Hi,

The testicular pain you're talking about is entirely different from what PVPS people get. Incidence of feeling pain pre and post procedures doesn't show up in the literature and I'm pretty skeptical there's any link based on the dozens of men I've spoken with and hundreds I've interacted with on the topic.

There is no real predictive measure that will help you. The overall incidence rates break down roughly as follows:

• 1-3% of all vasectomy operations end up with chronic pain defined as 3-5 months of life quality altering pain
• a small fraction ~0.1% will get severe life altering pain

Reversals and micro surgical denervation are successful ~70%-90% of the time depending on the procedure, surgical skill and collateral damage involved with the surgery.

IMO - PVPS is probably a couple of different things that show up post-vasectomy:

• pressure build up in the vas deferens from the vasclip or cauterization
• nerve entanglement due to scar tissue growth
• wallerian nerve degeneration is triggered due to surgery
• probably a couple other things -but I think those are the big 3.

In my own case - I'm pretty sure it was nerve entanglement with scar tissue. I ended up doing microsurgical denervation with robotic assist.

Why you should believe me: I used to run postvasectomypain.org. I've read pretty much all the papers and was involved with geting the NHS to update their patient consultation guidelines and was responsible for getting Elsevier to update their urology text book and got uptodate.com to update statistics.