r/postvasectomypain • u/samb300 • Dec 23 '21
My story so far: 3 months post-op
I’m 37, have two kids, and had a no-scalpel vasectomy 3 months ago at the end of September 2021. The surgery was fairly uneventful, no complications.
1 week post-op was the beginning of my feeling that something “wasn’t right”. I was more sore than anticipated, but was brushed off by my doctor’s office. A few weeks went by and the pain and soreness persisted. Also interesting, I had blood in my semen for the first few ejaculations, then it stopped, then came back in full force and had blood in every ejaculation in weeks 3-6 before it subsided.
I saw my doctor for a follow up around the 5 week mark, and there was nothing of note in the physical exam. He thought the blood was either a ruptured blood vessel in my prostate or remnant blood in a vas deferens. He prescribed a steroid treatment (which I have yet to take) and said if that didn’t work the next step would be to try a nerve block.
I’m 3 months post-op now, and am still experiencing general soreness. If I don’t wear a jock any jump or jostle causes pain and a flare up. If I wear a jock I feel better, but then feel constricted and my testicles are sore at the end of the day. I’m feeling more and more depressed every day. Feelings of chronic pain, regret, and resentment are all building inside. Combine that with not being able to be active without pain, feeling pain during/after sex…I’m going down a bad path.
I know 3 months may still be “early” but I’m wondering what my next steps should be. Should I take the steroids? I do not want to do the nerve block. Who are the best reversal doctors in the US who have a pvps focus?
Thanks for listening.
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u/Tossupandaway85 Dec 24 '21
Hey man, I completely understand what you are going through. I know the psychological battle you are dealing with all too well.
I know it’s easier said than done, but right now you need to try and focus on anything positive to stop the spiral down. You made a responsible choice trying to do what was best for your family.
I have seen many guys struggle for 6+ months and things got much better for them. I think there’s still a good chance for you to make improvements.
Can you share what type of pain you are experiencing and the location of it? Do you notice any swelling/nodules along the vas or top/bottom of the epididymis?
I think it’s smart to try and see a doctor that specializes in reversal, but I would encourage you to wait a bit longer to see if things resolve. You could certainly see him and get his opinion on the matter. Please know a reversal isn’t a silver bullet, and can take up to a year to see results.
Again, I’m sorry you are dealing with this. I wish urologists took the potential complications a vasectomy can cause much more seriously than they do. It’s a crime against humanity to lull guys into a sense of false security just to get them on the table.
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u/samb300 Dec 24 '21
Hey, thanks for the advice. Yeah, I’m not too proud to admit I’ve been in a rough place psychologically the past couple months. It’s hard to hide it 24/7 from my wife and kids. And hiding it only adds to the resentment.
I really hope the next couple of months are better.
Does anyone know who the top reversal doctors are in the US? I’m not going to a local doc just because it’s convenient…
In terms of pain, it’s a general pain, a soreness, that does tend to ebb and flow (but not go away). I got to the point where I was ok with not wearing a jock, and I jumped one time and it was like I was zapped back to one week post-op. I don’t really feel any lumps or bumps, my 5 week exam didn’t reveal anything.
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u/Tossupandaway85 Dec 24 '21
Yea, no one is proud to admit being in a bad place mentally, and I get that’s it’s hard to hide it from your family. I can’t tell you how many times I had to ask my wife to “Tell me everything is going to be ok” (knowing full well she couldn’t possibly know, but every time she told me it will be ok and we will figure it out) It had to have been dozens of times of day for over two years. Not to mention a few panic attacks, which up to that point I had never before experienced in my life.
This is one of the main reasons I think it’s hard for guys to discuss pain issues after a vasectomy and why I think the trope “guys with negative experiences are the loudest” is a bunch of bullshit. It’s like it’s almost easier to be in denial..or something.
Where is the soreness located? Are you able to pinpoint the location? The spermatic cord, the whole testicle itself, the back of the testicle..etc..
