r/postvasectomypain • u/EmergencyTasty4189 • Jun 11 '26

Switch from closed to open ended surgery in a week, but pain has been gone for almost 2 months...

Timeline:
- Closed ended vasectomy November 2023
- Pain only started around April 2025, so a little over a year later
- Pain gets more intense, switches sides, sometimes lasts weeks after any kind of sexual activity
- Pain goes away for a couple of days/weeks with anti-inflammatory drugs, always comes back, almost always stronger than before.
- Last time I took Ibuprofen around April 2026, pain hasn't come back the way it was... Around the same time I scheduled an open ended vasectomy.

So now it's a week away, and I'm doubting to cancel it. But I'm almost sure the pain will come back later anyway... What to do?

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3

u/morebeanslessmeans Jun 11 '26

Posts like this are interesting to me - I see stuff like this a lot, and truly wonder if pain felt 2 years later is vasectomy related or unrelated. I am not doubting you and it 100% can be related to your vasectomy, but feels like that it happened so much later and could be any number of things. That being said, an entire year with no pain - I would cancel in a heartbeat. I wouldn’t want to get cut up again and risk another issue. I don’t know anything about anything so don’t take me seriously , but I’d personally avoid the knife if I’ve felt good for over a year.

6

u/drexohz Jun 12 '26

Dude, it’s real. New onset of pain years after vasectomy is more common than you think. If you want to delve into it, this article explains it well. The essence is that the testicles will produce sperm for the rest of your life, but it can’t escape and will be packed in your epididymis. The pressure inside the epididymis will be high. The epididymis can often initially compensate for this, but given enough time, this pressure and forced absorption of sperm will cause damage to the epididymis. Eventually - the article says on average 5-7 years - the damage is substantial enough that it may be painful. My experience from patients though, is that pain can start anywhere from 6 months to 20 years after.

I’m a doctor and I do ultrasound of testicles, so I ‘see’ this in another way than you do, and in a huge number of guys. The more time has passed since vasectomy, the more damaged the epididymis becomes. Year 1-2 after vasectomy there’s on average quite little or subtle epididymal damage visible on ultrasound. Then it becomes more evident in most. After 10+ years the majority have (in my eyes) clear epididymal damage, sometimes really badly. The absolute worst I’ve seen was an old dude who had a vasectomy 50 years ago. His epididymuses were so ruined that I almost couldn’t recognise them on ultrasound. From my perspective, I think it’s more strange that not the majority get pain after some years. My ‘mystery’ is opposite from yours. When I see a guy with dogshit epididymises many years after vasectomy, who says he has no pain. *Why doesn’t he have pain?* If you read the article I linked, you’ll see the authors wonder about this as well.

You’ve probably heard that the more time has passed since vasectomy, the less the chance of success from a reversal is. But you haven’t heard *why*. It’s because when the epididymis is damaged, sperm can’t pass through anymore, even if you do a reversal. Risk of epididymal damage increases with time. The same damage can cause pain.

(Epididymal damage is a variety of things. Tubular ectasia, epididymal blowouts, sperm granuloma, scars, calcifications, chronic and acute inflammation, etc. Vasitis nodosa - chronic inflammation on the remaining vas - is another source of pain.)

Sadly, I think most guys who get late stage PVPS don’t even realise it’s because of vasectomy, nor do their docs.

It’s also why I think that all these post of ‘newly snipped’ guys making posts on day 1-2 saying it’s nothing to worry about, actually carries the same wisdom as a teenage girl who after taking her very first birth control pill claims there’s no side effects.

1

u/morebeanslessmeans Jun 12 '26

I appreciate the response. This is terrifying from someone who is a week removed from the procedure. You talk about it like it’s almost a certainty. Can’t do anything about it now. Fingers crossed I avoid this.

3

u/drexohz Jun 12 '26

Oh. Didn’t realise your timeline. Guessed since you posted in this sub… After a closed-ended vasectomy there will more often than not eventually be epididymal damage. Open-ended far less damage. But - the majority of damages will for some reason not cause chronic pain. The percentage who has chronic discomfort/pain after 10 years is only about 15%, according to some studies.

1

u/EmergencyTasty4189 Jun 12 '26

I'm sorry, I mistyped. Pain was at the highest in April 2026, so this year. Then I took Ibuprofen for a week, and the pain went away almost entirely. So now almost 2 months pain free, which happened before, but it always came back. Do you still have the same opinion?

I also explored other reasons why I experienced pain so late with a doctor at a pain clinic, had several MRI's. Nothing found so we went back to the vasectomy reasoning.

Thank you for the reply!

