The procedure itself went well, other than the IV stick for the sedation (not a fan of needles), I didn’t feel anything. Had the expected amount of pain going home and the next 1-2 days… but then it just didn’t go away. I had been given a few days of an antibiotic and told to take IB prof for swelling and pain. I ended up getting pretty bruised, but swelling (at least externally) wasn’t terrible.

  • Bactrim DS 800 mg-160 mg tablet
    Take 1 tablet every 12 hours by oral route for 3 days.

  • tramadol 50 mg tablet
    Take 1 tablet every 4 hours by oral route as needed for 10 days.

I emailed him about a week after my procedure and mentioned I was still having pain, he asked me to come in immediately as it was not normal. I ended up seeing his PA who took a look and his exam was extremely painful. He believes it was Epididymitis and gave me the below. Said he was almost certain I would be feeling better within 2-3 days and to let them know if not:

  • diclofenac ER 100 mg tablet,extended release 24 hr
  • Medrol (Pak) 4 mg tablets in a dose pack
  • ciprofloxacin 500 mg tablet

I emailed him after a few days and let him know there wasn’t any progress. He asked me to come in and see him. He took a look, said he could feel some swelling and asked that I give the medicine cocktail a bit more time to work. Said to let him know the next week if I wasn’t any better.

right epididymis tender to touch on exam. No evidence of large hematoma or spermatocele on exam.

pain likely due to small hematoma of spermatic cord.
Pt advised to continue current regimen, expect pain to improve with time.

After the exam, few days went by, and sent him a follow up

I’ve been in extra pain, the tubes/veins or whatever come down into scrotum from the top appear enlarged and are painful to the touch. The pain even travels into my right leg. It doesn’t appear the pain radiates from the testicle but mainly from whatever that cord is, which I’m guessing is the spermatic cord.

He asked me to come in. They did a nerve block. OHHH MYYYYY GOODNESSS. That was literally the worst pain I think I’ve ever experienced. Said I may need to have Pelvic Floor Physical Therapy.

Exam showed improved swelling on bilateral testicles.

Advised pt his condition is consistent with musculoskeletal cause with some inflammation to the nerve arch.

We performed an ilioinguinal nerve block in office today due to persistent pain.
We recommended PFPT to follow up in order to further to treat the musculature.

Will send valium 5-6 days to relax and abdominal and PF musculature to increase efficacy of the nerve block.

Pt told to contact the office to update on pain status.

After the nerve block, I was 100% numb for a good few hours. Was an interesting experience, especially when trying to urinate. Majority of my pain was gone, except for a random shooting pain that only happened maybe 1-2 times… and then all of the pain came back. He asked that I send him a follow up message that evening and let him know how I was doing and that I hadn’t received the Valium yet:

  • Random sharp shooting pains on left side, almost like the needle is back in (7 scale). Feels like mainly upper area but sometimes it’s a sharp pain in the left testicle. Both hurt when touched.
  • Random pain in the testicle where it feels like I’ve just been kicked, or they are being squeezed. Side it happens on is random.
  • When the random pains aren’t happening, it’s just a constant ache.
  • Have to continue to wear a jock strap, even tight boxer briefs do not provide enough support.

He decided he wanted to do some imaging and sent me immediately for a PELVIC/ABDOMEN CT W/ CONTRAST. He called me late that night with the results. Said for the most part, everything looked normal. Still believes it’s a mainly a musculoskeletal issue and said it appeared I was constipated :man_facepalming:.

Focus of air in the right inguinal canal and in the left hemiscrotum likely
secondary to ileal inguinal nerve block performed.

There is a marked amount of stool seen throughout the large bowel typical for
constipation

Mentioned it’s normal to have the pain of the surgery cause you to tense up and get blocked up. Told me to get some medicine and try and clear out over the next few days and to try the valium. Told me he was available via phone/text/email for me to update him over the holiday…

So that’s where I am… Just got my valium earlier today, no change in pain. Still wearing a jock strap as it is way more comfortable than not wearing it. I’ll tell you, as I’m sure many of you know, this is truly mentally draining. Especially reading so many of your stories, that the pain really never goes away for you. I can’t do many things I used to and I can’t even imagine trying to do anything intimate with my wife, I’m sure that’ll only make the pain so much worse. The thought on the pain is pretty consuming, all day, every day. Don’t get much sleep at all, unless I take something for pain or take one of the few Xanax they gave.

