Post Vasectomy Pain

Posted by Joe on June 13, 1999 at 10:10:00
Approximately 5 1/2 months ago I had a vasectomy and I am still experiencing pain in the scrotal area particularly the left side. My urologist had an ultrasound done on me and it revealed an enlarged epiditymis about twice the size as normal. He does not suspect an infection therefore no antibiotics have been prescribed.  He can only tell me to expect a long recovery and to take     ibuprofen for the pain. I am 42 years old and have always had mild chronic pain especially on the left side. At 15 years of age I was diagnosed with varicose veins in the left testicle underwent surgery. My pain never totally went away and I learned to live with it. I also have a hydrocele on the left side which according to my doctor has nothing to do with the pain. I am to the point where I do not have to take pain medication however I have had to radically change my lifestyle. Before I had the vasectomy I was running 20 miles a week. I have not been unable to run since. The left side of the scrotum is about twice the size as the right and is very uncomfortable. I cannot put any amount of pressure on the left side of the scrotum without it hurting.( My right side is normal and has no pain.) Sitting upright in a chair aggravates it and I cannot put my legs together without pain. The only time I am comfortable is lying flat on my back or reclining in a chair or standing still. I can walk short distances without pain. I noticed that I start feeling better after I have been off my feet for a few days but the pain and heavy feeling comes back if I have sex or exert myself. Is there anything that I can do about this? My doctor has cleared me after 5 months and 4 samples to have unprotected sex. Would removal of the hydocele help? What is the success rate of hydrocele surgery? Will exercising make it worse? Would removal of the epiditymis or testical be an option?   I've noticed that the left scrotal side is very tight and rides a lot higher than it used to. I would appreciate any advice that you could give. I have not yet been to another doctor for a second opinion. Thank you.

Posted by HFHS M.D.-AK on June 17, 1999 at 16:59:22
Dear Joe,
It is clearly not the normal patient who has the type of pain you are describing nearly six month after a vasectomy.  From your description and my limited experience in this matter, it is most probable that you had some bleeding after the vasectomy which caused a hydrocele to form.  Now this hydrocele is causing you pain and discomfort and the swelling you spoke of.  I think I could give you a more definitive answer if I had a chance to examine you.
I spoke with one of our staff doctors about your situation and he said you could aspirate the hydrocele and see if this resolved your pain.  The main drawbacks to aspiration however are reaccumulation of the hydrocele and introduction of infection.
You may also have a sperm granuloma, a collection of sperm in a walled off space in the scrotum.  These usually don