The Truth About Post Vasectomy Pain (…And Ejaculation After)

I give a Certificate of Honor to specially recognize every patient on whom I perform a Well, it’s not that a no scalpel vasectomy is the most gruesome thing that a man could experience in his life. It’s just that, in the real world of fish stories and Internet tales, it would appear to be the most gruesome thing a man can do in his life. And for taking that leap of faith, and believing that it won’t be as bad as they say it is, men in my practice get congratulated in this way.

Pain Down There

The most feared issue surrounding vasectomy? Certainly not the fact that men fire blanks afterwards. Most are just fine with having the gun go off without any resulting collateral damage. It’s the pain thing.

If you read the published literature on vasectomy, you will find that anywhere from 5 to 33% of men experience some form of pain after vasectomy, whether it is acute or chronic, mild or debilitating. I agree that there is the potential for pain when flow in any organ system is blocked, but these numbers seem awfully high.

What’s Going On?

Over the last 20 years, I have treated hundreds of men with scrotal pain in the absence of vasectomy, and have also performed thousands of vasectomies. I have believed every patient who said they had pain and tried my best to diagnose and relieve it. From this experience, here are my thoughts about vasectomy-related pain:

Early Pain

Procedure Pain

Operating on this place is different, trust me, than anywhere else on the body. Remember, it’s the scrotum, where the family jewels live, and not a finger or a toe. An awful patient vasectomy experience can be life changing for men. That’s why I use oral or intravenous sedation liberally, play cool jazz, promote diverting conversation, use two types of local anesthesia and move ever so fast (9 minutes) to ensure a pain-free experience.

Recovery Pain

I have followed hundreds of men online with Healthloop.com for several weeks after vasectomy, so I know every blip and bump in their recovery. They average 2 pain pills afterwards, and I even tell them to take one pill that evening and another the next morning, just to be sure. Along with a few scattered Tylenol or Ibuprofen pills, this is usually it.

Granuloma Pain

About 1-5% of men may contact me anywhere from weeks to months after a vasectomy with the concern: “There is a pea-sized bump down there and it hurts when I touch it.” This is inflammation around the vasectomy site likely due to the exposure of the body to sperm that either leaked out at surgery or afterwards. It is self-limited and resolves soon enough, and may be helped by taking ibuprofen regularly for several days.

Later Pain

Epididymitis

Rarely (<1%) men present with an episode of scrotal pain years after vasectomy. There may even be swelling, but no fever and no granuloma are present. This is classic epididymal “blowout” with sperm leakage due to prolonged backpressure in the system from the vasectomy. It is not infectious and so antibiotics don’t help. Ice, ibuprofen and time help the most. It usually goes away completely and that’s that.

Congestive Pain

Occurring in <1% of patients, this is the classic “post-vasectomy pain,” It typically starts as “discomfort down there,” that becomes more bothersome over time. There is no granuloma, but the epididymis can feel distended on exam. Often associated with a “low” vasectomy (nearer to the testicle and not higher in the scrotum), it is simply distention in the system that occurs as fluid and sperm build up over time behind the vasectomy. The best prevention is to perform a “high” vasectomy and leave lots of “piping” to relieve distention. The best curative treatment is vasectomy reversal to restore normal flow in the system.

Neurogenic Pain

Although very rare (1/250 cases), this is the “sticky wicket” of pain after vasectomy. It may begin with a less than optimal vasectomy experience (try to avoid this!) with pain that doesn’t improve, or even worsens. There is often a lot of anxiety present, but the physical exam is normal. Some urologists think that pinched nerves during vasectomy are the cause, but others do not. In my view, the best prevention is to do the simplest (i.e. “in line”) vasectomy that doesn’t risk damage to surrounding tissues and nerves and also to provide a great, up front, patient experience. I offer multimodality treatment that includes nerve blocks, neuromodulators, pain therapy and anti-inflammatory and have been very successful in ridding men of this condition.

So there you have it. The bare bones, nitty gritty on pain after vasectomy. Will you have pain after your vasectomy? Sure, as you heal you might. But after that, it is important to have common sense about things uncommon.

318 thoughts on “The Truth About Post Vasectomy Pain (…And Ejaculation After)

  1. The timing of this post could not have been better (Mine is scheduled for Friday, 10/3). The information you provided made me feel much more at ease considering the horror stories of post vasectomy pain on the internet. Now if I could just stop freaking out about the injections of local anesthetic, I might not cancel the appt (Urologist does not offer sedation). Thank you for this insightful post!

