Throwaway here. My vasectomy was quick and uncomplicated, but left me in constant testicular pain. Sex also became far less pleasurable. After a year and a half of no improvement, I had a reversal; this greatly improved my symptoms but I am still not as I was before.

PVPS is known to be real, but there are very few studies on it. Nobody really knows the incidence, there is no way to predict who will get it, and all of the treatment options suck. Reversal is the best, but is very expensive and often doesn't work.

The reversal cost me ~$14k out of pocket. It's often not covered by insurance because it is considered elective.

I wish I had more to offer than an anecdote. There's some forums out there of people who got it much worse than me.