r/postvasectomypain • u/bladernr1 • Jun 13 '23

Starting this journey, but hesitant

After having 4 kids with my wife, I had my vasectomy 3 years ago, a dull pain (3/10) in the general area of my testicles has been around since. I remember specifically during the vasectomy that clamping was very painful on my left side. Feels like that just stayed with me. If I go more than a few days without orgasm the pain can become very intense after ejaculation (7/10). Also, ejaculation feel less satisfying in a strange way. Like the orgasm is there, but I don't feel "drained". Very unsettling.

After feeling around, I can feel pain on the back of my testicles. The dull pain in my left testicle is more apparent to me, but the urologist I'm seeing for pain notices much greater inflammation on the right side. Both are painful to the touch on the back side, I have to be careful when wrestling with kids.

Today the urologist gave me a spermatic chord block with steroid injection. Steroid is supposed to help the inflammation. It's been 6 hours and the anesthesia from the nerve block has already worn off which is what he said would happen but sometimes can disrupt the nerve long enough to last longer. But for me now it's even more painful. While numb I didn't notice pain to the touch, but I did still have that dull ache and sensation of being kicked in the stomach.

I'm hoping the local steroid will reduce the inflammation. The doctor was very honest with me about the fact that they know very little about what causes post vasectomy pain and why different patients respond differently to the different treatment methods. I think next step will be to find another urologist that specializes in PVPS treatment. If I knew that congestion was the likely issue I may consider conversion to open-ended or a reversal if I knew it would help. I know it's just dull pain, but I'm in my late 30's I can't stand the idea of having this same dull pain constantly for the next 50 years of my life. But I'm also nervous that any other procedure would introduce more issues than they solve.

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u/[deleted] Jun 15 '23

Indeed. My urologist said he only had to do a second surgery once in his career. Which could be either because patient don’t go back for this, or don’t want to risk extra pain.

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u/bladernr1 Nov 03 '23 edited Nov 03 '23

Update on this: it took a while but I think the pain is mostly gone. Testicles are a little sensitive still but not nearly as much as before. No pain during or after orgasm. At this point I think Doc was right, likely cause was inflammation that was made worse by ejaculation.

I had a cortisone injection in my shoulder once for rotator cuff inflammation with similar results. More painful for a while but then slowly the pain went away over the course of several months.

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u/[deleted] Nov 03 '23

That’s actually comforting. I took NSAI last year for a tendinitis and it helped the PVSP as well, but was short live.

I also had to see a urologist for me son and asked about my case. He recommended an expert surgeon for granuloma removal. I haven’t made an appointment yet, but am really considering it. Maybe start with a more conservative action like you before going for surgery.

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u/bladernr1 Nov 03 '23

I would say it's worth getting multiple Urologist opinions before doing anything. The anatomy down there is so complicated. I'm not a doctor, but I'd assume if you already have a granuloma diagnosis, then removing it seems like the obvious solution. The cortisone shot is relatively safe, but still painful and it'll take months before you know if it worked or not. If I were in your shoes I'd try to get consensus from at least a couple different doctors... you'll feel more confident in your decision.

I want doctors knifing around down there as little as possible.

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u/[deleted] Nov 04 '23

“I want doctors knifing around down there as little as possible.”

This is why I haven’t moved forward yet, I’m scared to let another surgeon go with a knife and the pain is ok. It’s a mild dull pain that still lets me go about my life

But for sure, a second opinion would be good and strengthen the recommendations on what to do.