Post Vasectomy Pain Syndrome (Post Vasectomy Testicular Pain)

Testicular pain after a vasectomy, known as post vasectomy pain syndrome, is a relatively common problem which can have a major impact on quality of life.

About one in six men opt for a vasectomy as permanent form of birth control. A vasectomy is an operation to block, cut or seal the tubes that carry sperm from the testicles to the penis. The incidence of post vasectomy testicular pain varies in reports. One study suggested 15 per cent of men experienced long term, debilitating testicular pain after a vasectomy[1]. Other reports suggest the figure could be as high as one in three men being affected by different degrees of pain and post vasectomy discomfort, varying in severity and over time.

What are the symptoms of post vasectomy testicular pain?

Symptoms are pain or dull ache in the epididymides (the glandular tube the top and side of each testicle), discomfort with sexual intercourse or after vigorous activity, and pain during or after ejaculation. This pain can develop shortly after a vasectomy or many years after the procedure. It is sometimes described as a sharp, stabbing pain or for others, experienced as a throbbing pain and discomfort. Men report different degrees of pain – for some it is sporadic, developing after sex or sporting activities for example and for others it is more continuous and debilitating.

What causes post vasectomy testicular pain?

There is ongoing research to fully understand the causes of post vasectomy testicular pain and for some men, there may be multiple causes. These include testicular back pressure, inflammation, epididymitis (inflammation) scar tissue (fibrosis) and nerve damage. When pain in the epididymides is the primary symptom, the cause of pain is likely to be over-full and inflamed epididymides.

What are the treatment options for post vasectomy testicular pain?

For men with mild pain, conservative approaches can be helpful. These include heat or cold therapy, scrotal support and anti-inflammatory medication. For patients with more severe pain, a vasectomy reversal can be very effective. In one study, it was reported that 85 per cent of men who underwent vasectomy reversal in an attempt to relieve post-vasectomy pain syndrome became pain-free[2]. Another study found that 24 of 32 men had relief after vasectomy reversal[3]. In addition to vasectomy reversal, if nerve entrapment is also an issue, it can be treated with surgery to free the nerve from the scar tissue, or to cut the nerve. This is known medically as denervation of the testicular cord.

Read more

Read about a BPC patient who had post vasectomy pain syndrome and was treated with vasectomy reversal and denervation of the testicular cord.

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1 McMahon A, Buckley J, Taylor A, Lloyd S, Deane R, Kirk D (1992) “Chronic testicular pain following vasectomy”. British Journal of Urology. 1992;69:188-191.

2 Nangia AK, Myles JL, Thomas AJ JR (December 2000). “Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation”. J. Urol.

3 Myers SA, Mershon CE, Fuchs EF (1997). “Vasectomy reversal for treatment of the post-vasectomy pain syndrome”. J. Urol.