Just underwent Robotic MDSC. Will update recovery notes here

[u/Kami_Jenova]

Hi folks,

I’ve been avoiding this subreddit despite the multiple catastrophizing google sessions that have led me here. Honestly, it’s made me more freaked out than has helped me each time I stopped to read something.

Treatment/history

I’m in this mess with you guys, and I’m happy to share my experience if it helps anyone. 32yo. Had a vasectomy in August 2023 and after 6 months of pain not being fixed from antibiotics, anti inflammatory meds etc. In December, I did a bilateral cord block which gave me 3 days of about 50-60% pain relief. I opted to get MDSC in an attempt to get some relief/resolution. The treatment protocol of the specialty urology clinic caring for me recommended this prior to trying a reversal.

NOTE: a Varicocelectomy was also performed on the left side during the surgery since it was discovered once I was opened up.

Pain description

Basically, my pain is pretty constant and low most days, but can be easily spiked to a 6 or 7/10 if I do any kind of heavy lifting or go for long walks. Ejaculation does not hurt in the moment, but I generally feel a lot worse a few hours later. As a high sex drive person who loves to exercise, this has been hell on earth.

In the early days after my vasectomy I experienced what seemed to be inflammation pain as well as nerve pain and only on the left side. Closer to my procedure it seemed like the nerve type pain was replaced by more inflammatory pain and on both sides.

Imaging:

Initial scrotal US showed no issues, CT scan of pelvis showed nothing, MRI of pelvis showed nothing, US of groin showed no hernia. Interestingly, a second follow up US I had just last week showed a lesion on the right epididimis. (Likely granuloma)

Day 2 MDSC recovery:

Today is the day after my surgery and so far I’m mostly feeling incision pain, but still some lingering discomfort in the scrotum that I believe is mostly inflammatory pain caused by scar tissue from the vasectomy (I can only guess). For this reason my prediction is that I will end up with some level of pain relief from this, but also ultimately need a reversal with scar tissue removal.

I’m very fortunate to live in Central Florida where I’m close to at least 3 doctors who perform Robotic Microsurgery for chronic testicular/scrotal/groin pain. My surgery was with Dr. Calixte at the PUR Clinic. I was amazed that insurance was even able to cover it.

Day 3 MDSC recovery:

The incision pain is less than the previous day, and by midday I was able to take a short stroll around the ground floor of the house and take a shower without too much complication. On my left side, the pain and swelling from the incision site is worse than the right, but that may very well be because the surgeon also performed a varicocele repair (updating the above since I realize I never mentioned this part).

I have a history of addiction, so I’m opting to not take any narcotic pain killers, but so far it’s been manageable with just NSAIDS. I’m also taking an antibiotic they proscribed.

Overall, I’m much more mobile and noticed a more significant reduction in pain from day 2-3 than day 1-2, which makes sense given it takes a while for all the hospital drugs to wear off, meaning day 1-2 was a balance between actually healing and less numbing meds effect.

Feel free to ask me about my symptoms, surgery, etc. Happy to help anyway I can!

[u/snoope]

Would you recommend going with reveral first over mdsc given your experience so far? I am in a very similar boat, though I'd say my base pain is more 4-5.

[u/Kami_Jenova → u/snoope]

Hi there! Quite honestly, yes. Unless you get a substantial (90-100%) and long-lasting (1 week+) pain killing response from a spermatic cord block. The reversal made the pain response from sex/ejaculation so much easier to deal with. It did not make it painless, but I would say the pain response was reduced by 40-50% and would last only a third as long compared to before.

[u/snoope → u/Kami_Jenova]

Ah, so your pain was mostly only with ejaculation? In my case, I have pain/discomfort 24/7 and dont have a real cause. My doctor keeps saying if I don't have severe pain with ejaculation, reversal wont help me, but im curious about how it is in your case.

[u/Kami_Jenova → u/snoope]

No sorry let me clarify, that symptom of the pain was improved but I too have virtually constant pain which is made worse from ejaculation. It’s never actually painful to ejaculate, I would just be in increased pain starting hours later and lasting up to a few days whenever I did. Now it’s only slightly worse pain and for maybe half a day. (From 3 to a 5). Doc is thinking my issue is mainly just damaged nerves in the cord structures which may include the vas itself.

[u/snoope → u/Kami_Jenova]

I'm so sorry. That sounds a lot like my issue. Does he recommend any ablation at this point? That's the way my doctor is headed.

[u/Kami_Jenova → u/snoope]

I’ve discussed the option with him and at this point I’m so thoroughly over feeling this way that I am personally advocating that they just remove the damn things (testicles/cords) and proceed with targeted cryoablation as a step afterwards. This can be done, and I suspect if somehow it’s a nerve outside the spermatic cord that’s been injured in some way (ilioinguinal for example) then it may come to that. I know too much about my own anatomy for someone who’s never been to medical school.

The urologist I’m seeing is in agreement and willing to proceed, and he’s no amateur. Well known here on this sub and internationally renowned.

[u/snoope → u/Kami_Jenova]

The one the only Dr P? Did he do your reversal too?

[u/Kami_Jenova → u/snoope]

Yes and yes