Dr. Nudell offers comprehensive testing and treatment of what has become known as the post-vasectomy pain syndrome. This can occur in upt to 10% of men at some point after a vasectomy, although only about 1% ever seek or need any treatment. Many men who suffer from this are under treated or turned away by general urologists.
Most men who undergo vasectomy have no difficulties, but a small group of men develop chronic testicular or epididymal pain after the procedure. This is often caused by either a sperm granuloma that has developed at the vasectomy site (small “lump” at the site with nerves caught up in it) or from the obstruction to sperm flow caused by the vassal obstruction in the first place. Most cases resolve with the appropriate medical therapy.
This can include anti-inflammatory medications, chronic pain medications, or even testosterone replacement which if used temporarily cuts the production of sperm down in the testis and epididymal tubules “behind” the vasectomy site therefore taking pressure off.
Dr. Nudell also offers office cord blocks, a simple procdure whereby a combination of local anethsetics and cortisol medication is injected into the nerves well above the testis – this often breaks the cycle of pain and leads to recovery and functionality.
Occasionally, surgery needs to be considered – this takes careful planning be a trained micro-surgeon to yield success without worsening the symptoms. Some procedures Dr. Nudell might perform include removal of sperm granuloma, revision of the vasectomy at a lower site in the vas tubing, removal of the epididymis, or even microsurgical vasectomy reversal.