What causes right-sided testicular pain and constipation?

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Posted on Fri, 15 May 2015 in Urinary and Bladder Problems
Question: I have had pain in the testicular right side going on 5 years now ... I had a reverse vasectomy that only made it worse(vasectomy done almost 20 years ago never felt quite right since then) . Before the reverse vasectomy i tried testosterone shots and androgel cream....which worked at first only to bring on several side effects that made the pain worse) After having sex i am fine ...yet it seems like someone is slowly closing a vice around the lower side of my right testicle by the third day i am in terrible pain. If i take narcotics it makes it better only if i become constipated and when my intestines are full it feels like my testicle will explode . Gabapentin helps ...only to make me dizzy , clumsy ....and last month i had a very bad fall (on only 300 mg of gabapentin) which did much damage to my right shoulder . I am thinking it is neurological ....any explanation of what nerve could cause this in the testicular area or any other explanation would be appreciated.. I am also thinking of having my right testicle removed only to be scared off by many people who claim that phantom pain will follow. My urologist wants to do a nerve block on the right testicular nerve ... And if that works kill the nerve ...which i do not like the sound of at all. Please help ..
doctor
Answered by Dr. T Chandrakant 27 hours later
Brief Answer:
I would go by test of nerve block to see the results

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Your history is self explanatory.
I would go by your Urologist's view.
It is noted that the best medicine of Gabapentin doesn't suit you, hence it is worthwhile to try nerve block to see its effect. We shall then decide the further course of action.

Please feel free to discuss further, post the reports if any you have, ask further relevant queries or if you feel that there is a gap of communication.
I shall be very happy to assist you till you get well, I promise..
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 17 hours later
Hello and thanks for trying to answer. It is now 1:50am and i am having dificulty sleeping and the cause of my getting up to urinate is giving me trouble also. I am having trouble doing anything these days since said Urologist suggested that we do the reversal because "he couldn't make it worse!" .... well he did! He said i was a "good candidate" for the reversal working because he gave me two little shots near my testicular "nerves" which made the pain go away for a few hours" .... He Preformed the reversal a little over a year ago and i have been on narcotics ever since , which i am currently trying to taper off of because of all their lovely side effects...The reversal has caused a cute diabolical problem that gets worse and worse for 48 to 72 hours after i have sex now to a point that the pain has me needing Gabapentin and narcotics because i am curled into a fetal position because my right testical feels swollen and like someone is sticking a knife into it!

You see these days I have very little faith in surgeons because it was the original vasectomy almost 20 years ago that started the original downhill slide which i have never stopped regretting that i had. Because soon after the performance of said vasectomy I quit running and playing tennis shortly after because i started having back problems which i now believe that i have traced back to nerve pain from refered pain from a nerve whos genisis (my spell checker doesnt work on this wonderful hotmail..sorry) or termination (whichever way you look at it) started after original vasectomy because i have traced the nerve from around my right testical to where it enters my spine between the disks which another surgeon 5 years after the vasectomy suggested that i have back surgery ...hitting my spine resulting in a 2 weeks stay in the hospital hooked up to a morphine pump waiting for a "blood patch" to heal the resulting mistake of an operation that should have never been preformed! Thank God i didn't go for the other surgeons suggestion of putting a metal brace on my spine).
My current Urologist came highly recommended by another surgeon that put a bladder sling on my wife and wouldn't do my operation because the suggested Urologist "was better than him at this sort of thing! Now i am in constant pain. Because said "better" surgeon screwed up!
IM sorry this but this crappy spell check is too frustrating...i am tired ...and in pain... And i will try to complete this email tomorrow if someone can help me get on to my gmail account or can help me fix this crappy hotmail because my pain is such that i no longer have the patience to work on any technical problems anymore. I was a programmer in my pre-vasectomy life!
But the thought of killing a nerve puts me into somewhat of a panic! One expensive Urologist on a $250 phone consultation suggested that i have the test done to see if i have any tadpoles in my sperm (which i skipped because i was having the operation to relieve pain ,..not to be fertile again). That sounds pretty easy and wise and safe as a first step. What do you think?
Thanks ...signed frustrated, in pain and now...afraid!
I am especially afraid of going back to the urologist that did my reversal ... But i seem to have few options because no urologist wants to take my case on anymore! Except the Pur clinic in Florida...3,000 miles away that is!
Thanks again for trying.
doctor
Answered by Dr. T Chandrakant 8 hours later
Brief Answer:
Simple neurectomy can help you have better life.

