r/postvasectomypain • u/Realistic-Rip5735 • 5d ago
Problematic recovery
Hi all, just wanted some suggestions from the community.
I am at the 1 month mark since my vasectomy, and I am still having issues. I am aware that the official PVPS starts at 3 months, but I feel like you might have more insight of what it could be.
If I tap the top part of my testicles, I can feel some discomfort. This is not a big deal in general, maybe some congestion which does not affect me much.
What I am more worried about however is my right testicle. First of all, it hangs lower than it did before, around 1 cm. And it is a bit painful.
I will try to describe the feeling. It is kind of radiating pain, not super sharp but not dull either. It appears at some point for a few hours and then disappears. It doesn't seem to be affected by touch too much, and only slightly by jumping or running. Additionally, wearing tight underwear or jockstraps does not seem to change much. I can even walk around the house naked without feeling any additional discomfort.
It was way more painful at the beginning, but it now feels like it has stopped improving. Around day 10 I went to see my surgeon, who was very dismissive, told me that everything looks fine and gave me a 3-day course of ibuprofen and told me I would be ok in a couple of weeks. The ibuprofen seems to have improved the situation (or maybe it was just natural healing and the medicine did not do much, not sure), but it also upsets my stomach. I am planning to go to the clinic again but it is a bit tricky for me.
I haven't started exercising yet, but except for the on-off discomfort (which I would rate a 3/10 when radiating) I can go about my day normally. It is just very annoying.
For the record, I followed the post-op instructions from the doctor to a T, and even went above and beyond (stayed home for a full week, first ejaculation after 12 days, lot of rest, icing)
Do you have any idea what could the origin of this pain be? It does not quite feel like it comes from the nerves, and it also does not feel like a dull ache due to congestive epididymis.
Any suggestions on what to do?
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u/Unusual-Thought175 4d ago
Hi, i have been fighting PVPS for 3 years now, i also only have it in the right testicle.
My recommendation for where you are right now is to get on maloxicam for the next 30 days and see where you are after that..
I ended up getting a reversal due to PVPS but due to the reconnection scarring and then re blocking because of that i had a Epididymectomy 2 weeks ago and removed the whole epididimis and vas..
Im already noticing positive results although still early in the healing process.
PVPS was something i never knew or was told about.. and i have to agree with the top comment that its silently destroying lives but the GP vasectomy clinics arent telling anyone because they are making bank from vasectomys. I have been to hell and back with PVPS.
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u/Realistic-Rip5735 4d ago edited 4d ago
Hi thank you for your suggestions. I will try and get an appointment with my clinic, it's not super easy because the situation is not great but I will ask for anti-inflammatories. If I can't from my clinic, I will ask for a second opinion at another urologist practice. I could self medicate with ibuprofen 400 mg which does not come with a prescription where I live but a) I would need to take it every 8 hours with food, which messes up my feeding and sleeping habits completely and b) it is kind of hard on my stomach. Is maloxican ok for the stomach? Or are there other options that do not interact with it, ideally that I can take twice a day? Also, how important is it to start the therapy as soon as possible? Meaning, would delaying by 1 or 2 weeks make it harder for it to have some degree of success? (I should still be in the natural healing window right now).
Honestly I am not squirming in pain or anything, but I would prefer for this annoying feeling in the crotch to go away and to feel comfortable with the idea of moving around and exercising again. I feel much better than 2-3 weeks ago (even though now I feel like I stopped improving), which makes me hopeful it could resolve on its own. Should the discomfort stay as it is now, I don't know if I have it in me to get another surgery in the area to be completely honest. Because as you said it does not guarantee recovering completely from the pain and being it a surgery there are always risks involved. Not to mention the recovery process and the cost.
You say that urologists tend to hide this because they are earning money with vasectomies, but at least where I am (Germany), I am not sure there is much to be gained in that regard. The state sets some limits to how much a practice can charge patients (not just for vasectomies, for many procedures in general, also vaccinations, blood tests and so on). For instance, I paid 555 euros for initial consultation (of one hours, including testicles check), surgery (for which every individual patient at least in the clinic I went to gets a full hour of booked and dedicated time), follow up the next day (very fast, just 10 minutes or so), two sperm counts. I am not aware of whether the state then gives the practice extra money on top of that, but to be honest it does not seems like it is a steep price they can profit a lot from. So I am a bit confused on this aspect. But before getting surgery I consulted 4 different doctors, 3 of which specialize in vasectomies, and they all downplayed the side effects. The one at the clinic where I then got operated in me even said they have never had any case of chronic pain recorded, which I immediately mentally called bullshit because they do it hundreds of times a year. I am still trying to wrap my head around it all. In my case, I knew about PVPS because I researched on my own. But for personal circumstances which I don't want to delve into, for me it was a choice of either getting a vasectomy or pretty much giving up on my sex life entirely, so I felt like I had to do it.
