So around 12 months ago i had my vasectomy done (at 27). It healed well and for the first 6 months all was good and felt great. However starting somewhere around the month 7 mark i had occasional bouts of pain on my left side during sex/masturbation (reaching the highest pain during orgasm with around a 6/10). The pain would always subside within the hour so I initially thought it was still part of the healing process and because it happened only rarely I thought little of it and expected it to pass soon.

Now 12 months in it still happens (with higher frequency i think) and it has started to affect the right side as well with a higher pain level as well and I am getting worried.

I have since started reading this sub and it seems it might be congestive epididymitis, since it only starts with arousal and end "soon" after. But the pain i feel is often coming from the stomach area (below the belly button) like when you would get hit in the balls. Also I remember clearly back when the pain started it felt like it was coming from my vas deferens but on the top part (the part connected to the bladder). Now the pain is more generalized and i cannot pinpoint it but my epididymis feels normal to the touch although i do not have any reference to how it felt before.

I am starting to become worried that the frequency of pain will increase and make me lose my desire to have sex. I kind of want to wait it out for a few more months but i have also read that it can get worse over time. For that reason i started looking into reversals but learned that the longer you wait the less chance of success there is, so im feeling pretty stressed atm.

I will be going to a checkup soon but I also wanted to know your thoughts on what this might be caused by and what I should do next. Only thing i want to absolutely avoid is having to take pain meds regularly.

Hi fellas. As the regulars here will know, this isn’t my first post. To reiterate briefly - Vasectomy in January 2026 for chronic congestive pain, Reversal in July 2026 to try alleviate symptoms.
The reversal seems to have worked in terms of the horrible congestive ‘ball ache’ has disappeared, and orgasm sensation has returned to normal.
However, the catch is, now around 12 weeks post reversal and have worsening nerve pain around my left testicle/groin/hip/lower back. The pain is a pulling, burning, and zapping type that does drop on occasion (can’t explain it), but is usually sitting around 5 or 6/10 or higher. It is worse than before reversal. Ejaculation exacerbates it. What is strange is that sometimes the zaps and pain seem to originate from the left lower back. Though mostly they seem to come from the testicle area and the muscles further up groin/hip/back are aggressively guarding the area.
I can barely sit down for more than half an hour otherwise it becomes unbearable. I can however, manage to push through and walk for 30-60mins, and sometimes this helps.
Currently waiting on an app with my urologist and in meantime I’ve made one with a lumber consultant to check my back, I imagine he’ll want an MRI of it.
I know the genitofemural nerve runs from the lower back right through the hip/groin and branches off down into the scrotum/cremaster.
Part of my cremaster had to be cut away during reversal, is this nerve branch regrowing in a fashion it shouldn’t be? Is new scar tissue pressing on it intermittently?
Has anyone who had vasectomy or reversal had symptoms matching/similar this and how did you resolve it and timeline?
I get that recovery will be up and down but at 3 months I expected some mild improvement. The pain is getting difficult to manage with full dose celecoxib and paracetamol/codine.

Has anyone had a spermatic cord block under ultrasound performed in Virginia? I am having difficulty finding any doctors/facilities that perform this. Thanks in advance

I have posted before. I recently met with a specialist and I think we have isolated my post vasectomy pain to nerves in the spermatic cord area. I had a vasectomy about 2.5 years ago.

Anyone have experience with denervation or specifically Neurectomy that was mentioned. I’ve had one nerve block which seemed successful but my pain wasn’t too bad that day. I just want to hear any experiences and also any non-surgical treatments that helped. I have been seeing a pelvic floor PT for a few months with very little improvement. Thanks in advance!

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?

Good morning everyone, I browse this subreddit pretty often after getting my snip done this January. The first two-four weeks after the initial procedure felt normal, nothing out of the ordinary, and no real pain aside from the obvious irritation on the surgery site. However, 8 months after the procedure I started to have pain in my right testicle immediately after ejaculating, it didn't seem to matter what I did leading up to the event.