    1. Hi Dr. Turek,
      I had a no scalpel vasectomy about three months ago and I have had little problems up to about a week ago. I have a very mild dull ache in my scrotum for about two days which could be to increased excersise (not too concerned about this but thought I would mention it just to be thorough). What I am concerned about is I have had pain during ejaculation in my lower abdominal just above my groin. I have also had pain in my urethra before and during ejaculation but nothing after. Pain is probably about a 4 out of 10…any ideas?
      Thank you In advance

      1. Dear Matt, this could be any number of things. People tend to associate symptoms with events (like vasectomy). I would suggest that you definitely see a urologist (vasectomist or other) about these symptoms.

        1. Dr Turek,
          Thank you for your response. I scheduled an appointment with the urologist that performed my vasectomy for next week. I am pretty nervous as I have never in my life have had any pain during ejaculation before. I guess we’ll see what happens…thanks again!

          1. Matt,
            Just curious what they found out about your situation. I am suffering the same symptoms and its been a year after vasectomy. I am on my 3rd urologist and tried about everything. Please let me know, losing my mind, very depressing.

    2. I her my vasectomy over 3 weeks ago and the insicion site still hurts… I took antibiotics for a week to fight infection and keep it clean but still have pain.. when should that go away it do I need to see my doctor

      1. Nick, there can be issues with the incision site early on with sutures dissolving. Keep up with your doctor, as these tend to get better quickly. The scrotum heals very well in general.

        1. I had vasectomy in 203 ,in 2005 started feeling pain on my left side above the navel, been to India, south africa,, done scans, xrays , colonscopy, and other high quality medical centers in search of cause of the pain . They were not seeing the cause of the pain , until i googled ‘pain long after vasectomy ‘ when it returned someone with almost similar pain, in the stomach due to earlier done vasectomy. It makes me unhappy. What is the best way to cure or manage it

          1. Dear Zimbe, I am not sure that perinaval pain is related to vasectomy causally, despite it being related temporally. Keep researching! Be happy to see you and have a look.

          2. Dear Zimbe,
            I also have the similar pain, I have stopped diary products and alcohol completely. I have some relief now.

      2. Having the same problem been 8 day since my surgery and just the left side side stitches hurt ???right side has no problems are pain

  2. Great post. i just got the no needle no scalpel vasectomy last week. i felt 0 pain during the whole thing not even much tugging so agree internet is wrong on some of it. just slight pain here and there a week later. However i will admit after searching the internet im worried and wish i never had it now. between the sperm backing up. and now i read somewhere about the unused sperm gets disposed into the blood stream and your body can create sperm antibodies and i heard white blood cells will rise to fight off infection and could cause other sickness in the body. Im 39 now and try to be healthy my son means everything to me. just now very nervous if this is really safe. To be honest i did also ask before the operation about the orgasms afterwards was told they are the same, I must admit i dont know if its cause i was worried but i dont think they are as intense as before. Maybe its just because its only a week later and im not fully healed. or maybe the antibotic i am on keflex 2 times a day. Any insight on this would be great, i kind of wish i stayed of the internet to find the horror stories out. Thank you

    1. Mike, please give yourself some time! A week is not very long and it sounds like things are going well. Not sure what to tell you about sperm immunity after vasectomy but I simply haven’t seen any clinical conditions that might be linked to it. Sure, you can develop an allergy to sperm (which is what you describe) but this may only result in a longer time to pregnancy after vasectomy reversal due to the presence of antibodies on sperm.

    2. Hi had he same thing. The vasectomy went fine, little pain at the time, slight tugging on the right side which felt uncomfortable but over in minutes. After having it done, things come to light that have made me feel like that I wasn’t fully in the picture before the op. My biggest concern is the anti bodies and what long term affect they have. I saw a urologist he simply dismissed the subject saying that our bodies have lots of antibodies and it was nothing to worry about, but I can’t stop thinking what if. The two things which keep coming to mind are from the uk cancer research UK website. 1st is that they have vasectomy as an increased risk of causing prostate cancer although only slightly, but other sources say there’s generally no overall increased risk of it causing cancer but it does increase the risk of prostate cancer being more serious and spreading. The 2nd is they say a cause of non Hodgkin lymphoma is auto immune disease. So this concerns me more, does the auto immune response triggered by the sperm breaking the blood testes barrier cause long term, non cureable cancer, again nobody has given me a straight answer. Possibly because they have never seen it and maybe because it happens so long after the vasectomy that the two are never linked. Seriously would like it reversed.