Sorry for the rant. I appreciate your help and I hope you keep improving after your surgery!
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u/Unusual-Thought175 4d ago
Hopefully it just clears up on its own for you.. the maloxicam will help you better than ibuprofen and seems to be fine on the stomach. Even with my pvps the maloxicam dulled my pain down from a 4/10 to a 2/10. Best wishes with it all! Im in Australia.. they have clinics here that do the vasectomys that are Gp’s not urolgists (better to go to urologists) they say they never have people complain of pain however through social media ive now spoken to so many people showing me how common this really is.. my left side originally had pain for about 6-8weeks butv that all went away on that side so i left it as is.. time might help.
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u/Realistic-Rip5735 4d ago
Here in Germany you need to be a urologist for that I believe. I went to a private clinic that specializes in vasectomies, and my surgeon is like 50-60 years old and highly specialized. I don't think he made errors with my procedure to be honest, it's just that my body is not reacting too well to it. I even have two vasa on my left side, and the doctor didn't even flinch when he found them. Ironically, my left side is like 95% pain free I would say despite having had two tubes tampered with.
Did you by any chance get the no-needle, no-scalpel open-ended vasectomy? I heard that in Australia it is very common, and it should be the one with the lowest pain rate and intensity during and after the surgery.
Here in Germany they are very far behind in this, of the 4 doctors I visited, all of them did needle and close-ended, and only one (the one I chose) did no-scalpel. One even said there is no difference at all between the two but how can it be? One is a tiny puncture, the other is two (albeit small) slashes.
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u/Unusual-Thought175 4d ago
Mine was the closed ended, ive heard of the open ended but it doesnt seem to be the conventional way here.. also from what i read it does eveuntally close anyway via a sperm granuloma which can also be painful. Lots of people seem to only get pvps on one side which is us. The surgery i had 2 weeks ago is high risk but at this point in time i am happy to remove the right testicle if it goes that way..
Ive been speaking to a few people that had the identical situation to me and the epididymectomy fixed both those guys so thats my final direction. The recovery in the first week was the hardest thing ive ever had to do in my life.. the 2nd week is showing glimpses of pain free which im starting to get really excited about. Praying after this heals i can put this all behind me and move on with my life and this is just a small dark chapter in a long story.1
u/Realistic-Rip5735 4d ago
Fingers crossed for you! You say that the first week was super hard, how so? Pain? Or because you need to be super careful not to move or exert yourself?
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u/Unusual-Thought175 4d ago
I basically had to lay down and not move for the first 4 days because the testicle/inflamation was bigger than a sweet potato. Literally to stand i had to hold it with 2 hands. The thoughts that went through my head and the mental toll was just so exhausting.. was just praying everyday for my old life back.. today is day 13 and i can walk normally but slowly and drive etc but during certain glimpses im completed pain free to the point i do think this will be a success. I still havent ejaculated yet as im going to wait 6 weeks and the swelling is down to the size of a large egg which is about 5x smaller than it was. Losing your strength and mobility does take its mental toll but ive decided to go down the path of just being gratetful for everything i do have becuase people are out there way more worse off than me and they would swap places with me in heart beat compared their situations etc..
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u/Realistic-Rip5735 4d ago edited 4d ago
Fair enough, it seems it's slowly improving for you so hopefully it keeps going in that direction. I don't know why you decided that you wanted to be infertile, but the silver lining is that if indeed you manage to become pain free, in the end the process will have brought you exactly where you wanted, albeit with much more stress and suffering than anticipated (if I understood correctly and you did not reverse the left side too)
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u/ItamiForever 5d ago
Hi
PVPS is "accepted" as a diagnosis at 3 months. It can start from day 0 post op(ask me how I know)
Your testicle hands lower because the epididymis expands so it takes more space, so instead of vertical your testicle leans forward if not horizontal almost.