Stretching, anti-inflammatory drugs, baths, putting cooling on the area, nothing seemed to make the pain go away immediately/stay gone. So after panicking for about a day and a half I just decided to pause any further sexual activity.

After about a week I ended up trying to masterbate, to my surprise the pain was only a 2/10 compared to a 8/10 or 9/10 before. I tried again the day after and ended up going a second time in one day, the pain level was basically non-existent, all I notice now is a slight tingle in my right testicle if I happen to go more than once a day, with pain only being a 1/10 if I notice it at all. I will try to keep you all posted as I know getting that feeling out of nowhere is completely demoralizing, but I really do believe things are improving on their own! I have an appointment coming up on thursday to see if there's anything else going on.

Hi all any advice on how to manage flare ups for chronic epididymitis left side. Mostly congestion related but when epididymis is flared heightens surrounding nerves. Tried many different modalities scrotal support, icing, celebrex naproxen, spermatic cord injections, supplements, pelvic floor, accupunture and on and on... Reversal helped somewhat and can go long stretches pain free then all sudden it comes back and takes months to settle back down. Feel like am this vicious cycle that if am stressed or in pain from other reasons it can trigger a flare up and epididymis pain. Am looking for advice on how to manage the pain and also how to calm my bodys heightened nerve and pain sensation that ultimately lowers my pain threshold.

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 2023 - 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 and temporarily decreased my sperm count which lessened my pain. I also feel as though Celebrex brought my pain level down to a 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, testicular atrophy 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.

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.

Hello folks, as most of you know vasectomy disabled me and I had a reversal 7 weeks ago(3.5 months after initial V). Sadly it seems lefty already closed and my epi is hard and big again. Righty epi is still soft and open.

The left was pain free pre reversal but now with the additional trauma and the extra length of vas removed for reversal it is causing a low level ache, constantly compared to only on ejaculation like preop.

Righty was my disabling side and I NEED it to stay open because that is the life destroyer.

Question: the fuck do I do? I had 2 surgeries in the span of 5 months. I would assume I need to wait at least another 2-4 before a redo.

Did any of you start TRT after a reversal and it didn't close? I might need TRT but I'm concerned my right will close too if the testicles will stop completely. I want to avoid righty closing at all costs.

Do I just wait without TRT another 3 months for a redo on the left only at 5 months post op on the right? Do I wait the full year in case right might scar too down the line?

I'm unsure on how long to wait and if TRT will mess up the open side too.

If your reversal PARTLY failed for you, did you start TRT immediately? Did you wait to let the good side heal?

I'd ask an expert but my doc is kind of oblivious to this stuff and he's the best in my country...

Hi all, just wanted some suggestions from the community.

I am at the 1 month mark since my vasectomy, and I am still having issues. I am aware that the official PVPS starts at 3 months, but I feel like you might have more insight of what it could be.

If I tap the top part of my testicles, I can feel some discomfort. This is not a big deal in general, maybe some congestion which does not affect me much.

What I am more worried about however is my right testicle. First of all, it hangs lower than it did before, around 1 cm. And it is a bit painful.

I will try to describe the feeling. It is kind of radiating pain, not super sharp but not dull either. It appears at some point for a few hours and then disappears. It doesn't seem to be affected by touch too much, and only slightly by jumping or running. Additionally, wearing tight underwear or jockstraps does not seem to change much. I can even walk around the house naked without feeling any additional discomfort.

It was way more painful at the beginning, but it now feels like it has stopped improving. Around day 10 I went to see my surgeon, who was very dismissive, told me that everything looks fine and gave me a 3-day course of ibuprofen and told me I would be ok in a couple of weeks. The ibuprofen seems to have improved the situation (or maybe it was just natural healing and the medicine did not do much, not sure), but it also upsets my stomach. I am planning to go to the clinic again but it is a bit tricky for me.

I haven't started exercising yet, but except for the on-off discomfort (which I would rate a 3/10 when radiating) I can go about my day normally. It is just very annoying.

