post vasectomy pain

I underwent an open ended vasectomy about 10 months ago.  After a few months I noticed pain in my right groin area when about to ejaculate.  Since then this condition has worsened, despite a course of antibiotics prescribed by my urologist who thought it may be some infection.  Now the pain will arise even when I simply get an erection, but not always.  Indeed during one week I can have virtually pain free sex and then suddenly the next night I have a very sharp pain in the right groin area which makes it impossible to continue with the sex or even attempt ejaculation.  The pain will then remain, though at a much lower level, for days. Anti-inflammatories help but certainly do not completely eradicate the pain.  Any thoughts or suggestions?

[Kevin Pho, MD]

Here are the known complications for vasectomies.  The complication rate is about 5%.  

Mild Discomfort
Some men report a mild aching sensation to the scrotum for a few hours to a few days after the procedure.

Hematomas
Mild bleeding into the scrotum causing small tender swelling for a few days.(1/400). A major bleed into the scrotum causing a grapefruit sized scrotum which will take months to heal (1/1000).

Infection
Redness and pus from the healing site opening (1/100).

Epididymitis
Tender swelling of the epididymis, the tube connecting the vas deferens and the testes (1/100).

Sperm granuloma
A small, potentially uncomfortable, bead-like structure made of leaked sperm that may develop at the site where the tube was cut and blocked (1/500).

Post Vasectomy Pain Syndrome
A very rare complication of a persisting dull ache in the testicle where the inflammation does not settle down. It may resolve on its own or may need another surgical procedure 1/1000).

You may want to consider whether a scrotal ultrasound can help.  This can evaluate any hematoma, masses or epididymitis arising from the procedure that may be contributing to your discomfort.   Another option would be a pelvic CT scan to evaluate if any hernias or masses are present.

If post vasectomy pain syndrome is diagnosed, you may want to consider whether a repeat surgical procedure is an option.

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.

[HTGuy]

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