Hi. Thanks for your query. Noted the history and understood your concerns. Pain in the testicle with history of vasectomy and pain being referred to abdomen is indicative of testicular torsion as vasectomy would not allow epididymo-orchitis as the way for retrograde infection has been surgically blocked. Since this is 3 hours old, it is of utmost importance that an urgent color doppler and high resolution ultrasonography is done and if there is torsion, this needs to be reversed surgically within total of 6 hours otherwise there can be gangrene and will need removal of the affected part. Tell him this fact and he shall be ready if he understands the gravity of the problem and already lost 3 hours of being stubborn for not going to ER or nearest hospital.