      1. Dear Trebor, It definitely true that a vasectomy can result in you being “allergic” to your sperm. However, other issues or diseases have not been associated with this condition. In fact, 3% of fertile healthy men have antisperm antibodies. Please read my site as the prostate cancer and dementia issues are likely only statistical findings but not real clinical ones.

  3. Thanks Again! Well its been 15 days since the operation. Just took last antibiotic. (keflex 1000 mg a day) . To be honest the sensativity seems the same or even better but i swear its not in my head but at the time of ejaculation i really dont feel the rush i did before. afterwards i feel relived. I really hope maybe its the antiboitics or cause im not fully healed. Have read a few things about nerve damage possible down there but im not sure how much is affected by no needle no scapel . Any possible suggestions? i would imagine if it felt worse there would be alot more people bitching. Thanks again!

  4. Here is the one clip i found. Im not sure if this is the reason of less intense orgasms or not but it kind of made sence to me. But i really dont know how many nerves usually can be damaged?
    I am a medical professional and I attribute these poor orgasms to the surgeon damaging the sympathetic nerves along the vas. The best way I canexplain it is, compare it to parasympathetic denervation of the parotid and submandibular glands. You can still taste a sour taste but you lost the contraction of.those glands ducts. Sureyou can still taste sour, BUT the whole experience has changed, imagine losing the feeling of tasting the lemon but the floor of your mouth no longer tightens, puckers, etc. Its a terrible thing. Yes you can orgasm but the whole experience has changed for the worse. Ejaculation is a sympathetic response, the sympathetic nerves that innervate the vas are no longer connected. The.vas doesn’t contract. Its terrible. Trust me, worst mistake of my life.

      1. Hi Dr. Turek: Can you please comment further on Mike’s theory about the orgasm reduction problem possibly being a result of “damaging the sympathetic nerves along the vas”? If this was the cause, wouldn’t this affect everyone with a vasectomy since, in every case, the vas deferens is being severed? I still don’t know what to do in my case. It has now been six months and my orgasm sensation is still at about 60% of what it used to be. I have tried the following, but nothing has helped: kegel exercises, zinc supplements, and lecithin supplements. Do you have any other ideas? At this rate, I will have a reversal done but I am worried that, if the problem is nerve damage, the nerves can not be repaired in any case. Thanks for any input you can give me.

        1. Dear Ben, I cannot figure out how altered orgasm after vasectomy is related to nerve injury during the procedure. However I know that a vasectomy can alter the volume of ejaculate and the volume of ejaculate can be a “sensor” that affects orgasm. Might be worth checking a semen analysis for the ejaculate volume. I have seen this after prostatectomy for prostate cancer in which the vast majority of the ejaculate is missing and orgasm can be altered dramatically. Not sure exactly how to cure this except, maybe… vasectomy reversal!

          1. Dr. Turek; I had a no-scalpel vasectomy in fall 2016… having never had any surgeries nor ever been admitted to hospital nor even had any notable injuries, the whole experience was unique for me…the urologist who performed my vasectomy was very professional and caring…in fact I actually thought it odd how often he kept asking me if I was doing ok…he did the right-side first and it seemed to go ok except that it took almost as long as he told me beforehand the whole thing should take (about 20 mins)….then he went to the left…I could sense him getting a bit frustrated and he would often straighten up, pause, then start (doing something) again…I noticed him sweating quite a bit…he then told me he was struggling and that I had “a scrotum built for the north” which I took to mean it is perhaps thicker than average??…anyway, he was straining to (I think) pull the tube out to be able to sever it…when he did pull it out, I felt a linear pain right up into my lower-left abdomen (stretching maybe 3”-4” higher) it felt like he pulled a lot more than just a small length of that tube through…it stood out as notably different from what I felt when the right was done and I analogized it to being Mel Gibson at the end of the movie Braveheart when the English were tearing out his lower abdomen. Oh, for anyone else reading this…don’t use that analogy with your buddies waiting to have their procedures!! The left side took about 30 minutes on its own. Anyway, I’m about 16 months post-vasectomy and I have ongoing discomfort in my abdomen (scrotum is fine other than being a bit more sensitive to jarring such as my kids unexpectedly jumping on my lap).
            Is it reasonable to question the discomfort in my abdomen is from the vasectomy? My anecdotal asking around has certainly yielded mixed opinions but my family doc thinks it shouldn’t be. I note that the incision site on the left was very high, basically where the scrotum transitions to the shaft of the penis (which was higher than the right and higher than I expected from diagrams of the procedure). Can a severed vas retract into the abdomen? Can there be damage to genitofemoral nerve (or other nerve(s)) during procedure? Thanks in advance!

