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Pain along spermatic cord
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Pain along spermatic cord

I have a pain in the area above my left testicle that extends into the left side of my penile shaft. The pain is only present on the left side, and feel's like a constant burning/irritation under the skin, more intense at the base of the penile shaft. The pain feels like it runs along the left spermatic cord and then up into the left side of my penis. The pain last's month's at a time and then can subside for several month's, but never completely goes away,

I've had this pain now for approximately 2 1/2 years and it bagan about 3 months after I had a vasectomy. During the vasectomy, when the doctor cauterized the lower vas on the left side, I felt an intensely sharp pain in the left testicle at the moment the laser touched. The pain was so sharp that it made me flinch. Shortly after the surgery the spermatic cord on the left side was extremely tender and sensitive. This subsided after several weeks, but the pain has remained ever since. I experienced no such problems on the right side.

I returned to the original doctor twice, who performed a physical exam and said everything seemed alright and that the pain should subside over time, which it hasn't. I also went to a second urologist who said that my symptoms sound like nerve damage and there was nothing that could be done. He prescribed neurontin, which didn't help at all.

My questions are these -

1) Is it possible that a nerve was damaged when the left vas was cauterized, and if so is there any way to repair or reverse this?

2) I've heard that converting a close ended vasectomy to an open ended vasectomy can relieve pain, is this the case? or would this possibly lead to further problems?

3) Are there any other conditions that could be responsible for this pain? Is it possibly just coincidental after the vasectomy.

4) What would you recommend as the next step to take? The pain is bearable, but is affecting my sex drive and causing me a lot of stress.

Thanks!
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To answer your questions:
1) It is possible that there was nerve damage from the cauterization.  A referral to a neurologist can be considered.

2) I am not a urologist, so my insight into this question is limited.  I am not aware of that fact - however, you can discuss this with another urological opinion.

3) Any type of inflammation, cyst or scarring can lead to these symptoms.  A scrotal ultrasound can be considered for further evaluation.

4) I would obtain another urological opinion (preferably at a major academic medical center) as well as consider a neurological opinion.

If there is no treatment, pain can be evaluated at a pain clinic.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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