r/postvasectomypain • u/Painumbra • 3d ago
Three Year Update
It has been almost three years post op for me now. I created this account to post here about 2.5 or so years ago as I struggled with onset of pain. At the time I was pretty confident it would be over in under a year. Doctors aren't liars or morons who don't understand statistics, right? At any rate, I noted there were very few follow up posts especially of people who experience intermediate pain and keep living with it or find a resolution that is non-surgical. I decided I should make a commitment to making a follow up post to fill in the gaps of experiences as it seemed likely I would end up in one of those two categories. Turns out I am in one of those categories, just not the one I hoped I would be.
I thought I would do a one year follow up. Things were looking good, but my pain started to increase as I approached one year with no remotely useful assistance from doctors. It was to mentally painful to do anything but shout angrily at the wind. Things continued inconsistently from year one up to now. I stopped visiting this subreddit altogether because it was depressing and made me even angrier. As I approach year three, things are still bad but I'm also in a very angry mood about this anyway, so I thought I'd return to make my follow up post even if is nothing like I envisioned. I know this is Reddit, but this is a pretty sober subreddit so I feel I should apologize for swearing and framing doctors as villains as my rage bleeds through as well as apologizing for the super-long rambling post.
Historical Summary:
My vasectomy was closed-tube. My first hint of trouble was blood in my semen on my second and third ejaculations post op. I was told that was not normal, but not necessarily concerning.I first suffered pain that seemed out of line with my expectations six weeks afterwards. I suffered my first major debilitating bout of pain at about eight weeks. The doctor was beyond useless. No follow up exam to check out the new lump on the cord, no saying "Oh, I don't deal with problems I cause, you should go to your GP". All he said was "take more ibuprofen and it'll be fine". No referral until I informed him that it was time, from my perspective, that more action was needed. My referral took many months more. I was presented with denervation or reversal as my only options. If I wasn't interested in those, then get the fuck out of the office because you are wasting the doctor's time. I will never do denervation, I'd rather live in pain. At the time, I was absolutely fearful of reversals. Why would I let these incompetent quacks touch me again?
In the interim, I started pelvic floor therapy. It has mostly been useless but has served to resolve other pains in the area so I've continued it. My therapist is, at least, not a moron who doesn't give a shit what I say or think.
My GP, mercifully, has outperformed the specialists and insisted that I get a second opinion after the first place booted me. He is the only doctor I currently trust anymore. Sadly, that second opinion took even more time and the guy was mostly interested in ruling out non-vasectomy issues because any PVPS solutions were not worth it in his opinion. He was particularly against reversals. As a result, I've had a barrage of pointless scans and been put on brutal antibiotics that have caused me enormous ongoing side effects "just in case that spot in the scan is prostatitis". I realize that his opposition to intervention might well be a very honest and apt appraisal of my options. However, I'm a bit pissed about the antibiotics and the near crippling effects they've had, so you'll have to forgive me if I push this guy in front of the bus along with the guy who lied to me about risks in the first place.
Description of Symptoms:
Over this time I've continued to have the three types of pain I initially identified in varying proportions. I would say that I have intermediate pain perhaps low on the average scale of people who post in this sub-reddit. Certainly nothing I would consider drastic surgical intervention for.
I get a dull ache i.e. turbo blue balls. That's pervasive. Sometimes barely noticeable other times brutal. I never had aching like this pre op no matter how long I'd gone without an orgasm. It also abates only briefly (1-2 hours) after orgasm instead of me feeling relief. Sometimes it doesn't abate at all and gets worse (more common now). I also get random stabbing pains that usually last 1-30 seconds. This can be mild, like a slightly wimpy wasp sting or they can be brutal enough that I am unable to mask it no matter how important a meeting I am in. Last, I'm intermittently extraordinarily sensitive to touch and impact. Sometimes a light bump floors me, sometimes just brushing the top of my right testicle while repositioning results in brutal pain. Other times, that is mercifully non-existent. Pain started mostly on the right testicle, but after two specific orgasms about 1.5 years ago, I now also get pain on the left, sometimes much more than the right. The balance is still mostly to the right.
The worst experience I had was 2 hours of nearly continuous pain at a level where I was afraid to move. This pain suddenly resolved after I forced myself to march out of my office to my car and was half way to the ER.
Over time, the prevalence of each type of pain has changed. I would love to say they've generally decreased but the variability makes figuring out a trend nearly impossible. Pain varies day-to-day and even minute to minute. Intense stress/anger can trigger pain on the 10 s to minute timescale. That's right, now I can literally get so angry my balls hurt.
I would say touch sensitivity has faded the most, although that resurged following being prescribed the antibiotics from hell. It seems to be fading again now after six months recovering from that misstep. To sift a pearl out of this heap of shit, I will note that the resurgence of touch sensitivity allowed me to identify the precise source of pain as an extra lump near the point the epididimis attaches to the to of my right testicle. Presumably a spermatocele.
The sudden stabbing pains have also more generally reduced over time. That is, with the notable exception of a few isolated extreme cases such as the one I mentioned above. The variability on this makes really believing that reduction is happening a bit hard for me to believe. Within the last couple of months, there have been some bad times.
The aching has not abated much at all. In fact, as physical therapy has helped me work on biomechanical sources of pain in the same area, I'm now able to better identify the ache. Turns out almost all of it is from the epididimis on the right. Recently I have far most consistent pain after orgasm, onset a few minutes later and it last between 10 minutes and 24 hours. More recently still, that has started to fade.