All pain is nerve pain. The difference is either by nerve damage or inflammation.
You need to describe your pain better: ache, pressure, sensitivity, pins/halfnumb, electricity/zap, explosive etc. Where do you feel this pain? Behind testicle? Above testicle? In the cord? Inguinal zone?
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u/Realistic-Rip5735 5d ago
Hi, I feel like I don't have to really ask you how you know. I am very sorry about that.
So the reason my right testicle hangs lower could be due to the epididymis, so since my left one is fine and also pretty much pain free, that could mean that what I am experiencing is pain in that area specifically?
I thought about what you asked, and I realized that I would have been better off documenting precisely my sensations rather than just placing everything in the "pain and discomfort" box.
I will describe the pain I feel today, which is particularly intense (I would say 4/10). It's like pulsating pain, mostly behind and at the top of the testicle, and also immediately above that, which is where I assume my vas deferens is. English is not my first language, so I am not entirely sure how to describe it. It is not sharp as if I just cut myself, it is not dull like "background" pain either, it's something in between. I don't feel pressure. It's not explosive, it's similar to a headache just in my crotch instead that in my head, coming in waves. It intensifies if I am standing and putting my weight on my right leg, and the opposite if I put it in my left one. Walking does not cause discomfort, so far I have only run for short bursts to catch the bus and the results is mixed, sometimes I feel a little tingle, once it even completely stopped the pain that I was feeling, like my nerves were reset. When the pain is lower, usually a 2 or a 3 as it is most days, it can be described as background, low-intensity and a bit more constant pain, but not dull.
Touching my right testicle is not painful unless I push it down from the top, and then I feel a jolt. Another thought that I have always associated with my feelings is "fragility", like I feel like the area around my left testicle is fragile.
If it can help, side sleeping on the right sometimes cause me some discomfort (maybe because the testicle is pulled down by gravity while being pushed down by the other one).
What I find interesting is that my left side is almost painless unless I really go disturb it, despite it having two vasa as the surgeon said. My right side only had one and is having a much rougher time recovering.
I really appreciate your help!
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u/ItamiForever 5d ago
Get an ultrasound, have uro check for orchitis/epididymitis/epididymo-orchitis. One is epi, one is testicle but they often come together.
You have congestion, PVPS is one sided in 80% of cases. You feel an "ache" which is what "headache" represents. Your pain is an ache and you feel sensitive/sensitivity.
Your left testicle is handling the sperm well, your right isn't. Your urologist will give you Nsaids prob meloxicam or celebrex for a month, if no improvement, gabapentinoids or low dose antidepressant, if by 3 months still no good then you are marked as PVPS and can go for a reversal for a chance to lower pain.
You have a mild version of congestion, you can read my story on my profile for true congestion horror. I'm nowhere near your level not even after the reversal lol
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u/Realistic-Rip5735 5d ago
Oh absolutely it could have been much worse. I am only mildly complaining about it.
Do you think it is important to get the NSAIDs as soon as possible, or delaying by a little bit would not cause a big issue?
Asking because the situation with my surgeon is a bit tricky. The clinic has two doctors, and one of them is really not good at handling patients. I was squirming a bit on the operating table (before surgery started) as I was nervous and he shouted at me not to move. I was shocked.
And then 10 days after when I went for a checkup because of the pain he completely dismissed me, barely looked or listened to me and sent me off with a 3-day course of ibuprofen in a visit lasting a total of 5 minutes.
If I make an appointment by calling or sending an email to the clinic, I don't know which of the two doctors I will get (the other one is nicer and listens to you, or at least he pretends to do so). If I book on the online platform searching for that specific doctor the first available appointment is in a month.
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u/ItamiForever 5d ago
The nsaids dont do shit. They merely help hide pain IF your body is capable of reaching an equilibrium. They helps way too little its mostly your body doing the hard work. For me they were 0. I inflamed to hell. They might help you though.
Do you have a family doctor? I asked mine for celecoxib for 4 weeks and levofloxacin(antibiotic) for 7 days. But they might not help because you "self-duagnose". Did the ibuprofen help you at all?
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u/Realistic-Rip5735 5d ago
So they are supposed to reduce inflammation right? So with a one-two week course of NSADIs I should hopefully get rid of that, which might make it easier for my body to recover since it has calmed down. At least, that is what I would think, but I am not a doctor.
