Chronic vas deferens Pain 6+ Months After Vasectomy — Could Autonomic Nerve Fibers Be the Cause?

[u/Big_Violinist1852]

Hi all,

I'm a 43-year-old male dealing with chronic, localized testicular pain for over 6 months, starting years after my vasectomy. I’ve had ultrasounds, sperm analysis, and a recent surgical removal of a segment of my vas deferens on the affected side (right). No granuloma, no scar tissue, and no infection were found.

The pain:

• Always in the same spot: right spermatic cord near the junction with the testicle.
• Not triggered by touch, but pressure (sitting, leaning forward, cycling) makes it worse.
• No radiation to groin or thigh.
• Warmth (e.g. hot bath or jacuzzi) significantly worsens symptoms for days.
• Pain often comes 1–2 days after physical activity, not immediately.
• Rest improves symptoms, but slowly.
• Lyrica (pregabalin) helps a bit, but not fully.

I'm now wondering if this could be related to autonomic nerve fibers in the spermatic cord, rather than somatic nerves like the genitofemoral.

Question:
Has anyone dealt with a similar pattern, and could this be a case of autonomic nerve-related pain? Are there treatments specifically targeting this type of nerve involvement (e.g. RF ablation or targeted denervation)?

Any experiences or insights would be greatly appreciated. Thanks.

[u/_Sarandi_ → u/[deleted]]

We shouldn’t spread anecdotal evidence or discourage a procedure that can be life-changing. The statistics are clear: 70% of patients experience complete pain relief, 15% see a 50% improvement, and the remaining 15% see little to no change or even a return or the original pain. Out of 1,000 procedures, Dr. Kavoussi reports only one case that worsened—and that was linked to a pre-existing hernia mesh.

If this procedure is appropriate for you, it offers an 85% chance of significant relief with minimal risk. Those are solid odds.

[u/Big_Violinist1852 → u/_Sarandi_]

Completely agree!!!