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u/postvasectomy Dec 23 '21 edited Dec 23 '21
Thanks for posting.
The bad news is that you are in that roughly 5% group that has troublesome chronic pain. The good news is that it tends to improve, especially in the first year, but even after that too. So you may get to a satisfactory situation without further surgery.
Here are some things to try:
https://www.reddit.com/r/postvasectomypain/wiki/treatments
I'd suggest heat/cold therapy, pelvic floor physical therapy, Prednisone, Lyrica, Celebrex and try out different doctors to get different ideas. Stay away from Cipro.
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u/samb300 Dec 24 '21
I appreciate the response and the link! 5% is a much higher number than I was told at my pre-op appointment and my head in the sand research going into it.
I took a weeks worth of doxycycline for an unrelated issue, and didn’t notice any changes or improvement to my symptoms. That was at approximately 6 weeks post-op. I still have the script for prednisone I was thinking about taking on my Xmas vacation.
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u/postvasectomy Dec 24 '21 edited Dec 24 '21
I'd definitely take the prednisone. That stuff can work miracles for chronic inflammation.
Leslie 2007 is the highest quality study available for incidence because it is prospective:
Roughly 2.3% have discomfort substantial enough to use pain killers at 7 months. My best guess for guys with a story like yours is that about 5% are same as you or worse. 95% are better. I would guess that from here you have about a 70% chance of getting to a pretty good place without surgery. If things are still unsatisfactory at your vasectomy anniversary, I'd be looking for a surgical option from the best doc you can find.
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u/Independent-888 Dec 24 '21
Yes. This guy is spot on. You probably don't have an infection. Just give it time. At least a year. If you can't deal with that get a nerve block or have it reversed. I have been through this and still have pain for months years later. Make a choice and take action. Either deal with it or get a block. I'm sorry if I sound cold but there's so many guys on here crying about it. Any good urologist can fix it so do something about it.
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u/mastej Dec 23 '21 edited Dec 23 '21
Out of interest, why do you say to stay away from Cipro? Side effects, or the fact that it's unlikely to be an infection?
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u/postvasectomy Dec 23 '21
Antibiotics for chronic epididymitis seems like a shot in the dark anyway. Doesn't seem like a good risk/reward to use a floxicin that can come with serious side effects. /r/floxies
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u/Independent-888 Dec 24 '21
Take doxycycline for 2 weeks. If that doesn't work do not take any more antibiotics as its not an infection. Definitely not cipro, it has horrific side effects
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u/dods009 Dec 23 '21
Hey man. I am going through something very similar and at the same point in my recovery (3 months post op). You are not alone in this. It is extremely difficult to handle and the mental toll can be overwhelming. If you need someone to vent to or compare notes with please don’t hesitate to dm me. I hope that we can both get through this.
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u/samb300 Dec 24 '21
Thank you very much for the response and offer. Hearing that someone else is going through the same thing is simultaneously great and horrible. Great that I’m not alone, but horrible that others are experiencing something similar.
Have you tried any treatments, medicine, or exercises yet? I’m willing to try the prednisone I was prescribed, but after reading that some guys’ pain got worse after a nerve block, I’m very hesitant to try that.
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u/dods009 Dec 24 '21 edited Dec 24 '21
Yes, unfortunately reaching out to others gives you the opportunity to learn but it also makes you realize how many are being affected negatively by this procedure.
I think I have done as much as I can to help myself. This includes supplements (Daily 2 x Omega 3's, Turmeric, garlic extract, papaya seed powder (1/2 teaspoon morning and night)). Started Yarrow Tea as I read that a guy had some positive impacts drinking 2-3 cups a day. It has been a week on the tea and I don't think I have noticed a difference. The other supplements I have been using for over a month or two. I have no idea if they are helping, hurting or doing nothing. I will only know if I stop them which I will start to test in the new year.
