Normality

[SDem]

It has been just over three mos since my vasectomy. I had some bleeding/bruising and swelling. I have been till this day still experiencing some pain, mild mostly, and have been diagnosed with epididimytis, orchitis. My scrotum is still not normal size and certain exercise and sometimes sex aggravates the area. I have taken cipro for 1 week, then a week off then for 6 weeks straight. We (my urologist and I), did not take the possibility of an infection serious at first but when I was still complaining after several weeks I did them 500mg for 6wks. Ibuprofin has helped and I have managed to try them 3x daily for a week and scattered 1 or 2 600mg.'s pills here and there.I have no bacteria in my urine as of the 11thAug and I have been off the cipro for over 3 weeks and the ibuprofin for 2. It sounds like I have improved (and I think I have slowly) but I also have learned to live with it, careful not to aggravate it. My sex life has gone downhill, and I am getting very discouraged, but hold on to faith in God and anything the medical proffession can do. I had my last appointment the 11th of Aug. and my Dr. says I am coming out of the water and do not need to see him any more. My present symptoms include mild pain/discomfort in the epididimus and vas, and testicles, and I still need to wear a supporter. Some warm feeling and slight swelling after exercise, and also occassional mild nausea and mild fever. To boot I sincerely believe I have recanalized after close probing of the area, my Doc says you cant tell and to get a sperm count. My last one was 15count at 8 or 9 weeks, after about 20 ejaculations. My question is in your opinion have I been diagnosed properly and will it be a matter of time till I am normal and how long does it usually take? Am I rare and do you think I will ever see NORMALITY ? Thanx enormously, Steve

[Kevin Pho, MD]

Here are some complications of vasectomy from a website:

* A sperm granuloma occurs in about 3% of vasectomies. The granuloma is a hard, sometimes painful lump that is the size of a pea and may form over a period of weeks as a result of sperm leakage. The lump is not dangerous and usually resolves over time.

* Congestion of sperm may cause some aching in the area of the testicles for two to twelve weeks after vasectomy. Like a granuloma, congestion usually resolves over time.

* Epididymitis is an inflammation of the larger tube behind the testicle that connects to the vas. It occurs in approximately 1% of patients. Antibiotics are used for treatment.

* Antibodies are produced by the body in response to the absorbed sperm. The antibodies are not thought to be harmful but can make fertility difficult to restore later.

* Persistent testicular discomfort is rare.

* Spontaneous formation of a new vas deferens connection (recanalization) through the scar tissue left by the vasectomy occurs very rarely. This can usually be detected by a semen test after surgery. Recanalization occurs in as little as 1 out of 4,000 men (after a negative semen test has been performed at 12 weeks or longer after surgery).

You may want to consider a scrotal ultrasound to further evaluate whether there continues to be epididymitis.  I would also check the prostate to make sure prostatitis isn't present.  A rectal exam to express prostatic fluid should be considered.  A transrectal ultrasound to further evaluate the prostate for abscesses can also be considered.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.