Detailed Answer:
Thanks for your feedback.
Read and understood it. Read about reversal and the effects you have mentioned. The good part you said was that the pain had vanished after ''two little shots near my testicular "nerves" which made the pain go away for a few hours"

It also mentions that start of pains after vasectomy and some spinal surgery 5 years later. You have also written > ''But the thought of killing a nerve puts me into somewhat of a panic!'' and you are afraid of going back to Urologist that did your reversal; and no urologist wants to take your case and Pur clinic in Florida is 3000 miles away.

Simple surgery of exploring the lower part of the inguinal canal and cutting the nerves will solve your problem if you are really interested. This can be done any General Surgeon or Urologist.

This alone may give you a permanent relief and better life.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 12 hours later
Man/Dr. I sure hope that you are right! I must say that it sounds a bit too good to be true. I'll be a happy man and this will be the best 40$ i may have ever spent if you're right though. I will research it for a couple of days, call my Dr. And see what he thinks... Look at some detailed anatomy pictures to learn more about the inguinal canal and i will let you know what i am thinking of doing and ....If in my research i find some contrary information .....is it all right with you if i ask you if you could clearify?

Just a couple of quick questions come to mind though ....Besides making sure a surgeon is board certified how can I be sure that a Dr. Is a really great surgeon and will get this job done right. I don't heal quickly or painlessly , so i'll jave to be really sure that this is the answer to my problems. And again there are those words "cutting some nerves"....can they do some real damage with this procedure? " My pain specialist has a Floriscope or something like that ...it's like a real time x-ray that allows you to see the needle being put between bones for cortizone shots and things like that done real time. Do you think i could find a surgeon or urologist with something like this and i can have a local and tell him when he's getting right at the pain site? And lastly ...can i demand /request that a surgeon makes a DVD or video tape of my operation so that i can look at what he did, how he treated me, etc etc ? Because i'd really like to have a look at what was done just in case something goes wrong or I'd just like to see what it looks like inside there?
What do,you think about some of these ideas ? Thanks again! And do you know a great surgeon somewhere around XXXXXXX or tahoe California?
Thanks for some ideas for hope.
doctor
Answered by Dr. T Chandrakant 9 hours later
Brief Answer:
Yes, always ready to assist you.

Detailed Answer:
Hi.
Read and re-read the review/feedback by you.

I know, it is the nagging pain which takes away the maximum fun out of life.
That is why anything which can give good relief sounds too good to be true, I do agree with you on this point.

To assist you further, there may not be any role of Fluoroscopy in this procedure, but you can certainly ask the Doctor (Pain Specialist) and in fact He is the one who can give you injection of anesthesia locally to see if the Neurectomy may help you or not. It is also possible that he can do this for you too. Have you ever talked to him regarding this?

Making of the DVD of the procedure will be the choice of that particular Doctor and is abided by the law of your country, I do not the details about it. You will have to discuss with your Doctors.

How to be Sure about a Surgeon:
Anyone who has operated many hernias, hydroceles and any surgery in this area is aware of the nerves I am talking about. And you will have to talk to your Family Doctor / PCP, who can know a bit more details about who can operate you the best. This is just a fine arts and nothing else.

Do not worry about the '' cutting some nerves''. These are very small nerves and cut only if it is confirmed 100 % that it will help you.

I can not really know the best Surgeon in your area. I shall try.