          2. Dear Jay, honestly I am reading this and cringing! You are so descriptive about the details of the procedure! Gees. So, generally, despite how very difficult the procedure was, there is no strong correlation to the outcomes or complications. I am not convinced that abdominal pain is related to the vasectomy but a good inspection of the vasectomy sites would be in order to make sure. Typically, an inflammatory granuloma or congestion would hurt down there and not in the abdomen. However, if you developed “vasitis” a condition which I recently published on, it could cause referred pain into the abdomen.

          3. Dr. Turek: Thanks for your response. Are there any supplements or drugs I could take to increase the volume of my ejaculate? For example, I did an internet search and “Lecithin” was listed as having that effect. Ben

          4. Dear Ben, Good health is the best way to keep the ejaculate volume up. I know of no supplements that have been shown to increase ejaculate volume.

          5. Hi Dr. Turek: Thanks again for your comments. I keep feeling that the problem I am having with a reduced orgasm after my vasectomy might somehow be related to the problem I have with urine hesitancy. I have had urine hesitancy for at least 15 years. (Basically, it takes at least one minute for my urine flow to start, unless my bladder is full, in which case the urine flow does start immediately.) Can you think of any ways in which there might be a link between these conditions? (If it is relevant, I am 47 years old.) Thanks, Ben.

          6. Sure Ben, A urethral stricture can cause altered urinary stream and altered semen flow and orgasm. However, it is not related to having had a vasectomy. A simple urological evaluation though.

        2. I can relate to all this and listened to my Dr who told me it is all in head, sorry guys but I experienced a decrease in ejaculation and erectile dysfunction, and my penis was always cold after vasectomy. it is a truth that is over looked regardless what the medical profession says. also pain in my right testicular. it took 26 years to feel free of pain and gain feelings that I lost after a reversal, don’t be sucked in stay well clear of vasectomy

      2. I’m 7 months out from my vasectomy and have no pain most days do get the occasional aches when weather changes. But the thing I’m concerned most about is I’ve lost quite a bit of feeling in my penis. It started after my vasectomy. Best way to describe it is feels like I’m using a condom when I’m not. Any thoughts on this?

        1. Dear Matt, Typically a vasectomy does not influence penis sensation, but something else might; medications, diabetes, etc. This deserves a thorough workup!

          1. I’m with Matt on this one. I had mine done at the VA. After deciding 2 children was enough it seemed like the logical thing to do especially after my wife was having some issues with the pill.

            I went into this pretty excited to be honest. The pain lasted slightly longer than warned about but it did go away. Initially, all seamed well. Then I went through the granular lumps and they eventually faded out.

            My wife is gorgeous and prior to the OP I spent most of my time walking with an erection. Now, I haven’t even had a single morning boner since this all went down. Ejaculating can be impossible.

            Nothing has changed health wise other than the surgery. I have had my issues brushed off by the Doc and its rather infuriating. I have had blood work done several times, they say its good to go. Hormone level 320, they say is fine although I understand it to be on the lowest end of that spectrum.
            I think there is a small percentage of us having issues and it almost appears the response is always the same. Dismissive and outright denial.

    1. Hi Mike,

      I have exactly the same issues, 60% of what it used to be like before, absolutely the worst decision of my life, and most health professionals don’t even believe it’s a physiological problem and suggest you go and talk through your issues with a phychologist. I do hear your pain though and sympathise with what you are going through, certainly a life changer for me. I have tried councilling and seeing a psychologist but they had never heard of the condition, plus i have seen a urologist who accepts something may have happened but no idea what or how to fix it.

      It’s been 10 years now for me and I still think about it every single day, it’s the most frustrating thing ever. Makes life a real struggle if I am being honest, 1/10, maybe 2/10 cos it’s hard to stay angry for ten years. Frustration, anger, bitterness, a resigned depression probably sums up my journey to date but you know already I am sure.

