Post Vasectomy Pain

[Benno257]

Hi, had a vasectomy 5 weeks ago - scapel method with single entry point.
I seem to have the problem of congested epididimits (sorry for the spelling) - which comes and goes. Is there anything that can be done to encourage the natural absorbtion rate.
I also have sore groin area which i assume relates to the damaged vas area which runs up both hips. I was not told about this at all - is it normal and how long could it last. My surgeon suggested it could be scar tissue taking time to heal and mentioned 4 to 6 months! Again is there anything I can do to speed up the recovery and also surprised that I sometimes get intense pain quite a long way up towards the top of the hip.
I find it very uncomfortable all of the time and can not walk very far. Being physically active and having 3 small children this is proving to have a major impact on my quality of life and all I get told is give it time! Any advice would be welcome.

[Dr J Singh]

Hi,
I’ll highlight some of the common causes of the postvasectomy pain and I’ll suggest you to discuss with your treating surgeon for the right cause in your case.
1. A sperm granuloma could develop post vasectomy that becomes inflamed and aggravates the surrounding nerve endings. The sperm granuloma is a build up of extravasated sperm at the end of the cut vas tube end. The reason why it develops is still not clearly known. The treatment option is injecting it with steroids or actually cutting out the inflamed granuloma has been found effective in the past. The surgical option should be entertained only after the medical options have been used.
2. Inflammation of the surrounding nerves can result in the development of a neuroma. For the same, injections of anesthetic agents (nerve blocks) or steroids.
3. It is believed that by blocking both the upper and lower cut ends of the vas tube the normal passage of sperm from the penis and away from the epididymis and testes causes a build up of pressure and ensuing pain.  In regards to pain resulting from a congestive state from a closed ended vasectomy, converting that vasectomy to an open ended vasectomy or considering a vasectomy reversal have been identified as being effective.
4. Another possibility is the development of antibodies against the sperm which can produce the inflammatory reaction in the epididymal or scrotal tissue. The answer to this problem is a short course of steroids (prednisone).
I hope that helps. Please do keep me posted. Kind regards.

[Benno257]

Thanks for that. My surgeon says there are no granuloma - so that appears to rule that out.
Currently its the pain in my hips and lower abdomen which casues the greatest discomfort - it makes walking very uncomfortable and anything else impossible. Any reason why the cut would cause 'damage' all along the Vas tube? Is this usual? Is this somehting that should pass with time or is intervention required for this aswell?

Also with an open ended vasectomy what happens to the sperm - dont they leak out and cause the problems associated with the granuloma?
Thanks.