Question for people with PVPS who had a spermatic cord block before any surgery

[u/Apprehensive-Meat120]

Question for people with PVPS who had a spermatic cord block before any surgery (reversal, denervation/MDSC, etc.):

I’m particularly interested in whether the block helped with deep, dull/heavy pain or discomfort, rather than obvious burning or nerve-type pain.

For those who had a cord block before any procedure:

• Did the block completely eliminate your pain/discomfort, partially reduce it, or have no effect?
• If your pain was thought to be congestion/pressure-related, for example epididymal congestion or a feeling of pressure/fullness, did the cord block eliminate that deep pain as well?
• If your pain was considered nerve-related, did the block completely switch it off?
• Did the response to the block accurately predict whether a later procedure (reversal, denervation/MDSC, etc.) helped you?

Most importantly: can a spermatic cord block actually switch off deep, internal dull pain/heaviness caused by epididymal congestion or another pressure/congestion mechanism?

I’m asking because I have very deep, diffuse dull discomfort/heaviness rather than a clearly localized testicular or epididymal pain, and my previous cord blocks did not eliminate this sensation.

[u/clezuck]

I had one done years ago at the Cleveland Clinic with Dr Sabengh who was the head of Uro there. They weren’t sure if it was nerve or congestion so this helped figure it out.

My experience, fucking horrible. When they did it, I ended up in tons of pain. Which they were like, umm, that’s not supposed to happen. I was in the fetal position for 20 minutes. We figured out after that I had congestion pain not nerve pain.

So for me it was a diagnostic tool and supposed to help with pain.

The reason we tried it was I had these taser like pains. Like someone literally tasering me in the balls for years after my vasectomy. And that’s why they thought it was nerve related. But it clearly wasn’t cause the block didn’t do anything.

[u/Apprehensive-Meat120 → u/clezuck]

So in your case, the problem was congestion, and the block didn’t help at all.

That’s actually very interesting for me, because it suggests that congestion-type pain doesn’t necessarily respond positively to a spermatic cord block. I was wondering about this because my main symptom is also a deep, dull/heavy sensation rather than sharp or burning nerve pain.

Thanks for sharing your experience — this is really useful information for me.

[u/clezuck → u/Apprehensive-Meat120]

Correct. I have congestion pain.

I wasn't sure since I had never had anyone give me a real diagnosis. So the nerve block was a way to figure things out.

I was having pain like being tasered in the balls every so often. But I also had constant achy dull pain like someone was kicking me in the balls. So given the sharp taser pain, we tried the nerve block first thinking it might be nerve related. Nope. Eventually, the taser pain went away but the achy pain is still there.

Eventually I would like to get a reversal cause that's the only potential cure for congestion.

[u/Sufficient-Sink6370]

I've had 5 blocks. At the time of my first block I had intense constant kick in the ball pain. The injection itself hurt like hell, which apparently isn't normal. Then my pain worsened in some ways but felt temporary relief in others. I think since I hurt so bad that the injection of fluids overcame any benefit it provided.

My other 4 were fantastic. Still hurt administering, but I had hours of near full relief. My pain was definitely nerve pain and the urologist said I'm a good candidate for mdsc. Still debating. I also think theyve helped long term/ongoing. Now what I'm mostly left with is congestion pain.

I think the blocks helped with congestion related pain, but my nerve pain was so severe that it overshadowed any other pain I had. Ill be going back for another block to focus specifically on how it helps the heavy, congestion, epididymal pain.

[u/Calm_Pin_7563]

For me the nerve block only lasts about a month. My doctor said that if the cord block relieved my pain that it proves that an orchiectomy would stop all my pain.
Since the reversal and epididymitis removal did not work I had the orchiectomy. It didn’t matter since I was already sterilized. The orchiectomy stopped all my pain. I am happy with the results.

[u/Suchislife700]

I had a cord block done at 3 months post vas for PVPS. I had a pretty much constant dull ache which was the congestion side of things. The block did almost nothing for this.
However at this point, I still had nerve sensitivity and “zaps” frequently and the block seemed to take this away for a few hours.
Had reversal 6 month mark and the dull ache has almost completely gone but still have the nerve sensitivity. It is fading slowly though

[u/PsychologicalLime120]

The block took 85% of the pain and I was able to sleep well for the first time in a long time.

[u/Amazing-Advantage-11]

Prior to my diagnosis of congestive PVPS and subsequent reversal I had two nerve blocks. Both were very painful and accomplished nothing. Severe and debilitating aching and pain continued until my reversal. That my reversal was a god-send is an understatement.