NANGIA, A. K., MYLES, J. L., & THOMAS, A. J. (2000). VASECTOMY REVERSAL FOR THE POST-VASECTOMY PAIN SYNDROME: A CLINICAL AND HISTOLOGICAL EVALUATION. The Journal of Urology, 1939–1942.
Mean time to pain onset after vasectomy was 2 years.
Presenting symptoms included testicular pain in 9 cases, epididymal pain in 2, pain at ejaculation in 4 and pain during intercourse in 8. Physical examination demonstrated tender epididymides in 6 men, full epidid- ymides in 6, a tender vasectomy site in 4 and a palpable nodule in 4. No patient had testicular tenderness on palpation. Unilateral and bilateral vasovasostomy was performed in 3 and 10 of the 13 patients, respectively. Postoperatively 9 of the 13 men (69%) became completely pain-free. Mean followup was 1.5 years. We observed no differences in vasectomy site histological features in patients with the post-vasectomy pain syndrome and matched controls, and no difference in histological findings in patients with the post-vasectomy pain syndrome who did and did not become pain-free postoperatively.
“To our knowledge nerve proliferation at the vasectomy site has not previously been evaluated as a cause of pain. ”
Seems like first study to investigate nerve proliferation. N=13 for sample size.