Chronic pain after vasectomy: a diagnostic and treatment dilemma.

Vasectomy is a very common operation and has been accepted as a method of family planning by ≈ 42 million couples worldwide. While it is usually a well-tolerated and highly effective form of birth control, it has a risk of significant morbidity in ≈ 1% of patients [1]. One particularly troubling complication after vasectomy is chronic testicular pain, which has been defined as intermittent or constant, unilateral or bilateral testicular pain for ≥ 3 months. The pain is intense enough to interfere with the patient’s daily activities and prompts him to seek medical attention [2]. The definition of chronic testicular pain after vasectomy has developed with time, as have the names of this syndrome. Various terms have been applied to this condition, including postvasectomy orchalgia, congestive epididymitis, and chronic testicular pain. Currently the syndrome is generally termed postvasectomy pain syndrome (PVPS) [3]. In this article we review the salient diagnostic and therapeutic features of this vexing medical problem.