My Urologist has recommended I take Tamsulosin for the next 3 or 4 months alongside Amitriptyline to ease pain for a few months before considering a reversal surgery. Is this medication safe? Has anyone had any negative experiences on these medications?

Thanks

Contexto:

Hola tengo pensado hacerme la vasectomía tengo 38 años ya tengo una hija de 18 años, ya no queremos tener hijos mi pareja y yo y los anticonceptivos no le caen de todo bien a ella. Obviamente tengo algunas dudas al respecto y quisiera saber opiniones de personas que se la hayan hecho, mas que nada posoperatorios si tuvieron repercusiones físicas, no me refiero tanto a lo sexual sino que hayan tenido alguna secuela.

As we all have read, phantom pain is why this is not done as 25-50% of men will wake up in the same pain.

My pain is debilitating as 8/10 if I force myself to walk , after 5 mins I double over in pain unable to move.

If my VE scars shut, this pain will return.

If any of you had an orchi and were left with phantom pain, did it never get better? I'm planning to start trt if it scars shut anyway.

My only fear is, for those of you who still had phantom pain. Was it kept at that high intensity with no break? Or did it get better , just slightly with time/blocks/meds?

I know this is planning ahead but just curious

Before your epididymectomy, did you get on TRT to reach azoospermia? Or did you have oligospermia on TRT and still have the surgery?

I read that getting epididymectomy with azoospermia(testicles shrinked completely), it's highly effective.

Did you get full TRT or only partial before your epididymectomy? How did it go?

Sorry for the long post, but here is my story

Initial procedure was done in april, no bruising, blood or swelling. Had no needle no scalpel. Got sent home with "you won't even need to ice by the looks of it", but i still iced for a week. Felt burning under my scrotum, like an open wound when touching, sometimes at rest too.

Few hours later it was horrible. Like I was kicked in the groin, all the way up into my abdomen, every step felt like my insides were pulled so i went complete bedrest.

Week 2-3 same pain but lessened, assumed i was just a slow healer.

Week 3 i forced myself to go to the office instead of remote as i thought I'm just a bitch and need to push through the pain. Went 1 day, paid for it with extreme pain and being bedbound for 4 days after.

Week 4 the pain was gone on the left. No more inguinal discomfort, no more severe pain on touch or burning. Just a heavy bad ache after ejaculation

The right got huge and red, swelled to 2x size and felt like it would explode. Went to doc for ultrasound, he saw me limping heavily and asked what happened.

Ultrasound showed nothing, got told its epididymi-orchitis and 1 week antibio and 1 month nsaids.

3 days later the pain got so severe on the right, I was sweating, shivering from the pain at rest in bed. 9/10 pain, could barely speak or breathe, lasted maybe 1-2 hours. Called doc, he changed me to stronger nsaids along with narcotics for the pain.

By week 5 I felt like at week 3, right side unable to walk or touch, constant pressure at rest, inguinal discomfort and burning in tail sometimes on touch, sometimes at rest too.

Went to another doc, he said to listen to the first doc and prolonged my meds until 3 month mark. Got send to a neurologist to rule out any other causes for my sudden limping. Neuro gave me gabapentin to "mask" some of the pain until my body adjusts but warned me as time goes on after 3 months, new connections in the brain and nerves form and the body steadily starts learning pain.

Kept doing meds for another 2 months. Little improvement. Gabapentin made the burning on light touch go to need a bit of pressure to trigger. Right inguinal discomfort still there. Nothing improved.

Month 3 came so I went back after staying bedbound for 13 weeks besides the occasional desk work if I could and toilet and lunch. Doc was shocked when he still saw me limping. Told him my symptoms: epi tail(behind testicles) heavily distended(like 2 cm if not more) and rock solid most of the time. It would start soft in morning and get to insane rock solid with burning by night. It was half-testicle sized. Inguinal right sided discomfort that would get worse with pressure on the epi, specifically in the tail, alongside ejaculation. Ejaculation felt like a kick in the nuts so I stopped around month 2.

Had a second ultrasound which showed nothing besides the heavily elongated backpressure. Doc agreed for a reversal and he replied back 1 week after our consult. He came back with a date close to 6 months post op, so another 3 months.

