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.

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.

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.

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.

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.

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.

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.

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.

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.

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.