      Reading a couple posts on this site, i sign up to the damaged nerve thing as a possibility, incidentally the initial anaesthetic was very painful for me, same for you I wonder? Unlikely I know, but could this have caused any damage if injecting precisely into a cluster of nerves etc? Probanly not and more likely I think is that the surgeon, who according to my wife debrided the vas to reduce the chances of it joining up again spontaneously may have damaged nerves, is this normal procedure could this have caused nerve damage? I remember my wife discussing it at the tine and saying it was normal to do quite a bit? Innervation might be a little different for everyone but what I can say is that I definitely don’t get that rush from my scrotum upon orgasm any more at all, but still ejaculate a reasonable quantity I think, not that I can easily compare before and after the op though.

      So the other possibility that seems to fit could simply be reduced volume as for me post op, it certainly feels at best like you have just orgasmed only recently, and are empty it feels that you simply have not done much and are just going through the motions, basically “faking it” every time. Again so frustrating not to get that release you want evan though you do ejaculate quite a bit. I used to get a much better orgasm if i had not ejaculated for ages, like it has built up and then released however i have spoken to a couple guys who say it makes no difference to them if they have orgasmed recently or not. I am trying to identify what might be slightly different as it’s a rare side effect, my testosterone levels tested out just above average so everything appears normal there.
      Oh as far as supplements go I do get a little benefit from tribulus and horny goat weed in some OTC tablets available in NZ where I live.
      Anecdotally ten years back when I was researching this is did hear of somebody else with similar issues having some success with a reversal. Trouble is that a reversal is even more invasive and i cannot afford the 10k AND my wife is worried that it might result in permanent pain etc. Personally i am happy to borrow the cash and take the risk even for onky a slim chance of returning back to pre-op days.

      Mike – if you want to discuss this further or are considering a reversal I would be very happy for my email to be released to you to see if it makes a difference for you, or perhaps anyone else out there who might be reading this, if it helps yo pu it would encourage me to get it done.

  5. Thank you so much for your time it means the world to me i spent hours looking at sex theropist,docotors,ect i TRUELY believe the feeling is not in my head. i feel amazing till it cums time to ejaculation. then almost feels like nothing, i called the dr and asked about the nerves maybe are damaged he said didnt think that was a issue. Sex used to feel amazing now each time after im more depressed. Is there anything i can do or look into that might help me? i mean its been 20days now. maybe it will get better ? thank you so much. here is a article i seen that had some medical backup that i thought made sence.
    ⌂ Home

  6. Think my biggest fear is there was damage to the Sympathetic nerves. but dont even know how anyone could tell or if it is fixable thanks

  7. Any thoughts? Things seem the same, even went to get opinion to see if it was in my head was told doesnt seem like it. at 3.5 weeks. Wondering if any chances it will come back or any ideas of what to do or check, I kind of think its that sympthic nerve on the vas? But not sure how hard it is to mess that up. feeling before orgasm is 100% or even better. orgasm not much feeling at all 🙁 thank you

    1. I am having the exact same problem as Mike: My orgasms feel far less intense. What a disaster! I only had the surgery 10 days ago and so I am hoping it will get better with time. However, it seems that for Mike, it didn’t get any better. I can’t believe how stupid I was for getting the vasectomy. All I had to do was keep using condoms. Now I am stuck.

      1. Dear Ben, please don’t judge the future of your sex life 10 days after having a vasectomy. This system is built for speed…give it some time to heal etc. You can always consider a reversal if you think your sexual health issues are vasectomy related…

        1. Thanks for your response. It’s now been two months and the intensity of my orgasms remains diminished. I have been looking into vasectomy reversals and I saw that I shouldn’t ejaculate for at least a couple of weeks thereafter. This is a big problem for me because I often can’t sleep unless I ejaculate. (Basically, I lie awake for 30 minutes unable to sleep, then I masterbate, then I fall asleep within 2 minutes.) How can I cope with this? I would assume that there is some hormone or something that is being released in my body when I masterbate. Can I buy it in pill form? Is there anything else I can do? If I masterbate the same day as the reversal, will it destroy the reversal? Thanks.

          1. Ben, you have an interesting problem…I wish there were a pill that produced the same effects as orgasm..it would replace every other drug on the market in days! Ejaculating too early after a vasectomy reversal has serious risk of pulling the delicate tubes apart due to the powerful muscular contractions of the vas.