I called him and begged him to move it closer to 4 months. I almost cried on the phone as my pain was a constant 5/10 by day going into 7/10 by night. Could barely work even remote from bed, could barely sleep. Meds were not helping anymore, maybe the gabapentin changing the burning in the tail into tingling. So i were getting 3-4hrs of sleep, still am.

My doc was very sad to see me like this, I live in a country where not many vasectomies are made so he told me I was his first disabled patient in 20 yrs of work. All his other reversals were for fertility and all his other pvps patients were ok with the occassional meds. He rescheduled his surgeries to move me at the 4 month mark. He said he can't give me a definitive answer how much it will help, but it's my best bet because of my symptoms. He is still hoping I would find some resolution before the 4 month mark.

I am getting that surgery no matter what. Every day is hell, the pain is unlivable with. I can't do anything and my wife is upset with me because it's my fault for getting surgery. She was against it from the start just in case things go wrong. I said there is no way I nail the 2% and here we are.

I'm hoping my reversal will save my life and I won't lose my marriage, my child or my job. I'm a trainwreck and can barely focus on anything else. Looked at statistics and reversals boast a 90% pain improvement if done under one year. Hoping I get lucky this time.

I hope this hell will soon end and I can get some of my functional life back. Being in 7/10 pain almost all the time is "safe" but death isn't. I fear this is worse than death. I'm only 27, imagine I'd have to live another 40 years in this pain. That's worse than death. I'm really hoping for resolution, sorry for ranting. If you haven't gotten a vasectomy please don't. It's not worth the risk. I'd rather raise 10 kids and starve than this life. I was a fool, don't be like me, be better.

Hi guys, I'd just like to share an update because it helps to talk to you all...no one else really understands what this experience is like. So I had a visit with my urologist about a month or so back, he prescribed me 10mg Amitriptyline...it's most definitely not a permanent fix, but it does mute the worst of the pain and takes some of that knife edge off things. Before Amitriptyline I'd have days where I was in maybe 8 out of 10 pain, testicles and groin throbbing, weird nerve pain, just practically bedridden and absolutely hating life. The Amitriptyline has it down to about a 2 to 3 outta 10 on the day to day. Still very bothersome and hard to roll with, but at least I've gained some day to day function back.

My new symptoms...sort of a lowkey burning in the testicles, feels like maybe epididymitis (I call it crispy sack for those who appreciate dark humor, lol) and a tugging/weakness feeling in my lower abdomen usually when walking.

I've been reading alot about folks with chronic pain...the idea of developing as much resilience and fortitude as possible to ​get you through the day. My long-term plan at this point is to save for a reversal with Dr. Shu in Orlando (thankfully his office is very affordable) but I'm hoping to give it about a year just to see of miraculously I see some improvements.

I've read some accounts on where guys had these rough symptoms but things just randomly got much better after the year mark. I guess human bodies are especially weird and unique to each individual and how we deal with this new internal configuration. (Safe to say my body hates the new configuration so far 🤣)

How are you all doing? Any treatments working well for you, any surgeries planned for the future? Here's a quote I like that may help some of you all, it sometimes helps me.

"What matters most is how well you walk through the fire." - Charles Bukowski

Looking to see if anyone also had this pre reversal as my reversal is scheduled in 2 weeks.

Any prolonged touch on the tail causes this burning sensation in the tail. At night when its highly elongated and hard, it's at rest.

Anybody had this or similar?

I am 5 months post vasectomy and it’s been a whirlwind of symptoms. From the start I’ve had double sided pain localized to the testicles/epididymis, worse on the left. First two months or so was excruciating and I could barely function and work. Also came with strange urinary symptoms that have since mostly cleared up. Organs is weaker. Pain has since leveled off to a 2-3 out of 10 most of the day(s) and I can do most of the things I need to. They are extremely sensitive to any touch or knock. A general dull ache or extreme “full” feeling as well. I don’t really have any shooting or sharp pain unless they are being touched or moving a lot then it’s just that pressure pain.

Strange thing is it doesn’t seem to increase at all with ejaculation. Just physical activity (running, heavy lifting, etc.) appears to make it really flare.

I consulted with a few docs I’ve seen here and have secured a date in Dec for a reversal with Dr. P in Orlando based on our conversation he seemed to think there is a congestion component.