Please go ahead with details and let me know, I shall be happy to assist you till you get alright.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 27 hours later
Hello and as always thank you for getting back to me. Where do you live? Where in the world am i talking to someone who is trying to help me? this is one of the things that fascinates me the most about the internet. I could be talking to someone in Russia , Serbia, Alaska, or Bolivia even. And there is this nice person trying to help me to live again. Where do you live if you don't mind? My dream now is to get over this pain and travel and meet people in other countries. What is yours?

My country has (although a great and mighty country) some problems right now. The insurance battle that rages in our country is very expensive and equally as confusing. I had to switch health care plans because my wife had to take a lower paying job because it was steady work, and because the health care expenses were half as much. So right now i dont even know if i can go to that pain specialist or not. I have an appointment with my doctor in about a week and i will ask him to check what pain specialist my insurance will "allow" me to see. And i will ask my doctor about the inguinal canal and the neurectomy also. And i will see if he wants to send me to a specialist or a pain clinic or what. He is treating me with pain medicine since i had my operation in March of 2014 and i am trying to taper down the amount of medicine that i take so that i can see where my real pain level is at. I was up to 2 60mg oxycontin and 6 oxycodone and 300mg neurontin at night and 3 1mg xanax a day for the anxiety all this causes me (?antidepressants make me more depressed and on and on)
As i said before, there is a problem in my country. And that is, if they don't see it they really don't believe you. And i am beginning to wonder if my doctor is begining to wonder if i have this debilitating of pain or,not. Although he has been very good to me up until now, but now he has the DEA (drug enforcement agency) breathing down his neck on how much pain medicine he is allowed to prescribe or not. He is also just a lowly physicians assistant and i feel sorry for him because he is overworked because the main physician at the practice that I go to, hardly ever keeps hours anymore because he gets cluster headaches and I think this last bout with them may have damaged his mind because he doesn't seem to be aware of what he is doing anymore. I asked him if he knew that LSD helps with cluster headaches and that they have a new LSD that doesn't make you hallucinate.... And he said that he was aware of them but because he was a physician the drug police would not allow him to use it in his profession. So there are 2 layers above the doctors here ...the insurance companies and the drug police (DEA) and it is sad....they are allowed to intervene with someones treatment plan if they don't think it sounds right to them. It frustrates my doctor very much. It may be why he had this last series of cluster headaches... I don't know. But he complains of their interfearance often.

As you say these nerves are small and anyone who is familiar with neurectomy and the inguinal canal should understand if this will help me or not, so you can bet i will be talking to my doctor about it. My other option is to have the right testicle removed...and I am very worried about doing that because it even sounds more invasive than a neurectomy and i don't even know what a neurectomy really is. But I am getting desperate to get rid of this pain. I feel like a prisoner to these medications and the DEA. Because they will not let me have more than a one month supply and what would i do if I lost some? the pain completely saps me of energy so that I can't even do the organization to get it together to do the paperwork and get up and go traveling ( which is what i love to do ) or get another job ...because i can only work odd jobs because i never know if my pain will let me work multiple days in a row or not.
I thought i was getting better in february of this year. I had tapered down to 1 30mg oxycontin and 3 oxycodone a day yet one day after my third week i was trying to clean up fast and i fell (i believe it was the neurontin i had recently taken because the pain was starting up again) and i fell with all my weight on to a hard hard clay surface directly on to my shoulder and now i can barely raise my right arm above my shoulder , i have 1/3 the strength and i had to start taking more pain meds again. This is why i said i'm beginning to wonder if my doctor even believes me. This is why i'm beginning to be freightened and want to get well so bad. Either this long stint on these meds has made me weak or one of the things all of these doctors have done to me has messed up my nervous system. I used to have great balance.
Sorry for the long long letter but i am alone and i can not decide i i should go back to the urologist who spent 6+ Hours working me to get the neurectomy and tests or not. After all i do think he made my left testes side better. And what do you think i should do about having a test to see if any sperm is present to see if the reversal was at least somewhat successful. Its an embarrassing procedure. But it may be necessary. Well i'm sure you're tiered of reading all this. So i will close with saying thank you for attempting to help me again and i with be sure to talk to my doctor about this at our next DEA mandated session.
I just want to be well .....so that i can be there 100% for my wife and kids. Which i haven't been far for many years now. Have this nightmare of a proceedure (vasectomy) be a distant memory. Run , travel , play tennis , work and visit the person who finally solves this awful part of my life so that i can thank them with a smile on my face and a spring in my step.
P.S. Hot XXXXXXX spell checker is again not working with my i-pad....sorry
Have a good day
Thanks again
D
doctor
Answered by Dr. T Chandrakant 6 hours later
Brief Answer:
We shall continue on till you are absolutely OK. Give feedback .