  8. Interesting post, a related question regarding the “truth”: is it possible that vasectomy can cause severe nerve issues in leg?
    I had vasectomy exactly 9 weeks ago. During the surgery left cut went well without any problem, however when surgeon prepared to cut the right vas deferens he pulled it quite strongly and I felt pain in lower right abdominal area, around the place of appendix. I told him, and he pulled with less force so pain was little less bad. Two days after the surgery I started to have a serious lower back pain in the middle. Then it “moved” to the right side, and a few days later it “moved” down to the right leg. I went to neurologist and he said it seems sciatica. Also it turned out I dont have knee reflex(!). A few days later also a strange skin sensation (like ants) started on front right leg. Also after four weeks my left quadriceps was visibly smaller and was much weaker on the right side than on the left side. They made MRI as they thought I have a nerve L4 compression by a herniated disc, but this is not the case. So my question is: is it possible that during vasectomy pulling the vas deferens too strongly can cause the above symptoms? Fortunately the leg weakness is improving now, also the lower back pain and leg pain disappeared, just the strange skin sensation on front of right leg, lack of knee reflex, and a slight right testicle pain still I have. Thank you for listening.

    1. Dear John, Although strange sensations can occur during vasectomy, they will all likely resolve with time.

      1. Dear Paul, Thank you very much for your reply, so you say this kind of frightening nerve problems in lower back and in leg can be realted to vasectomy? 🙁

  9. Hello dr. Turek
    I came across your website while searching pinched vas deferens. I had my vas deferens pinched a couple years back. Since that time my vas deferens has gotten much thinner to the point i doubt it is conducting any blood flow at times. The testicle it is attatched to is decreasing in size. My question is if there is a surgery to have the pinched section removed to restore flow so i can get back to my reg life again.
    I live in canada, but i am desperate to get this fixed as it is something thst i do not want to live with for the rest of my life.
    Thank you,
    Lee tataryn

    1. Dear Lee, this sounds VERY unusual. Is this “pinching” a result of some trauma. If by “pinching” you mean there is a thinner segment surrounded by a normal vas above and below, then it may be possible to reconstruct. If there is no traumatic cause, it may be to due a consider that some men are born with called ‘congenital absence of the vas deferens’ and it may not be correctable. A urologic microsurgeon should be able to help you with this. Call us anytime!

  10. I had my vasectomy done exactly 11 months ago. I’ve had an increase in pain to my scrotum at times of achieving an erection. I feel around the pain site, and can feel, what I’m guessing is the vas defron, being stretched I can run my finger down the tube, and in the mid section, I feel like a pea size object, hurts to touch. This is present on both sides. The pain increases as my erection increases, to the point of uncomfortable intercourse. At times, the pain seems to run up to my inguinal area. Is this something that will eventually heal on its own, or will I need to go back under? I appreciate your time.

    1. Dear Juan V, From my experience, painful “peas” near the vasectomy site are typically granulomas and resolve with time or antiinflammatories. Have your doctor check this out and get rid of that pain!

  11. Hi Dr. Turek,
    I had a no scalpel vasectomy done nine days ago. I iced and followed directions very well. I had some pain in my left testicle, along with some bruising to the left side. I believed that to be normal and had no concern about it. The right side, had almost no pain and seemed great until yesterday. On the eighth day after the procedure I began to get sharp pain in the right testicle. It was uncomfortable to say the least. Today, the pain is very sharp and fades away. It then comes back and fades in waves. It feels as though someone flicked it with their finger. When I feel around the testicle to try to determine where the pain is coming from, it feels like the area that was cut is bigger on that side and the pain is definitely from there. I have become very worried about it. Any help would be great!
    Thanks

    1. Ronald, these are the kind of concerns that are best vetted with your doctor! There can be lots of twinges and twangs early on after a vasectomy, and they usually settle down with time. But let your doctor know; that’s called care…

    2. Hey Ron, Im reading your post and I have experienced the same exact pain you’re describing on the left side. Very sharp pains and comes in waves. Im 3 weeks out since my vasectomy and this just started a few days ago. Its like an electric feeling. Any advice? did yours go away? I def need some help!

  12. Have you ever done a repeat vasectomy to clear out a granuloma or clips that are causing irritation to the nerves?

    1. Dear John, Yes I have. A granuloma suggests a leak in the vasectomy and redoing it to remove the granuloma and seal the leak can help. I have never found that clips alone (without granuloma) are bothersome however, and I use clips ALOT!

  13. Is it possible for nerve damage to occure and cause inner thigh, hip and lower back pain after a no scapel vasectomy?

    1. Dear Jeff, this type of hip and back pain is NOT typical of vasectomy. In fact, I have never seen this. However, back pain can refer to the scrotum.

