It is important to remember that PVPS is a very rare condition.
If you are considering having a vasectomy it is likely that you want to enjoy sex without the worries and risks of pregnancy that come along with it. A major part of the vasectomy recovery period is focused around sex and when you can begin to enjoy sex again.
A vasectomy is considered low-risk as it has little-to-no side effects. However, some patients may develop post-vasectomy pain syndrome (PVPS) which involves dull pain in one or both testicles any time after the vasectomy, the cause of which is not known. This is very rarely seen in reality and there is no specific reason for this syndrome. PVPS can feel dull or sharp and can be debilitating enough for some patients to seek help.
How common is PVPS?
PVPS is a potential complication of vasectomy procedures, but it is relatively rare. Studies suggest that PVPS occurs in up to 1 in 1000 patients.
What are the symptoms of PVPS?
Symptoms of PVPS include:
- Pain and tenderness in the scrotum.
- Pressure or pain after ejaculation.
- Dull ache in one or both testicles.
- Epididymitis (swelling of the tube that is attached to each of the testicles).
- Pain during sex.
What causes PVPS?
The cause of PVPS is not completely understood, however, many cases of PVPS could be caused by:
- Infection: Inflammation can cause epididymitis and damage to the scrotum.
- Back pressure: The tube that is cut (vas deferens) during the vasectomy which is in charge of carrying sperm from the testicles can cause back pressure.
- Nerve compression: A narrowing of the nerves to the testicles.
- Scar tissue: Scar tissue may form and cause pain.
What factors can increase my chances of getting PVPS?
PVPS is not associated with any age group or lifestyle factors. However, the risk of developing PVPS may be higher in certain cases, such as in:
- Patients who have a history of chronic pain or discomfort in the testicles or scrotum.
- Patients who have had a previous surgery in the groin area.
- Patients who have a history of epididymitis (inflammation of the epididymis).
- Patients who have an autoimmune disorder.
What treatment options are there for PVPS?
Treatment options will depend on the root cause of PVPS and how severe the pain is. Treatment should initially begin with non-invasive methods such as medication to ease your discomfort. You may also be offered physical therapy focussed on relaxing your pelvic floor muscles. This option is usually considered for patients who have pain in their pelvic area or pain when they urinate.
If your PVPS is caused by something that can be removed or fixed by surgery, you may be offered this option as a last resort if other methods have failed.
What complications can PVPS cause?
If untreated, PVPS can lead to psychological distress as patients may feel like avoiding sex completely. Patients who suffer with PVPS may not be able to take part in normal activities depending on how severe the pain is.
How is it diagnosed?
Your clinician will conduct a physical examination to check for tenderness, swelling, and any signs of scarring. Your clinician may also suggest having an STI test to rule out other potential causes of pain and discomfort.
Can other things be mistaken for PVPS?
Epididymitis may be mistaken for PVPS. Epididymitis occurs when the epididymis (the tube that is connected to each of the testicles) becomes swollen and painful. It is often caused by an infection, and can therefore mimic the symptoms of PVPS.
How can you prevent PVPS?
While there is no guaranteed way to prevent PVPS, there are several steps you can take to minimise your risk:
- Choose an experienced clinician: This can reduce the risk of surgical complications.
- Discuss your concerns: Ask questions about the potential risks and complications, and make sure you understand the procedure and the outcomes.
- Follow aftercare instructions: This includes taking any prescribed medication (if appropriate) and avoiding strenuous activities for a few days.
- Rest and recover: Take time to rest, avoid heavy lifting and exercise.
Seek medical attention if you experience any unusual pain and discomfort. Early intervention can help prevent PVPS from becoming a chronic condition.
How long does post-vasectomy pain syndrome last?
In most cases, PVPS usually goes away on its own within a few weeks or months after the procedure. However, for some patients, the pain may persist for a longer period, and in rare cases, it can become chronic.
Chronic PVPS is defined as pain that persists for more than three months after the vasectomy procedure. It can be a challenging condition to treat, and the treatment options depend on the severity of the symptoms.
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Page reviewed by Dr Praveen Jayadeva
Page written by Shannon Abraham
Last reviewed date: 29 March 2023
Next review due: 29 March 2026
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- PMC: Post-vasectomy pain syndrome: diagnosis, management and treatment options
- Health line: Epididymis Function, Definition & Anatomy
- Mayo clinic: Post-vasectomy pain syndrome – Symptoms and causes
- Sparrow: Post-vasectomy pain syndrome
- Birmingham Prostate Clinic: Post Vasectomy Pain Syndrome
- Sperm Check: Post-Vasectomy Pain Syndrome: Why Some men Struggle With Chronic Pain After Vasectomy
- Cleveland Clinic: Post-Vasectomy Pain Syndrome: Causes & Treatment.
- Translational Andrology and Urology: Post-vasectomy pain syndrome: diagnosis, manage and treatment options
- BJUI: Chronic pain after vasectomy: a diagnostic and treatment dilemma