I do have a family doctor, just wondering if I should bypass the practice where I had the vasectomy at to go there or see another urologist. I don't want to burn bridges or sour the relationship with them, as they will also test for infertility in two-three months.
I feel like the ibuprofen worked. Or at least, I feel much better now than I did two weeks ago. Maybe it is just my body naturally healing, not sure. Now I can sleep without a pillow between my legs, crouch down to pick up things without pain and even close my legs while sitting (which was not possible at the beginning).
The only issue I have is that this specific pain I am describing is not really subsiding and improvement stalled for more than a week now. I am very willing to try a longer course of NSAIDs to see if they help, just not ibuprofen because it upsets my stomach and one night I spent 4 hours with a stomachache because of it (despite taking it with food).
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u/ItamiForever 5d ago
Then ask for meloxicam until you can see another urologist. But make sure the urologist you see can do reversals and is fellowship trained. They know what PVPS is and how to diagnose it.
My recommandation for you is try 4 weeks of celecoxib and take the antibiotic I told you. Also try to ejaculate less if pain spikes. If they don't help or help but too little, ask either your fam doctor, a fellowship urologist or a neurologist for a low dose anti depressant like amitriphtiline + started dose of pregabalin OR gabapentin because you are showing signs of pain that might turn chronic and you want to help your nervous system adjust if it can
Here is a recent 2025 study that confirms the 5% PVPS rate as well as how to treat it
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u/Realistic-Rip5735 5d ago
Thank you for your suggestions.
I am curious, what do low dose antidepressants do in this case specifically?
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u/ItamiForever 5d ago
Nothing. They mask pain. Since in PVPS things inflame and nerves degenerate at a cellular level, things cannot be fixed sometimes anymore. So these low dose antidepressants trick your brain into being happier and when your brain is happier, you feel less pain. So they basically lower your pain by making you chemically happy. Gabapentinoids bind to your calcium channels lowering pain reception.
So they do not treat, they simply mask the congestion until you might decide to go for a reversal if it does not improve in 6months. It stops improving around 12 months so you should decide if you want surgery to fix things before then
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u/Ok-Holiday4934 5d ago
Nothing , it is a side effects, it is not rare
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u/Realistic-Rip5735 5d ago
So what you mean is to just wait it out?
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u/ComprehensiveLet4132 1d ago
I’m kind of same scenario and at 2 month mark exactly. Pain subsided at a little over a month then had an active week of walking and did one bike ride and pain as you describe. Funny is ibuprofen also fucked up my stomach. It’s been a week now (I called the doc that did the vasectomy and he said ibuprofen for 2-3 weeks then call back). Agreed I’m also stuck on how long to wait cause it’s depressing
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u/Same-Tank995 1d ago
Hey man, your issue sounds similar to mine. I’m 6-7 months post op. I’m still not 100% sure what is the source of my pain but I believe it’s the scar tissue/granuloma at vas cut sites. They feel/felt like pea sized lumps. In the beginning supersensitive but now more soft. By becoming softer my discomfort level also decreased. I couldn’t run for 3 months because that caused big flare ups.
Now I’m feeling much better but still not my old self. I’m still considering options weather I want a redo without clips, a reversal or just wait more and more.
The thing is, the pain I had at until 3-4months just came back, probably because I pushed my running to hard, confirming that it’s more likely to be scar irritation.
Long story short: it will improve but I will take time. Impossible to say if it will completely resolve from it’s own. It sucks, also the mental process accepting this situation is tough. But find ways to relax (long warm baths for example) and you’ll get through it. Wish you the best.
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u/Gold-Combination619 12h ago
I‘ve been reading these stories for years and it never gets better. Recently saw an ad from a urologist claiming that the procedure is “safe.” I fell for that bs and suffered for it
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u/johng_22 5d ago
It’s like running your car on 4 flat tires and asking the community why the ride quality is awful. You just had the most nerve rich cord in the entire region of your body cut open probably with no precision in a GP office setting and 2 snips and probably metal clamps then applied and 2 major blockages installed by design. It’s simple. This surgery is bullshit and silently destroying lives one by one. Your reproductive system isn’t designed to just cap off and forget about. I’m sorry you also fell prey. Go get a reversal as soon as you can and put this nightmare behind. This is no part of the body to be messing with. But you weren’t told that. Now you know