    2. Jeff, this is exactly what happened to me and many others after a vasectomy. The nerves that run your core muscles terminate in your scrotum. Any damage can cause chronic pelvic and back problems. Take a look at postvasectomypain.org — this is a relatively common occurrence.

  14. I ended up with major loss of sensation when ejeculating pain in the right testicle and groin and somehow cronic back pain which may be due to being moved when asleep who knows. I’m going to get it reversed soon hope it works it’s been a nightmare.

  15. I had a no scalpel vasectomy 6 weeks ago. I waited 7 days to go back to work (riding motorcycle up to 200 miles per day). Left epididymis is full and swollen, feels like the vas on testicle side as well. Feels hard to the touch and hurts. Started as dull ach and heaviness. I’ve taken two separate rounds of cipro. Still hurts, ranging from almost no pain, dull ache, to sore, tender, and up to sharp shooting pains the last couple of days.
    My dr thinks maybe a suture has caused an abscess on vas, and says he’ll just go back in and cut out. Understandably, I’m not eager to have surgery again willie nillie. Does this sound right to you? Should I request an ultrasound or any other tests before? Feels like starting to get worse on right side now.
    Btw, no scalpel, and cauterize and suture each end of both vas. Thank you

  16. I left a comment already, but it doesn’t seem to have posted. I had a nsv about 6 weeks ago. Waited 7 days to return to work (maybe should’ve waited longer since I ride a motorcycle for work). About 10 days after had dull ache and heaviness in left testicle. Saw dr, said epididymitis and took cipro for 10 days. This seemed to help a bit; however, about 4 weeks out I decided to ease back into working out and felt pain and heaviness again during some light-moderate weight deadlifts. The next several days saw an increase in pain and sensitivity while working. I went back to dr, he prescribed cipro again for 14 days. In examination, said almost feels like variocele. Thinks a suture may have caused an abcess on left vas. If antiobiotic doesn’t clear up, he’ll just go back in and remove. Just finished the 14 days of cipro and still hurts. Left epididymis feeling very full and hard to the touch. Hard lump at bottom of epididymis and upper area feels hard and full. Painful to the touch. I have also started feeling sharp, shooting pains in both testicles, more so on left side. Also feels like epididymis on right testicle starting to feel hard as well.
    Does my dr. Line of thinking sound correct? What are your thoughts/ recommendations? Are there tests i should request like ultrasound before going back in? I’m not excited about the idea of having surgery on my poor scrotum again. I’m more than willing though to get my life back, just want to make sure we get it right.

    1. Rick it is not only difficult but medically inappropriate to suggest care to you on line. You really need to be a patient as this picture is complex and often helped out by having a simple but thorough physical exam. Typically pain early on after vasectomy is hematoma, inflammation or possibly congestion. Treatment is diagnosis specific.

  17. Hi doc. As if this morning I am only on my 8th day post vasectomy. Regular vasectomy with clips. Felt relatively good post op day 1/2. 3/4 felt bad. 5 felt better. 6 felt even better. Days 5/6 were mainly just groin area pain and lower abdomen pain.
    But yesterday, 7 day post op got meaningfully worse. Pain back to testicles, mainly right side. Pain in legs and groin and abdomen. Barely got any sleep las night at all. Frequent urgency to pee a lot…. But small amounts. I also started coughing and got the chills a bit. Sitting on the toilet is actually the one place that feels best and where I’m writing this. Testicles definitely feel achy and stopped up again mainly/more right side.
    I know the answer will be it’s still early days, and probably to take antibiotics given the chills, etc.
    But lookin for any further thoughts and reassurances.
    The Internet is NOT a fun place to be when this pain starts post vasectomy.
    Does the congestion like feeling usually clear up? How long does that usually take?
    Many thanks

    1. Dear JerBear, the best place to be (or to contact) after a vasectomy with your concerns is your doctor or his assistants!

  18. I am currently at day 9 after a NSV. The procedure was fine and except for the anesthetic being administered, I felt no pain. I also have had almost no soreness in the scrotal area at all. However, I noticed on day 5 that I was experiencing some pain and discomfort around the upper groin (basically where the groin meets the top of the leg) on both sides. I also noticed pain in my lower back under and around the love handles area although also occasionally closer to the spine. When I talked to my urologist after day 7, he said it was referred pain from the vas and to give it another week. I am not in a great deal of pain or anything but it is lingering and I was just wondering if it is typical to experience these symptoms after a vasectomy. I haven’t read much about upper groin and back pain after a vasectomy and most of the posts here have related to testicle pain. Is what I am experiencing fairly common? I know it hasn’t been very long since the vasectomy so I shouldn’t be too anxious. I just don’t know if I should be more concerned.