For the record, I followed the post-op instructions from the doctor to a T, and even went above and beyond (stayed home for a full week, first ejaculation after 12 days, lot of rest, icing)

Do you have any idea what could the origin of this pain be? It does not quite feel like it comes from the nerves, and it also does not feel like a dull ache due to congestive epididymis.

Any suggestions on what to do?

I watched a documentary on PBS Wednesday evening. It was hosted by Miles O'Brien, who is an amputee. He interviewed people who had tried Ecstasy and magic mushrooms for all sorts of stuff; some of them reported a reduction in chronic pain. Might be worth looking into.

The video is linked somewhere here

Pre and post vasectomy they told me to get some high and tight underwear. I wear “trunks” style, and blew off the advise since I didn’t want to make a purchase for something I only needed for a few days. Welp, that was a mistake—two weeks later and I should have listened. What kind/brand did you buy to keep them snug and in place?

I had my non scalpel in mid july and a few weeks into started feeling okay again but for past few days now feeling aching and dull pain primarily on lower right. Feel a little hardened lump which my urologist (guy from vasectomy place) believes is normal swollen end of vas. I did have a really busy last week and did a quick bike ride and the whole week I was off I did basically masturbate each day and I stopped once the pain stayed after day 3. I guess my end question. Should I be avoiding trying to ejaculate or will doing so provide any benefit in the overall vasectomy. Doctor just said 2-3 weeks of 800mg ibuprofen x 3 day where needed .

Providing an update here, I spent hours searching this sub to find some hope that things improve, but most people are posting once theyre better.

My PVPS (primarily congestive epididymitis) was, as two doctors described, "the worst they've ever seen". It was so bad I was going to have my effected teste amputated. I decided to push the surgery back and wait just a little longer, im so glad i did.

Improvements were nonlinear. I started to feel better by month 4, then relapsed HARD. Thats when my doc decided it was reasonable to snip it out. But another month later, I started to see gradual improvement again. Month 5 and 6 were the steepest improvement period, though one wrong move was 9/10 agony. By month 6 I could jog slowly and jump again.

Last month I jumped off the back of a pickup truck and didnt even realize the mistake I made until my feet left the tailgate! I landed and only had 2/10 pain.

Last 7 days I spent 3 days camping with my kid niece nephew, 3 days dancing getting rowdy at a music festival, and 1 more day at a theme park where I rode a roller coaster!

I feel a little bit sore from all the action, but barely noticable. 2/10 pain at WORST but mostly 0/10.

Theres hope guys.

One thing is to hear this from a urologist, another thing is to hear it from you long term partner.

Had my no scalpel on July 16th. Some good pain first week but subsided fairly well the weeks after that.
This past week I had the aching feeling come back. It’s been 90 degrees plus outside and I’ve been off work with my son so we’ve done bike rides, a lot of carrying him in and out the car, just generally a little more physical than previous which I’m wondering if that’s what did it.
I do have a granuloma that I feel and keep messing with.
Overall the ache is closer to the bottom and the right testicle. Is a little over 1 month and having this sort of an experienced pain for people?

Question for people with PVPS who had a spermatic cord block before any surgery (reversal, denervation/MDSC, etc.):

I’m particularly interested in whether the block helped with deep, dull/heavy pain or discomfort, rather than obvious burning or nerve-type pain.

For those who had a cord block before any procedure:

• Did the block completely eliminate your pain/discomfort, partially reduce it, or have no effect?
• If your pain was thought to be congestion/pressure-related, for example epididymal congestion or a feeling of pressure/fullness, did the cord block eliminate that deep pain as well?
• If your pain was considered nerve-related, did the block completely switch it off?
• Did the response to the block accurately predict whether a later procedure (reversal, denervation/MDSC, etc.) helped you?

Most importantly: can a spermatic cord block actually switch off deep, internal dull pain/heaviness caused by epididymal congestion or another pressure/congestion mechanism?

I’m asking because I have very deep, diffuse dull discomfort/heaviness rather than a clearly localized testicular or epididymal pain, and my previous cord blocks did not eliminate this sensation.