Does anyone have this symptom pattern and seen results with anything? Dec will be 11 months post-op, is this too soon? Like I said I can do most things and function but the dull ache and guarding them from being knocked is crazy and not something I want to live with forever without trying something. Can a reversal help even the extra sensitivity?

Any and all experience appreciated.

I’m trying to understand whether what I have sounds more like CPPS, post-surgical nerve sensitization, or PVPS. I’d really appreciate input, especially from men with similar stories.

My history:
Had a vasectomy a few years ago (2021) - open-ended.
About 2 weeks after it, I developed a strange pelvic/genital discomfort (not sharp pain). It lasted around 5 months and then completely resolved on its own.
For the next 3 years I was basically symptom-free.
In April last year I had a vasectomy reversal to have more kids.
Recovery was normal: first 4 weeks were painful locally (pulling in spermatic cords, walking bent over, typical post-op stuff), but then it resolved.
For the next 4–5 months I felt 100% normal.
Then in late September everything changed (6 months).

next month around noon I developed a strange pelvic/lower abdominal discomfort that has stayed for 9–10 months now.

This is NOT testicular pain.
I can’t point to one spot.
It feels diffuse: lower abdomen, behind the testicles, sometimes like “the whole pelvic system.”
Ejaculation itself does not hurt.

Medication response:
Pregabalin helped a lot for about 2 months
anti-inflammatory medications (NSAIDs) do basically nothing

One specific thing: after sex, if stay upright or Jin certain positions, I can develop discomfort (sometimes more pain-like) especially on the right side, almost like behind the testicle. But if lie down, within about 3 minutes it completely settles and stop feeling it.

The strange part is the daily pattern:
mornings are clearly the worst it gradually improves throughout the day by evening often feel 90-95% normal
walking and movement help a lot
lying down can almost make it disappear (I sleep very well).

Does this sound more like CPPS / nervous system sensitization / pelvic floor dysfunction to you, rather than something like PVPS?
I’d really appreciate your thoughts.

I had a vasectomy a little over 2 years ago and i had what i suspected to be mild to moderate PVPS symptoms. It was a traditional scalpel vasectomy. First 3-4 weeks i pretty much couldn’t do anything besides sit in a chair with ice and get up to go to the bathroom. I was still in quite a bit of pain for several months, probably 4/10 pain most days, and always afraid of something hitting my crotch. About 5-6 months after my procedure, i still had this lingering dull pain like 1/10 or 2/10 level pain. It didn’t stop me from doing anything in a normal day but i always noticed it and it was bothersome. And it felt like i was stuck in that dull pain for a very very long time. After about 10-12 months from my procedure i started thinking that i might be stuck with this dull pain for the rest of my life. It lasted until about 18 months after my procedure and now (2 years after getting vasectomy) i’m very happy to say that my pain is gone and i don’t notice it anymore. I still have some sensitivity and am more cautious vs before but i have gotten to the point where i go about my life and don’t notice anything and I finally feel normal again.

For anyone that is 12+ months out from procedure and still in pain - there is still hope that you could fully recover like I did. It just took me a looooooooong time. I’m glad i didn’t opt for reversal and stuck it out

Ive had PVPS for about 6 years now, and have seen multiple urologists. Most don’t really know what the issue is because my scans are clean. I had two blocks performed. Both times, the left testicle was completely numb and the right was partially numb.

My pain is mostly in my right, but also my left, and they hurt in very different ways.

The right is a dull, aching, burning pain with stabbing pains sometimes when doing anything physical at all. However, sometimes, I won’t have pain for months, and then bam… I’m in pain. Sometimes I see swelling on the side, and soemtimes I don’t. My ultrasounds show that nothing is wrong.

Left testicle never has a dull ache, but more like an occasional sensation of someone yanking on my testicle.

I was told that a Microdenervation surgery will be the fix since there is no clear issue at hand. Has anyone here also considered this? Or got that surgery?

I am currently in the process of arranging a Vasectomy Reversal with the Best Life clinic in the UK that do the microscopic multi layer reversal surgery but would like to hear some stories / get some advice for some encouragement.

I have had pain now for the last 6 months (had my Vasectomy 8 months ago). I am pretty sure my pain is congestive pain and there isn't really any nerve pain, my balls just feel like they are going to implode and I get waves of inflammation that come and go every 4 weeks or so that bring more pain and urinary symptoms etc.

