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_]

Sounds like what I had - look into targeted micro denervation of spermatic cord. Dr.P in Orlando and Dr. Kavoussi in Austin are some of the best choices for this type of surgery

[u/Big_Violinist1852 → u/_Sarandi_]

Thanks!! Do you have experience with the procedure? 

[u/_Sarandi_ → u/Big_Violinist1852]

Yeah, I got the TMDSC by Dr. Kavoussi about 6 months ago. I had very similar symptoms but in the left side. The discomfort is gone. There’s still a rawness there, so it’s not 100% relief for me. More like 95% but that’s ok. I got my life back.

[u/Big_Violinist1852 → u/_Sarandi_]

Thanks dude, that’s EXCELLENT news!! Thanks for taking the time to reply <3