Table 1. Ideal patient selection for each surgical treatment option for PVPS.

Surgical treatment option	Patient selection
Excision of sperm granuloma	Palpable sperm granuloma on physical exam
Microdenervation of the spermatic cord	Successful temporary relief with spermatic cord block
Epididymectomy	Pain localized to epididymis and not cord and/or testicle
Vasovasostomy	No concern for possibility for future fertility
Orchiectomy	Failed all other medical and surgical treatment options

PVPS, post-vasectomy pain syndrome.