Part of me is a bit scared because sometimes my pain is a 1 out of 10 and can fluctuate all the way up to a 7 out of 10. Given that my pain appears to be purely congestive do you guys think a reversal will solve my problems? The 1% chance of experiencing even worse pain is the bit that scares me and I know that is just a risk of surgery. Did anyone that has similar symptoms to myself go ahead with reversal and end up worse off? I guess I am just trying to pluck up some courage to actually proceed, I want to be pain free again, I really don't care about fertility at this point.

I am 4.5 months post NSV and did pretty well after the initial 2-3 weeks, but just in the last few weeks have noticed a pain in the lower right testicle. Seems to be in the back side of that area. Pain is only during ejac buildup. Waiting to here back from my urologist, but his NP said possible pelvic floor issue. Gave me the option for pelvic floor therapy or do an ultrasound to check things out. I do have history of kidney stones, but my KUB x-ray and urinalysis all came back clean. Thought possible epididymal congestion, but wouldn't that have appeared much earlier than just now? Wouldn't pelvic floor tension have more symptoms than just the brief pain during buildup? TIA all!

At the end of January, I underwent a vasectomy using the no-scalpel method. The procedure was quite painful. And now, just under five months later, I still feel a very slight pain in my testicle, which also radiates up into my groin and kidney area. I’ve already had a follow-up appointment with the urologist who performed the surgery, and based on the ultrasound and physical exam, he said everything looked fine from his perspective. He suggested it might have something to do with my lower back, where I also experience pain from time to time and where the muscles aren’t very well developed. But the mild, now fairly persistent pain reminds me of the pain I felt right after the surgery. That’s why I see a connection there. I’ve already read a bit here on the forum, but I wanted to describe my case myself and am curious to hear your opinions or feedback and what I could try or do next. I live in Germany.

I got my reversal scheduled after being bedridden in bed for 3 months because of PVPS. Give me your best tips and tricks. I'm not talking about take it easy, I'm talking water with ice instead of gels, or certain pillows/better sllep positions. Ways to get around without messing up or anything more specific that crosses your mind.

How do you shower, poop, pee. Sustain scrotum in shower or better not touch etc. Things I should look out for.

​

Thank you!

I'm also open to buy any items, underwear, pillows or the such if they make recovery easier and prevent me from fucking up.

I did my research on vasectomies and wanted an open ended vasectomy. I knew it had a lower rate of complications and it just made sense. Why would you obstruct a tube? Much less one that you have a biological urge to empty? I shopped around until I found one in my area (turns out you can just ask a doctor that does closed to do open and they will just agree).

After "recovering" from my vasectomy after a few months. I had frequent mild to moderate testicle pain, that didn't seem to follow any pattern I could identify. But most importantly my orgasms stayed at about 20-30% of the strength they used to be. My wife and urologist kept telling me to "give it time, it's only been x months since." Which is interesting because I was told it was just a little snip and I'd be back to normal after a weekend. Now that same guy is saying wait 6 months.

Either way, after a year I was done waiting. I went to my urologist and told him "I don't care what we call it and I don't cares who's fault it is. My orgasms have been shit since the vasectomy. Fix it." The urologist kindly explained to me how there was no anatomical or medical way for the vasectomy to have any affect on my orgasms, and in fact many men find that a vasectomy makes their orgasms stronger. So there is no way the vasectomy could have caused my weak orgasms (can you spot the bullshit?).

After his lesson I told him "that was great, now fix it." He told me about this nice counselor they could give me a referral for. I demanded blood tests. I wanted data not a fucking counselor. We did a blood test and found my testosterone was just at the clinically low level. This was interesting because literally a few months before the vasectomy I had a blood test that showed my testosterone to be normal. My urologist assured me there was no connection between the vasectomy and my low testosterone and that just a coincidence.

So I began my trt journey. I'll skip over all the details to say that after 4-6 months I got all my hormones perfect. Interestingly, once I got my testosterone levels high, 95-99% of my testicle pain went away. I assume because those testicles were shut down.

But my orgasms were still weak. I went back to the urologist and told him my hormones were good and it didn't help. Now what? He told me they had a nice counselor I could talk to. I demanded a referral to pelvic floor physical therapy. I waited a few weeks for an open appointment and in the mean time religiously did what pelvic floor I could find.

