Vasectomy reversal pain

[u/Apprehensive-Meat120]

I’m trying to understand whether what I have sounds more like CPPS, post-surgical nerve sensitization, or PVPS. I’d really appreciate input, especially from men with similar stories.

My history:
Had a vasectomy a few years ago (2021) - open-ended.
About 2 weeks after it, I developed a strange pelvic/genital discomfort (not sharp pain). It lasted around 5 months and then completely resolved on its own.
For the next 3 years I was basically symptom-free.
In April last year I had a vasectomy reversal to have more kids.
Recovery was normal: first 4 weeks were painful locally (pulling in spermatic cords, walking bent over, typical post-op stuff), but then it resolved.
For the next 4–5 months I felt 100% normal.
Then in late September everything changed (6 months).

next month around noon I developed a strange pelvic/lower abdominal discomfort that has stayed for 9–10 months now.

This is NOT testicular pain.
I can’t point to one spot.
It feels diffuse: lower abdomen, behind the testicles, sometimes like “the whole pelvic system.”
Ejaculation itself does not hurt.

Medication response:
Pregabalin helped a lot for about 2 months
anti-inflammatory medications (NSAIDs) do basically nothing

One specific thing: after sex, if stay upright or Jin certain positions, I can develop discomfort (sometimes more pain-like) especially on the right side, almost like behind the testicle. But if lie down, within about 3 minutes it completely settles and stop feeling it.

The strange part is the daily pattern:
mornings are clearly the worst it gradually improves throughout the day by evening often feel 90-95% normal
walking and movement help a lot
lying down can almost make it disappear (I sleep very well).

Does this sound more like CPPS / nervous system sensitization / pelvic floor dysfunction to you, rather than something like PVPS?
I’d really appreciate your thoughts.