Post-vasectomy Pain – Neurectomy Options
I realize this is a hernia forum, but also have come to realize their is significant overlap between hernia and post-vasectomy pain sufferers in terms of symptoms and nerve involvement. I’m hoping the experts here might have some thoughts/ idea they could share, hoping they might see vasectomy pain patients occasionally in their own practices.
I’ve had testicular and to a lesser degree abdominal pain since roughly 10 days following a vasectomy performed Jul 2012. While it has improved from near incapacitation levels, it continues as a daily struggle with pain, particularly late in the day and evening and especially with sitting. A hot bath or shower will nearly resolve the pain completely during and for a short time following, so I feel there is some neuropathic damage in the scrotum and the ability to trigger with sitting and tamp down with hot water refutes a centralization or “wind-up” theory in my non-physician mind. I’ve had lots of conservative management, including gabapentin, medrol dosepacks, NSAIDs, time (over 3 years and counting), as well as reversal, robotic denervation of the spermatic cord and Botox ablation in the spermatic cord region. None of these has been truly effective, though symptoms are not as extreme as the first 2-3 months following vasectomy. I’m currently seeing a pain mgmt (anesthesiologist) locally who has tried 3 bilateral ilioinguinal nerves blocks with limited success. Next up is perhaps the genitofemoral nerve, which seems to be frequently indicated in testicular pain cases.
My next options seem to be nerve ablations (cryo, rf, alcohol) if responsible nerve can be identified via blockade series, inguinal orchiectomy and neurectomy of these peripheral nerves.
My greatest appreciation for a forum such as this to allow exchange of information, ideas, etc. I feel like my issue must be neuropathic in nature since a reversal was performed and patency achieved. Many thanks in advance to the caring physicians on this site – these issues have a huge impact on quality of life for sufferers and their families, and I would be truly greatful for time taken to read this and provide any opinions, thoughts, recommendations on my unfortunate plight.
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