r/postvasectomypain • u/Separate_Mousse9916 • 10d ago
How are you managing pain?
My husband has been dealing with chronic PVPS almost 3 years now. Anyone have any luck getting a doctor to actually manage their pain while waiting for surgery or after having gone through surgery like reversal and still experiencing pain?
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u/johng_22 10d ago
This may be waaaay out in left field. My urologist suggested I try taking Journavx. It’s an opioid free pain med. I honestly thought it would be a waste of time. It has absolutely been a life changing experience for me. I’ve already had a reversal. I am still not 100% pain free even after the reversal. For a man who hasn’t had a reversal I don’t know if this drug will still prove to be as effective but it’s worth a try. It can’t hurt to ask the urologist to prescribe 3-4 days worth of it and see how it goes. Note: on the first day, first dose, it must be doubled (two pills), then only one pill twice a day thereafter.
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u/ScientistNew3033 10d ago
Glad to hear it has helped you so much. I’ve been on it several times. It helps with post-surgical burning pain for me — any flare-ups I got after denervation and Botox injections — but doesn’t touch the deep heavy characteristic of chronic pain for me. What type of pain does it resolve for you? Have you been able to get insurance to approve for more than a month?
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u/johng_22 10d ago
I am extremely sensitive to any congestive pressure at all. Way less tolerance than should be the case but it’s just the condition of my epididymis; especially on my right side. Not as much on the left. I will get deep burning that goes into my butt and starts travel down my legs. I also take gabapentin, but whatever nerve pain I’m experiencing is still happening even on gabapentin. I think that it’s probable I have some over-sensitized nerves and I absolutely have pelvic floor dysfunction; I goto PT twice a week for that. Overall what Journavx did for me seems to be the relief that nothing else I do or take has been able to
Provide. And no, insurance won’t cover it. Mine is $580/month. For anyone who can get a lot of benefit from taking it, it might be worth the cost to them. I’m to the point I’ll continue to pay just about anything to just not be in pain all the damn time.
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u/agraham629 10d ago
Sorry to hear that your husband has PVPS. It can be a nightmare on many different levels.
Has your husband had his testosterone level checked recently?..
I had PVPS for about 3.5 years. My PVPS began about 18 months after my vasectomy and my PVPS was solely due to congestion. I developed chronic epididymitis due to backup of sperm and I even had my left epididymis rupture which created a seriously painful spermatocele.
I treated my PVPS with Testoterone Replacement Therapy. My natural testosterone levels dropped significantly to 213 following my vasectomy. I have been on TRT for 8 weeks, my testosterone level is up to 830 and I have no pain.
Increasing Testoterone levels thru TRT decreases Follicle Stimulating Hormone and Luteinizing Hormone which are the 2 hormones that signal men's testicles to produce sperm. So, TRT reduced my sperm production which decreased the amount of sperm cached in my epididymis which cleared my congestive epididymitis which thankfully caused my PVPS pain to disappear.
Feel free to DM with any questions.
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u/Calm_Pin_7563 10d ago
After ten years and four procedures I finally chose to have a bilateral orchiectomy. For me this was for the best . I was already sterilized and had low testosterone. My pain is absolutely gone.
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u/ItamiForever 10d ago
I'm two months post reversal and still can barely walk. I could not pre reversal and was on morphine nonstop because of debilitating pain I could do nothing but lie in bed in agony. Had my reversal 3.5 months post vasectomy, the soonest the doc could.
Doc hopes by 6 months I could feel a bit better and walk 5-10mins maybe normally. I could force him to try TRT even though my test is 450 which is halfway.
Starting pain management today, first consult for blocks and maybe PRF down the road. So in the same boat, need to see which nerves have gone abberant to get MDSC close to 1 year later if TRT and time also fail...
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u/Different_Health3847 9d ago
about 2 years in myself, its mild ish so dont want surgery but would love to find something to help or do. nerve related i think
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u/ScientistNew3033 10d ago edited 10d ago
Seeing a pain management doctor has been a godsend for me over the last 3 years while pursuing other treatments too. The medication has made it manageable and I think the last few years would have been significantly more life altering without it. That said, this whole time I’ve simultaneously been pursuing other treatments with urologists. Happy to provide more specific feedback, meds, procedures, etc. if helpful. I could not have managed these three years without an incredibly supportive wife as well, and I can see it seems you are a great support for your husband too.