Scrotal Pain & Discomfort 6.5 Years Post-Vasectomy
Aug 9th 2009adminPost vasectomy pain syndrome
From Paul:-
Brief history:
• Had traditional vasectomy (closed-ended, open incisions) in early 2003.
• General surgeon (did 2-3 per week) said left vas was difficult to find. Surgery seemed to take long but was eventually completed.
• Experienced substantial pain on left side for several months and frequent urge to urinate for several weeks. Eventually saw two urologists. First one prescribed Cipro & ibuprofen, and diagnosed epidydimitis. Second one diagnosed continued infection and prescribed Doxycycline and waiting. I was told the scrotal ultrasound showed nothing. Both urologists advised against further intervention.
• I never experienced any change in sexual function or pleasure.
• Discomfort eventually subsided and was gone for several years before starting to return to the same left side.
Over the past couple of years I’ve experienced spontaneous (that is, with no “jostling”) pain in the scrotum with increasing frequency, always on that left side (but not as painful as the first several months post-vasectomy). Additionally, that side of the scrotum is constantly tender to the touch – I have to constantly watch where and how I sit, make sure my daughter or the dogs (very small) don’t bump me there, etc.
I mentioned this to my GP, who ordered an ultrasound. The results noted a 2cm hydrocele – a hydrocele also was noted during an earlier ultrasound but I don’t have any details on it. My GP says hydroceles don’t cause pain – there was nothing to be done for me and I would have to tolerate the pain. That was the end of the conversation.
I am also leery of GPs who say “there’s nothing to be done” as if they were specialists. This isn’t the first time I had a medical professional be cavalier about my scrotal pain issues, so I’m leery for that reason as well. But since my GP refuses to pursue this issue, I’m stuck unless I file a complaint and/or switch doctors. She’s otherwise provided good care, so I’m not ready to level any accusations yet.
I would like to clear this up soon; I’m unemployed but hope to find work in the next few months. I did wait-and-see until it was becoming unmistakably worse, and at 6.5 years post V it doesn’t seem like further waiting will help.
Any advice or suggestions would be greatly appreciated. Thank you!
Post vasectomy pain (PVP) syndrome can manifest in varied presentations and intermittently over time after the vasectomy. PVP is thought to be due to congestion of the epididymis or damage to the peri-vasal nerves at the time of vasectomy. Physicians not familiar with this condition will oftentimes overlook this as a cause of pain. Scrotal ultrasounds are often obtained to rule out more serious conditions when a patient complains about testicular pain. Scrotal ultrasounds will find problems such as hydroceles, varicoceles and spermatoceles in 60-70% of men when performed randomly. Some of these pathologies found on ultrasound can be confused with PVP. Hydroceles and spermatoceles are rarely associated with testicular/epididymal pain. Varicoceles can be associated with this type of pain, but the predictive value of correcting a varicocele is only around 50% for men with testicular/epididymal pain. A detailed physical examination by a specialist can diagnose PVP and treatments for PVP such as cord denervation, epididymectomy and vasectomy reversal are successful in up to 90% of patients with this condition.