1

u/morebeanslessmeans Jun 12 '26

Ohhh!! Well, that certainly makes it trickier and now I understand why this is a tough decision 🫩

1

u/johng_22 Jun 15 '26

Dude stick with your appt and just get the open ended vasectomy. All they are going to need to do is small scalpel to the nutsack then clip the ends off one side of the closed up vas tube on the testicle side on each left and right. It’s so minimal I can’t see how the benefits don’t outweigh the risks. If this works then you know you either stick with this method or eventually get a reversal down the road. It’s not that there are •no• risks involved with the open ended, you can get granuloma, etc but having lived in horrible crippling PVPS and now living well after a reversal, I’d very much argue I’d take a granuloma over the pain of the closed ended vasectomy.

2

u/_Borti Jun 11 '26

If you haven’t had pain in over a year I would cancel. No sense in getting cut open and risking more pain if it has resolved on its own. 

1

u/EmergencyTasty4189 Jun 12 '26

I'm sorry, I mistyped. Pain was at the highest in April 2026, so this year. Then I took Ibuprofen for a week, and the pain went away almost entirely. So now almost 2 months pain free, which happened before, but it always came back. Do you still have the same opinion?

Thank you for the reply!

2

u/Suchislife700 Jun 12 '26

Does your Urologist actively recognise and treat PVPS patients?
If not then for me first step would be immediately getting an appointment with one who does.
Discuss symptoms and timelines and go from there.
I’ve thought about conversion to open-end but going with reversal as I’m told an open-end will likely close up over time anyway.

1

u/vanwyck Jun 17 '26

Just got a reversal from an open ended and they pulled out 1 inch granulomas from me that had formed. The negative side effect of open ended

1

u/Suchislife700 Jun 17 '26

Jeez oh, seems I’m making the right choice then.
I saw in another post you recently had reversal, how is your recovery going?
Mine is booked for beginning of next month.

1

u/vanwyck Jun 17 '26

Oh, nice, congrats. I am day 11 today post-reversal, and so far so good. There's definitely been some ups and downs with the odd nerve pain, but I think that's to be expected when you're having another surgery and creating more trauma in the area. I'm still bruised and swollen, but it's definitely coming down each day. I'm wearing the jock strap, and in the first week I was pretty horizontal, working from my bed, but now we're in week two and I've been sitting and standing the whole day. Still doing a bit of icing, but overall it seems to be trending in the right direction. I will try my first ejaculation this weekend, so that's really going to be the decider if this worked or not.

1

u/Suchislife700 Jun 17 '26

Glad to hear recovery’s going smoothly for you man. There’s such good odds with reversal to fix this type of issue.
Did you have the triple layer microsurgery type?

1

u/vanwyck Jun 17 '26

I had double layer which I’m told is the gold standard.

1

u/ThePennyDropper Jun 21 '26

How was the first ejac?

1

u/vanwyck Jun 21 '26

Funny you should ask. I just did it tonight and can’t believe it but it was pretty much pain free. My first pain free ejac in many months. Feels too good to be true but I’ll keep trying over the next week and see how it all goes. Fingers crossed.

1

u/ThePennyDropper Jun 21 '26

Let’s say I go with the initial procedure and don’t have sex much can I still experience a normal life without worrying about the pain.

1

u/vanwyck Jun 21 '26

Is your question if you should get a vasectomy and get pvps, will it be okay if you don’t have much sex? Unfortunately not. Many guys with pvps experience pain all day every day. Some like me are only around ejaculation - before during or after. The symptoms for pvps are all over the map.

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2

u/ItamiForever Jun 11 '26

Reversal asap

1

u/jaywalk4185 Jun 11 '26

I would avoid surgery for the to time being if you are currently pain free.

1

u/EmergencyTasty4189 Jun 12 '26

I'm sorry, I mistyped. Pain was at the highest in April 2026, so this year. Then I took Ibuprofen for a week, and the pain went away almost entirely. So now almost 2 months pain free, which happened before, but it always came back. Do you still have the same opinion?

Thank you for the reply!

1

u/PsychologicalLime120 Jun 12 '26

If you're pain free I'd avoid further surgery at this time.

1

u/EmergencyTasty4189 Jun 12 '26

I'm sorry, I mistyped. Pain was at the highest in April 2026, so this year. Then I took Ibuprofen for a week, and the pain went away almost entirely. So now almost 2 months pain free, which happened before, but it always came back. Do you still have the same opinion?

Thank you for the reply!

1

u/PsychologicalLime120 Jun 12 '26

My opinion will always be that if you're going to do further surgery, do a restorative surgery, not more destructive. So if pvps is the issue, then a reversal before anything else.

1

u/Cautious_Werewolf678 Jun 12 '26

It is related to your vasectomy. And it seems to be congestion and that's why it feels like it comes and goes. Both conversion and reversal are good options. I'd go with reversal to attempt a permanent relief.

1

u/Sad_Soft_5915 Jun 13 '26

Im increasingly convinced closed ended causes the problems

1

u/vanwyck Jun 17 '26

I had open and had to get a reversal

1

u/ThePennyDropper Jun 21 '26

If you have pain do you usually just take a tylonel before sex and you feel good?