Detailed Answer:
Hi.
Very good morning here in XXXXXXX My Country.
Well, my dreams help others- help yourself, being in the Medical Profession helps.

Oh, This Insurance is playing havoc all over the world and has infiltrated in XXXXXXX too, we are facing the problems as Doctors as patients' choices start changing and the worst part, their choices hover around the ''allowed'' hospitals and no choices remaining about a particular Doctor or Institute.
They miss a big bus sometimes and land up at different territory of complications and loose lots of man-hours and the worst the health aspect.

Please ask about the inguinal canal and neurectomy and most important can it be done at the spinal cord level.

Since I have connected with internet based consultations, my observation is people all over take so much , so many pain-killers. It wonders me why have people to take so much pain-killers. Is it that that tolerance levels have really gone down so much. We do not find this much in my practice in XXXXXXX

Read about the Physician and his assistance.

these nerves are small and anyone who is familiar with neurectomy and the inguinal canal should understand if this will help me or not, so you can bet i will be talking to my doctor about it > yes, this is possible, workable solution.
This may be a choice between the intractable pain making life miserable and a mild numbness one may get after neurectomy. All the patients accept the numbness as this is far far more tolerable than the pain.

Orchidectomy???? NO WAY , boss.
Do not go for it.
I was just wondering about your reasons for reversal of vasectomy.

I used to have great balance. >> You can have it again...

We shall discuss further till you get a solution which works for you.

You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. T Chandrakant 42 hours later
Hello Dr. T Chandrakant

Wow a Dr. In XXXXXXX .... Is talking to me! ...about "my" little problem ...when you have such gigantic problems there! Thanks for taking the time and I will especially take to heart when you said ... Quote> "Orchidectomy???? NO WAY , boss.
Do not go for it.
I was just wondering about your reasons for reversal of vasectomy."

That was the first time any Dr. Or anybody for that matter... Has shown or spoken with any emotion or passion that what I'm thinking even matters! Everyone seems to be so indifferent to my problem. They look at me as if they don't believe me or they really don't care. Thanks! I really mean it. The surgeon who was so unsuccessful repairing me with the reverse vasectomy acted like .... Whatever you want to pay for....he could or even worse, he would do it! In fact I think he has said to me something like " Orchidectomy ... Well I think thats a little extreme .... But if you want to pay for it .... I could do that too! ". It is like he was saying if you want to pay me... that he could and would do anything ...as long as I was paying for it with cash! He could do it! When he spends 99% of his time implanting eggs and simple reconnections for people who are willing to pay. It was like the almighty dollar would give him the ability to do anything! If, I had the money and was willing to pay!

