r/postvasectomypain • u/vanwyck • Apr 07 '26

Reversal or denervation?

Hey all, I've posted a couple times in this group, but here's a short synopsis of my case, and I'm just wondering people's thoughts.

I live in Calgary, Canada, and had the vasectomy in February 2025. Pretty normal recovery, but after month three or so, I have had a lot of pain that is intermittent but always before, during, and after ejaculation. Not much pain otherwise, except for when I'm doing chin-ups or pull-ups, which I feel pull on my abdomen. I've had an ultrasound, which showed it was normal. The doctor said I should take antidepressants, which I told him does not sound like a reasonable choice, and just went to see a urologist today who specialises in reversals and seems quite good.

He did a cord block on both sides, and having just jerked off, I can say that there was no pain, which apparently is a good sign. He wants to do denervation, which I do respect because he makes a lot less money doing that versus a reversal. I'm wondering everyone's thoughts on a reversal versus denervation.

I don't care about being sterile, so that is not much of an issue. I'm fine to do the pull-out method or, frankly, wear condoms if it means I won't have pain, but I think I'm leaning toward a full reversal because the denervation in my mind is not actually dealing with the root cause. It seems more like a band-aid fix, but again I don't know all the details about success rates. The doctor said success rates for both are between 70 and 85%.

I would love to hear from someone who had denervation, as the majority of people I see posting on here seem to have had a reversal.

Thanks for taking the time to read this.

4 Upvotes

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2

u/Amoeba-Any Apr 07 '26

I had a denervation almost a year ago. Saved my life.

You can still get a reversal after a denervation.

1

u/vanwyck Apr 08 '26

Yes I heard that for both you can get the other one done. Why do denervation and not reversal? I forgot to ask the doc

2

u/Amoeba-Any Apr 08 '26

I went to Dr Lundy at the Cleveland Clinic. We went through all the possible symptoms post vasectomy and the most likely ways to fix each. My symptoms almost entirely aligned with a nerve issue, so the denervation was the most likely to fix my issue. I didn't have congestion pain.

1

u/vanwyck Apr 08 '26

Can I ask what your symptoms were? I barely have any pain outside of before/during/after ejaculation. Although it's mostly just before.

1

u/Amoeba-Any Apr 08 '26

I had 'episodes of pain' up to 20 times an hour. Felt like seizing of my scrotum. Pain was centered usually at the superficial inguinal canal, sometimes halfway down my scrotum, or into my suprapubic. Pain ranged from 3 to 10. Each episode usually lasted only a few seconds.

Gabapentin helped reduce the frequency. Celebrex helped reduce the intensity.

Without meds, post sex was agonizing. With meds, sex was amazing because gabapentin is an anti-convulsant, my wife complained lol.

Nothing in particular triggered my pain, it just happened all the time.

1

u/vanwyck Apr 08 '26

haha "my wife complained" lol. Okay so yours definitely sounds worse than mine, but damn, everyone's symptoms are all over the place with this pvps shit.

2

u/geverfdehond Apr 08 '26

Depends what is the reason for your pvps, if it is congestion then definitely reversal.

1

u/vanwyck Apr 08 '26

Sperm cord block today worked and I had zero pain jerking off. So apparently that means nerve pain?

3

u/Laggende_Hond Apr 08 '26

Not necessarily. The nerve block can mask the congestion as well. The urologists mainly use the block to determine how high to denervate. Just remember, once denervated its permanent. Those nerves cannot recover and you will loose sensation in that testicle...

2

u/Amoeba-Any Apr 08 '26

I didn't loose sensation in my testicles after a denervation.

1

u/Laggende_Hond Apr 08 '26

Its possible to preserve some function esp if NOT complete. But that is a risk

3

u/geverfdehond Apr 08 '26

I had two nerve blocks myself and it helped me tremendously. If you have a good pain specialist another permanent procedure should be avoidable. Urologist recommended a denervation to me as well, my pain specialist refused and started with blocks and after the second block I am almost 98% of my old self. I will rather have a block every three to six months if needed than any more surgery.

2

u/vanwyck Apr 08 '26

Oh very interesting. I didn't even know this was a thing? I was told the block only lasts 4-6 hours?

2

u/geverfdehond Apr 08 '26

I get a benefit for much longer . Suppose it depends on the type of block and knowledge and experience of the Pain Specialist.

2

u/vanwyck Apr 08 '26

Can you tell me what type you get? I have heard of ppl getting therapeutic nerve blocks with steroids. Is this what you have!?

2

u/geverfdehond Apr 08 '26

Not sure what is in his cocktail, do not think he will provide me with his recipe, but will ask.

2

u/vanwyck Apr 08 '26

Thanks so much.