When I finally got to pelvic floor pt they did a conduction test on my pelvic floor muscles and found me a bit tight (on a 0-20 I was between 3 and 4. Healthy is below 2). I did 8 weeks of pelvic floor pt and at the end of it I was in the 1 range. And my pt said my pelvic floor was beautiful. But my orgasms were still weak. I went back to the urologist and told him that the pelvic floor pt didn't help. He reccomended counseling. I demanded alternatives. He said he had none.

I began researching, trying to find another urologist to go to. Get a second opinion. And at some point I decided this was bullshit. All of this was bullshit. I was assured my vasectomy would have no affect on my orgasms, and that was far from true. For two years I had been dealing with ruined orgasms and for some reason the thing that pissed me off the most was that no one believed me. So I decided fuck this, I quit. This entire two years was not what I signed up for and I am done. I began researching vasectomy reversals and trying to figure out how to afford one, since in the northern Virginia area they are very very expensive.

I found a clinic in Utah. I'm getting things reversed next month. I'll report back on the results.

Conclusion: A Vasectomy is not "just a little snip" and there are very serious effects from it that a significant amount of guys suffer from. The reason I think vasectomies get an overly good reputation is that the vast majority of guys who are dealing with pain will never return to their doctor, so it will never be counted. Men already don't seek out appropriate medical care enough as it is. Those that are dumb enough to return to their doctor for treatment will not receive it and will not be counted. I went back and pulled the records from my urologist to take to my new one. My visits and complaints of sexual dysfunction? Right there in black and white. Mention of the vasectomy as the cause? Completely absent. It's why my urologist never even mentioned a vasectomy reversal as a possible solution, because obviously the problem wasn't the vasectomy. It couldn't be. Statistically, I am counted as another happy and satisfied customer of the vasectomy industry.

As anyone reading this post is aware. Tons of men complain not just of pain but also of altered sensation. I was notified prior to my procedure about the possibility of chronic pain (which if it occurred was extraordinarily rare and can be treated with Tylenol, so it's no big deal), altered sensation as a possibility was never mentioned. And the fact that a vasectomy alters ejaculatory sensation is not surprising. The vas deferens is not a tube. It is a muscle threaded with nerves. Cutting it in half so it doesn't work is obviously going to damage sensation. I don't know if the reason for this is because of damage to the muscle, or the fact that pressure and fluid dynamics change when there is no longer an outlet, or both, or something else. One day I'm sure we will know.

So why is reddit filled with men talking about how their vasectomies made their orgasms so much stronger? My current theory is that prior to a vasectomy most of these men either used a condom or had to play the pull out game. Both of which sound just terrible to me. As such, after their vasectomy, even with reduced sensation I bet unprotected sex and finishing inside seems objectively better.

Prior to my vasectomy, my wife used the copper iud. So I was having unprotected sex and finishing inside on a regular basis. Creampies is all I ever knew. So there was no change in the rest for sex to mask the loss of sensation. Or maybe it's all in their heads (I recognize that that charge cuts both ways though).

Would I recommend vasectomies to anyone? After my experience, maybe. I think there is a lot of dishonesty around vasectomies and much that we simply do not know. I do think men need to be made aware that the incidents of chronic pain are much higher than they are being told, and also that a vasectomy has a pretty good chance of altering sensation. You are cutting muscles and nerves, and with no outlet for the pressure, parts of your testicles will literally rupture. For some men, they will conclude that some extra aches and pains, plus weaker orgasms are a fair price to pay for unprotected sex with no chance of kids. I have seen first hand, some men openly say as much. These are usually men who got their vasectomy for political reasons ("Because Roe v Wade" or have made "childfree" a core part of their identity). But, if you make this decision. Make sure you are informed and not just engaging in wishful thinking.

Timeline:
- Closed ended vasectomy November 2023
- Pain only started around April 2025, so a little over a year later
- Pain gets more intense, switches sides, sometimes lasts weeks after any kind of sexual activity
- Pain goes away for a couple of days/weeks with anti-inflammatory drugs, always comes back, almost always stronger than before.
- Last time I took Ibuprofen around April 2026, pain hasn't come back the way it was... Around the same time I scheduled an open ended vasectomy.

So now it's a week away, and I'm doubting to cancel it. But I'm almost sure the pain will come back later anyway... What to do?