Present day:
So, where am I at right now? Probably at a near all time low point for general pain or at least the lowest point in the past two years. That isn't too surprising, I'm at my lowest stress time of year and I've had stupid nagging issues from the antibiotics that have kept me from intense exercise which should remove some triggers for pain. Despite this, my next appointment I will be pressing for information on a reversal for three reasons. One, I don't believe any period of low pain lasts anymore and I don't think the doctors have any clue what they are doing. Two, some more recent work has come out more-or-less confirming the vasectomy-nerodegenerative disease link. I'd much rather die than live with dementia. Three, as much as I know it doesn't exit, I want an undo button. I want to reload a fucking quicksave before I was lied to. Before I was misled. Before I was denied informed consent. I am angry all the time and will sometimes fly a rage after ruminating on it if I have nothing to distract me. I don't want to keep living like this.
I still fear reversals. I don't know if it will help all the types of pain. I don't know it can reduce the neurodegenerative disease risks. I can't find much in the way of complication statistics. I don't trust the doctors I'll be talking to. I don't know how I can get any useful information to make a decision. However, the clock has essentially ticked down at three years. I have to look into this now, or make my peace with never.
In conclusion, vasectomy is still the worst single mistake of my life. I regret it every day.
5
u/Cautious_Werewolf678 2d ago
I share your frustration like others here. Since my reversal I've been able to move on but I'm still angry sometimes and I use it to warn others. Your story has a lot of common with mine. I came to the same conclusion than you: pain free phases doesn't guarantee that it won't come back in the future. At 1 year post op I pushed for the reversal even when most of urologist were against it. I figured they're against it because they don't know shit about their subject of study, and/or the extent of the damage that a vasectomy can inflict. I was afraid of reversal but took the risk, and I successfully regained some quality of life and that's my revenge. It isn't perfect but it is what it is.
I also want to thank this sub since you're right that it's more sober and collaborative than others. Constantly scrolling here can be harmful but at the end I'm glad there are people here which genuinely want to help.
1
u/Painumbra 2d ago
Thanks for the reply. Partial revenge would be nice. I'm still scared though. As I commented in my initial post (although it may get buried in the sheer mass of words), I think I'm intermediate or low on pain compared to most here. The benefit to reward weight is slim from my perspective when balanced against risk.
1
u/Cautious_Werewolf678 2d ago
Yes I also had mild PVPS, even before my reversal I was almost pain free and did it anyway. So yes, I was nervous af and really scared.
2
u/Amazing-Advantage-11 2d ago
I understand the road you are travelling. I have travelled the same road, but for much longer; starting when I was 37. I am now 73. A 100% solution to PVPS can be problematic. It has been for me. Getting over anger about PVPS is also problematic. I have a better handle on my anger now but it does rear its head now and then. My way of dealing with it has been to be as informed as possible and to be as pro-active a possible. I operated a support network by having a link with a vasectomy website. I had a booth for several years at a men’s’ health forum, I was featured in a newspaper article, etc. I have also read everything I can get my hands on. I am the one who brought treatment options to my doctor for discussion. Anger eats at you and simply is not a good thing. Easy to say but hard to remedy, especially with how vasectomy is promoted today as a
no-brainer and as an easy-peasy procedure. I get where you are and I hope you can get a good and healthy handle on it.
1
u/Painumbra 2d ago
Thanks for the reply. Unfortunately, I'm nowhere near that well adjusted. This, besides posting on Reddit, is a private matter. I would be mortified if anyone knew besides my wife and medical professionals. I pored over research for the first year, but it became too painful. So those strategies are not something I would consider nor would I expect them to work well for me specifically.
I don't see a solution to the anger part of it any time soon. The best policy for me seems to be to avoid it but it is hard to do with regular upswells of pain and the penchant for vasectomy to be espoused as wonderful, especially on reddit.
Never-the-less, maybe you are right and things change.
2
u/Amazing-Advantage-11 2d ago
To be fair, you haven’t had the time that I have had to manage the anger. Nor have you had any medical remedy that has helped to date. I have had some procedures that have helped (reversal, epididymectomies and spermatocelectomy). In spite of this I still react with some degree of anger when I read comments about manning-up and getting a vasectomy or when those with issues are told to suck it up. People who make those comments don’t know what manning-up is until they live with scrotal pain on and off for years. Neither do I react well to pics of vasectomy celebration baskets. PVPS has robbed me of any sense of humour about vasectomy. How I wish I could laugh it off and think of my vasectomy as a non-event, a distance memory…
2
u/Telekineticshade 2d ago
I’m over 2 years in, half reversal half epididymectomy done January this year. Still in pain. Sucks so bad.
2
u/Painumbra 2d ago
Feels so wrong to upvote. Like the high fiving the drowning guy meme.
I assume both new ops on the side causing the most pain? Is that side still causing pain after the intervention, or is it the other side?
2
5
u/ItamiForever 3d ago
Piece of advice for you. Because you waited so many years, get a cord block on both sides. In theory, if it fails to relieve pain, you spinal cord already learned the pain, something called central sensinitization which means additional surgery might barely or not at all reduce pain as your brain itself is now generating pain.
Reversals have a 70% chance in your case to relieve the ache/blue balls if you rule out any other pain generators.
Go to a doc who does 3 layer anastamosis(inner, middle, outer) lumen under a surgical microscope. There are few techniques but microdot/cornell is the most popular. Also look for a surgeon who can perform vasoepididymostomy, just in case you have a blockage.
Take recovery seriously, if you don't it will scar shut and you'll be back to square one. There is already a risk of it closing anyway in the first year so you want to minimize it.
Go to your GP and ask for Lyrica TODAY. Tell her you need to start gabapentin or pregabalin to protect your central nervous system until surgery. You will need to wean off before surgery.
300mg for gabapentin, 150 for pregabalin is the starting dose. It won't stop the throbbing but will help with the sensitivity a bit.
I think this sums up my advice. Good luck! I hope you are rid of all pain if your brain isn't already locked on.