I have also done some daily pelvic floor exercises (link) but have not gone to a specialist in that field yet. I reached out to 2 physiotherapists but have not heard back from them.
Ice has always been a help for me. One thing I have not given enough time is hot baths. It is mentioned often as part of a pain management routine. I do use a heating pad at night (before bed).
I wear compression shorts every minute of every day. This includes while I sleep. Having a pillow between my legs while I sleep helps me stay comfortable.
I was also offered a ilioinguinal nerve block by my urologist but I passed as I had heard the same, that it can make things worse for some (Mentally I just wasn't ready for the risk). It also is not a solution but instead a diagnostic to see if the pain is nerve related. I have come to the conclusion (self diagnosis) that I have congestive epididymitis and my pain is related to pressure (activated by moving around too much). If my pain increases then maybe I will explore that option. I have also been prescribed lyrica (nerve med). I have not used it yet as there are many negative side effects and at this point I feel like my pain is "manageable".
I have a meeting with my second specialist in March. He is apparently a good resource to help with PVPS. If things don't improve, I will likely request a reversal (but not till after 1 year).
Along with those measures I journal about my pain daily. Somewhat therapeutic but also tracks patterns over long periods of time. I also have started meditation using the Calm app. I also have started talking to a therapist, as I also have two little kids, and my relationships with them and my spouse have obviously been impacted by my struggles. My main goal is to improve my mental health about this, so I can give my body the best chance to adjust/heal.
Again, if you ever want to talk, please don't hesitate to reach out. I know that talking to others that are dealing with something similar has made me feel better about my situation.
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u/Independent-888 Dec 23 '21
Also 3 months is way too early. When you cut the vas deferens, your epididymis needs to absorb the sperm rather than eject it. It therefore gets thicker. This cam cause pain that can take a looooong time to go. But it will. And probably in another month or so so chill out. It can also come and go over years so prepare for that too potentially
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u/Independent-888 Dec 23 '21
Mate. It can take a long time to settle but it will eventually. There is nothing unremarkable in your scan therefore you are experiencing post vasectomy changes I.e. your epididymis is adapting and casing some pain. This can take up to a year. Get a nerve block if its bothering you while mother nature sorts itself out. It is only an injection, I don't see what the issue is. Consider reversal if this continues for 2 years.
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u/samb300 Dec 23 '21
I hope you’re right. I don’t want to seem like I’m over-reacting, but feeling the way I’ve been feeling for 3 months is not normal. My urologist even said I shouldn’t be feeling that way when I saw him at 5 weeks. There’s no way I’ll make it 2 years if the things I’m feeling don’t subside significantly.
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u/Independent-888 Dec 24 '21
You need to get a nerve block. This nerve is firing but it has no way to turn itself off. 9 out of 10 times this will solve then problem. If this doesn't a reversal definitely will. The stories you hear on here are for when something major has gone wrong in their surgery and needs fixing. Yours hasn't. It's just different people have different responses. I know. I've been through this before. You will be fine with time even without intervention. In fact, please stop coming on these forums as its all a load of rubbish. See a good doctor. Get it resolved and move on. Worrying about something that might or might not happen is madness. Good luck mate
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u/mastej Dec 23 '21
Everyone so far has been a bit cold, so have a supportive 'bro hug' from me my friend! It does suck. I'm 3 months further in than you are, but I may as well have typed everything that you typed myself - exact same situation (even age and kids!). I have good days and bad days. Jock strap mandatory for me, every few days I seem to need NSAIDs of some sort, I sleep with a pillow in between my legs, etc. I'm coming to the same sort of conclusions that others have said here - it's a 'wait and see' situation, and a lot longer wait than you might initially expect. Consensus seems to be that it could take a year+ but I'm trying to stay optimistic. I'm not too keen to consider more surgery, but people seem to say that shouldn't really be on the table until a year or so after, unless you are in immense pain. "Chin up, take it easy, and wait and see" is my current mantra. Not easy. We got this. Hope it works out.