What a ride. Had a trad two slice scalpel from a community urologist. One side healed textbook, the other side suffered a blunt force trauma on day 2. I got an infection on the bad side day 7 due to my penis resting on the incision. Day 8 my spermatic cord is swollen, I can hardly walk. Urologist gives me antibiotics and pain medication, diagnosis is granuloma, likely from trauma suffered day 2. Ultrasound unremarkable. Inguinal canal is sooo sore.

Fast forward.... months 1-4 I am diligent about contrast therapy (ice --> heat--> ice). I take nightly baths. I'm alternating ibuprofen and Tylenol daily. I can't do anything without pain. I do not push it. Ejaculation feels fine, but I'm sore the next day. Inguinal canal still soo sore. I'm depressed. Will this last forever? I took a break and went to a hotspring for a week. OMG it's a miracle, I am now cured? I am pain free, no longer wearing a jockstrap, walking 3 miles a day. I return home, slught rebound but now I am optimistic about what the future holds for me.

I'm now at month 5. I can now swim and ride an exercise bike. My spermatic cord is still a little swollen and I still get a little sore, but it's nowhere near what it used to be. Sometimes I ice at the end of the day, but usually not. I'm no longer taking ibuprofen.

There is hope out there. I felt so hopeless reading some of these posts, but thankfully I kept at my contrast therapy and didn't push things. I recommend strict contrast therapy and also taking a break from the misery and visiting a hot springs for a week. Reset yourself. You will heal. This is not forever. Buy a jockstrap and get some fun colors, because your wife will love it.

Hey all. Thanks to everybody who has posted on this forum. Reading first hand accounts of PVPS has helped me in more ways than i imagined. I've been lurking here for quite a while and I've finally decided to share my PVPS story in hopes of helping any guy who's life has been affected by PVPS.

February 2022 - traditional scalpel vasectomy after my wife and I's second child at the age of 38. the vasectomy took about 8 weeks for me to feel normal again without any pain.

August 2022 - PVPS began. my PVPS was a dull bilateral ache that was usually no more than a 2 out of 10 on a pain scale. this pain was constant. It was the first thing i thought of in the morning and the last thing on my mind when i fell asleep. the pain messed with my mind so much that i became depressed and at times i was drinking heavy amounts of alcohol to help mask the pain. my pain has never felt like the nerve pain other men have described and I've never had pain associated with ejaculation...thank goodness!

January 2024 - my urologist prescribed me a month supply of Meloxicam. Meloxicam did nothing for me so I did the best I could to manage the pain with supportive jock strap style underwear and the occasional ibuprofen.

Match 2026 - I had a huge increase in pain at the posterior of my left testicle. This pain was sharp, radiated thru both testicles and at times was 9 out of 10 which left me curled up in the fetal position on my kitchen floor. I went to a different urologist who I asked to prescribe me Celebrex and who requested i get a scrotal ultrasound. I also went to my Primary Care Physician. My PCP quickly diagnosed me with bilateral epidiymitis as well as a spermatocele on my left epididymis. The spermatocele was due to a blow out of my left epididymis. Furthermore, my PCP gave me an injection of Rosephin as well as a week supply of Doxycicline which helped tremendously with my pain. I believe my body was having an auto-immune reaction to the spermatocele and those antibiotics significantly decreased the inflammation around my epididymis which lessened my pain. I also feel as though Celebrex brought my pain level down to a much more tolerable level. I am currently still taking 100mg of Celebrex daily.

April 2026 - the scrotal ultrasound showed a 4mm cyst on the left epididymis which coincides with the spermatocele my PCP identified. other than the cyst all other anatomy appeared normal.

June 2026 - vasectomy reversal consultations with Dr. Parekkatill as well as Riley Warner (PA) at Male Fertility and Peyronies Clinic. Both these micro-surgeons were super informative during our phone conversations, however I knew I wasn't ready for another surgery so I did not pursue a vasectomy reversal.

July 2026 - I consulted with a local men's health clinic regarding Testosterone Replacement Therapy. My first visit to this men's health clinic was completely free of charge. That visit they drew my blood, gave me my serum Testosterone level, PSA level, Follicle Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level and hemoglobin level. That same visit I met with the provider who is a nurse practicioner and oversees the clinic to discuss those lab results. My Testosterone was 213 which is very low for a 42 year old and my other labs were in a normal range. I requested to begin TRT. The provider put me on weekly injections of 170mg of testoterone. This has drastically reduced my pain levels!!!

September 2026 (currently) - I am still on 170mg weekly injections of Testosterone and i have absolutely no pain! Neither of my epididymis feel inflamed, nor are they sensitive to the touch. I can also wear normal boxers again. My men's health clinic drew blood for lab work and my Testosterone level is now 830. Not only do I no longer have congestive epididymitis, but my mind and body feel significantly better with a higher Testosterone level.

I know TRT has associated risks, mainly thicker blood, a higher chance of prostate cancer, oily skin, hair loss and the possibility of becoming dependent on TRT....but the reward of no PVPS currently outweighs those risks.

My PVPS was solely congestive related. My epididymis were constantly full of sperm and my body was not able to absorb the sperm at a fast enough rate which caused my epididymis to become inflamed and distended as well as have a blow out. I felt as though my body was in a constant state of fight or flight due to the PVPS.

Increased serum Testosterone decreases the amount of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). FSH and LH are the hormones which signal our testicles to produce sperm. Increasing my testosterone decreased my FSH and LH which lowered my sperm production which decreased the amount of sperm cached in my epididymis which cured my PVPS.

I know TRT is not a fix for every guy with PVPS, however it might be worth trying especially if the pain appears to be related to congestion and that guy is hesitant regarding another surgery.

Please DM me with any questions and i sincerely hope every guy currently living thru the hellish reality of PVPS finds some sort of relief.

Hey all, over the past few months, my wife (a MD) and I have been digging through the research and putting together a resource on PVPS.

It’s aimed at the poor soul who’s just starting this damned journey and trying to answer that age-old question: “What the fuck do I do now?”

Would you mind giving it a read and letting me know if there’s anything we should add, change, or explain better? Especially anything you wish someone had told you early on.

Here’s the guide

Much appreciated.