I am not rich. But I'm sure compared to some of the poor in your country I might appear to be ...but I just realized...that my surgeon and my Dr. havn't even explained to me just what it was that I was talking about when I said that "I just want the damn thing taken out if you can't fix the problem". I just realized I really didn't realize what it entailed! Because my surgeon didn't really look for any problem while he was in there... He just said to me he didn't see any problems...because he really wasn't even looking for one! He just knew ... That he had told me a reconnection may fix me...and that was the job that he was being paid for and that was what he was going to do! Come hell or high water! It took him almost 6 hours to do my two reconnections! Because he had to do both of the more complicated epidimectomy...or what ever! The one where your tubes are so clogged with junk (old dead sperm) that they have to reconnect to the epididymus. Which I'm pretty sure that I told him that if that was what he was going to do...that I didn't want it! ... Or because i had this unnatural and stupid operation done to me almost 20 years ago now. He said he'd reconnect it...and by god he would. He had little more true knowledge than I had ...if it would fix my problem or not...He just knew he said he could do it...I was paying...so he was gonna do it! Wow! I get it now! I can be a little slow sometimes.
So I went on YouTube...and I watched a Orchidectomy ..and it scared the hell out of me! It really did. Thank you for being so honest...so blunt...or passionate. I really appreceate it! I do. Unless the pain becomes unbearable I won't do such a horrible thing to myself. I honestly didn't know what I was asking the surgeon to do! And he was happy to take my money.
Nobody ever said to me "why don't you do a neurectomy" instead! I think that may have been my only chance... Was someone who was willing to take a look at me with an MRI...or possibly a little exploritory proceedure. But the insurance company didn't want to pay for the MRI and the other Dr. didn't want to take the time or initiative to suggest to me an expoloritary proceedure...because he was too busy making the big bucks making big money doing prostate operations, or maybe ...who knows!? ...maybe he could have gotten sued for suggesting it !?.I don't know why I had a reversal now! We cover everything with a coating so it looks and sounds good here in XXXXXXX ..and nobody cares...as long as they get paid. And the insurance company doesn't have to pay! "Why did I have a reversal done?"Because everybody is so busy making money here in California...that they really don't have the time to diagnose someone in a little pain that they can cure with a pill!
And frankly ...the inguinal canal thing scares the heck out of me also. Sorry. Maybe I don't understand it enough but I don't want anybody cutting my groin muscles! I am going to ask about the neurectomy and hope that one of the small nerves by my testicles needs to be clipped. But that is all i'm going to do. And I'm going to pray that I don't have to have it done here in XXXXXXX California. I'm not sure that there are any good surgeons here.
I've read about a guy in Florida that helps people with vasectomy related pain...and that is all he does. But he scared me by saying "that we would pray that it works". I don't know why it scared me. Maybe because i here it so little here. I don't know! All I know is that I didn't want to have 10 kids. I did what I herd everyone was doing to stop from having so many kids. And now
I'm in this mess. I'm a simple man...lost in a sea of technology and money and now... Also in pain whenever I do what most men love to do (have sex with their loved one). And now I can barely even do that anymore! Thanks to this mess this last surgeon has left me with!

But I have taken up too much of your time already. I thank you for your advice. I will "ask about the inguinal canal and neurectomy" and see what they say. But I don't know who I'm going to ask!

And I hope that I meet a Dr. That seems to care as much as you do.
So good day for now Dr. And what is this thing that you wanted me to do and then talk to you by email?
D
doctor
Answered by Dr. T Chandrakant 3 hours later
Brief Answer:
Searching would definitely give a person / Doctor who will help you.

Detailed Answer:
Hi.
Good morning here (4:39 am of a great Saturday morning, started with your conversation).
Very true, this is the scenario almost everywhere and in every field, it seems.
You are talking about Vaso-epididymostomy. Read your thoughts and mind.

Inguinal canal: no muscles are cut , just an aponeurosis of the external oblique.So please do not worry. opening the inguinal canal is the most common operation that a Surgeon does. This is to do a Hernia operation and as I said earlier, any Surgeon who does Hernia can do this.

** I've read about a guy in Florida that helps people with vasectomy related pain...and that is all he does.
This is a good news.
But he scared me by saying "that we would pray that it works".
Must be God-fearing.

I Have a small suggestion:
Can you find an old-timer General Surgeon around you? He can really help you with his experience and wisdom. You are right in saying that all the people have lost in the cycle of new technology and ...;
The first option of a Doctor who deals in vasectomy related pain in Florida is also a good choice.

Please let me know.

Take care.
Get involved into something that can help reduce the pains, the stress and the anxiety; may be a hobby, photography or anything where one looses on all the trouble.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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