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Sorry man. I also hate that this forum exists, and that I know about it. I’m 6 mos out with ongoing pain on one side. The upside is that it sounds like your uro is responsive and trying to help. I’ve has ultrasound and meds but not much else. Although I don’t think I want the nerve block from the sounds of it!

I would say you’re still somewhat early in the process and be hopeful that improvement will still come. I know I got a bit better from 3 weeks to 3 months. And I know how you feel about the despair. My little daughters love wrestling with me and I haven’t done it in six months. :frowning:

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Ahh man. Sorry to hear you’ve still got pain after 6 months. Are you trying to just wait it out and see what happens or do you have a path you’re trying to take to get you feeling better?

I have a lot of kiddos so I can definitely feel you on the heartbreak of not being able to really roll around like we used to be able to. When my wife went to her gynecologist the other day and when she mentioned I was having pain still after a few weeks he was shocked, he said that was maybe only the 2nd time he’d ever heard of anyone having such issues :expressionless:

It was as reading my story including radiating pains onto the leg. Some guys report that things improve for them very slowly over the course of 2-3 years, for me, a reversal took 90% of the pain and issues away

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Glad to hear that! I’d happily take a 90% improvement. The reversal stories on here are almost as bad as the original vas stories. How was your recovery?

I’m 10 months post reversal, still recovering mate. Much better than pre reversal, but still only about 90% what I use to be when I were complete. I kept a journal on this forum of my recovery

Went to the dr today. Valium did nothing. He did another exam and said he still believes it’s nerve/musculoskeletal related. Pain isn’t at the vas site so doesn’t think it’s a trapped nerve and since it’s in both the testicles and epi. Prescribed Lyrica that he wants me to try for a week and to see the PFPT on Wednesday. Follow back up with him in a week and see where my pain is. Wants to exhaust all other options before trying surgery on something.

Only other thing he’s debating is another type of nerve block he said they can do where they use an ultrasound and go through my butt! Sounds enjoyable.

Good call trying non-surgical therapies first even though they often seem like a waste of time. Keep us posted on the approach “through the butt.” I had one uro talk about trigger point injections to facilitate PFPT. I also had a caudal injection close to the buttocks when I had lumbar spine pain. But, never had nor heard of a nerve block in the butt to treat PVPS.

Your symptoms were just like mine early on and the quick zingers/jolts were the worst. Here I am 6 months later and still dealing with the same issues. I have been doing pelvic floor PT for the past 3 months and it has helped, but you have to be patient.

I still can’t run and I just barely started to walk 1 mile a day, but still with a slight limp. My twinges are not as bad and I at least got off all the drugs.

Time will be your best friend and definitely wear tight underwear. At least now I’m able to work a bit more which I missed the most, but this damn easy surgery had me partially disabled for a while. Hang in there and you’ll start to feel a little better.

Glad you’re starting to see some improvement. What’s PT like? I haven’t even attempted to EJ yet, everything ok there, or does that hurt too? Did you try lyrica?

The exterior manual PT is fine and it really relaxes the muscles, but the internal anal stuff hurts. She seems to think it’s also helping, but I’m not too sure about it. I’m willing to try anything as long as I see improvement.

I had sex 7-8 days after and couldn’t really perform, so the wife laid there and I was super gentle going in. I thought maybe if I released pressure it would help, but my right testicle would get swollen and would hurt at a higher level for two days. This will improve as now I am able to have sex with somewhat normalcy , still have to be careful. Also, the EJ feels better than they first did initially. My pain is at a baseline 2-3 on most days so I don’t need the drugs. They had me on Gabapentin for 2 months and it made me feel all spacey and also gained a 10 pounds on it.

I originally was giving it 6 months before I did a reversal, but now I’m giving it a year before I do anything. My wife and friends are super supportive, this really helped with the first 3 months since I got super depressed and I was thinking suicidal thoughts. There’s some good stuff on this forum, so read other stories. Sorry you’re here, but just hang in there and give it time. I’m probably 85% of normal.

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I’m glad you’re making such progression! I appreciate you sharing the info.

I went to the PFPT yesterday and she didn’t really feel it’s entirely related since most of my floor muscles seem fine except my Bulbospongiosus muscle was painful when touched. She have me some exercises and told me to come back in 2 weeks but I’m not hopeful it’s going to help much.

One thing I did just figure out is the source of some of my sharp shooting pain, at least the ones I couldn’t really tell where it’s coming from. It’s the puncture site itself. If it gets pulled or touched in any way… YOW!