Post Vasectomy Pain Syndrome

Background:

Post vasectomy pain syndrome is thought to result from a build-up of fluid in the epididymis following a vasectomy leading to a chronic dull ache in the testes.

  • Up to one-in-five men have ongoing pain or discomfort after a vasectomy which eventually resolves with time. (Urology Care Foundation, 2019).

Treatment:

  • Adequate scrotal support with jock strap
  • Avoid strenuous activity
  • Sit in a warm bath as needed for discomfort.
  • Anti-inflammatory such as ibuprofen 600 mg 3 times daily or naproxen 220 mg twice daily taken with food or a proton pump inhibitor to help prevent GI upset or the possibility of GI ulcer/bleed.
    Treatment course 7 to 14-days depending on the severity of symptoms.
  • If these measures are not enough to relieve pain, local nerve blocks or steroid injections may be provided by a pain specialist.
  • In cases where pain does not respond to therapy, surgery may be required, including a vasectomy reversal.

Sperm Granuloma

Background:

During a vasectomy the vas deferens are cut and cauterized or tied in order to prevent the passage of sperm. Over time, a mass or lump may develop as a result of the body’s immune reaction to sperm leaking from the cut end of the vas into the scrotal tissue.

  • Statistics suggest that 15-40% of men develop a granuloma post-vasectomy. (Viera, 2019).
  • A granuloma is not cancerous or harmful. May be painful or sensitive to touch or pressure but usually improves over time.

Treatment:

Treated with anti-inflammatories, such as ibuprofen. If sperm granuloma causes significant scrotal discomfort, it may be treated by surgically removing the granuloma.

References: Viera, A.J. (2019). Patient Education: Vasectomy (Beyond the Basics). UpToDate. Retrieved March 25, 2020. https://www.uptodate.com/content/vasectomy-beyond-thebasics?search=post-vasecomty%20pain%20syndrome&source_result&selectedTitle=3- 3&usage_type=default&display_rank=3

What is a vasectomy? (2020). Urology Care Foundation. Retrieved March 25, 2020.
https://www.urologyhealth.org/urologiconditions/vasectomty#treatment.