  19. I am currently on day 9 of a NSV. The procedure was fine and I felt almost no pain and have had only a little testicle pain since. However, on day 5 I began feeling some discomfort and pain in my upper groin ( just above the intersection of the groin and top of my leg) as well as lower back pain in the area below the love handles although also sometimes closer to the spine as well. I visited my urologist on day 7 and he told me this was referred pain from the vas and to give it another week to resolve. I am not in a great deal of pain and I know not much time has passed since the procedure but I was just wondering if what I am experiencing is typical. I have read many post about testicular pain but have not heard as much discussed about upper groin and lower back pain. It is more a lingering annoyance at the moment but I was just curious.

    1. Dear Nathan, I would agree that this sounds fairly typical of post-procedure discomfort. Remember the vas runs from the scrotum through the groin to back behind the prostate.

  20. hey Dr. Turek, I had my vasectomy done with no complications but the next day the surgical site opened up and began bleeding, this led to an infection that took two weeks to resolve. I tried getting help sooner with my urologist by they refused to acknowledge that I had an infection and that my pain was made up/exaggerated, it took me being admitted to the ER to find out about the infection. since then I’ve been have constant tingling/electrical pain in my lower right abdomen, lower back and my right calf to the knee. this pain has been persistent for 90 days now and I’m unable to run or lift anything very heavy at all. I have done a lot of research and spoke with other urologist but the only thing they keep bringing up is that it is Chronic nerve pain and that it most likely won’t go away.

    1. Dear Jesse, It may take some time for an infection to “declare” itself so that time frame is not all that unusual. However, your pain is very complex in character and certainly atypical after a vasectomy. The combination of lower back and calf pain makes me think more of a thoracic/lumbar back issue. I do not agree with calling this permanent nerve pain at this point. You should continue to pursue care.

  21. Hi Doc, I had my vasectomy 4 months ago and have had occasional pain in the tubing near where it looks like the procedure took place. I now have severe pain from a ‘knot’ on the right side and radiating to right groin and lower back / upper leg. Is this serious and any recommendations? I’m taking ibuprofen but that’s it. Many thanks for any insight.

    1. Dear Josh, You should certainly reconnect with your vasectomist on this issue, as it sounds a lot like an inflammatory granuloma, which is typically very treatable.

  22. Good evening,
    I am writing in behalf of my husband. Over 1 year ago we chose vasectomy over tubal ligation. This I feel was a mistake. My husband’s procedure was painful, extreme pain and “pulling” during the operation. His post-op went as planned but ever since the surgery he has had chronic pain. There are no pea-sized masses but the pain he feels is debilitating. My husband states it feels as though someone is “squeezing” his scrotum. He has gone back for an ultrasound and the result are normal. The doctor looks and treats my husband as though he is making this pain up. I see the pain, anxiety he has everyday due to this issue. I don’t know where to turn. Reading your site gave me hope, hope that one day he will suffer no longer. If the pain is truly neurological, how is diagnosised? Can nerve blocks negatively impact sexual performance? Are there any physicians on the east coast can help. Restless in the Carolina’s.

    1. Dear Christine, This sounds like a classic case of male “disfigurement” due to vasectomy. It simply didn’t go well. In my experience, this takes about 6 mos to resolve with pain therapy, NSAIDs and time. He should get better, you gotta believe.

      1. Wow. I hope for Christine and her husband’s sake, that you’re right that it will improve. And I truly hate to be discouraging, but this was a very scary post to read for me. What she describes is exactly my experience, and I haven’t seen it mentioned as clearly before: Vas was pulled way too tightly during the procedure, and I’ve had chronic pain ever since.
        In my case, it was the left side and the first side done. Tear-inducing pain, even under anesthesia. Of course, I didn’t really know how wrong it was until the second side was done, without the same pain or intense tugging. The first 6 months I couldn’t walk normally. After that, the episodes of pain (dull, non-focused aching) have waxed and waned periodically in their severity, so I just learned to block it out as best as I could. But now, ten years in, the pain is getting more consistent and more intense, to the point where it’s interfering with daily activities. I’d say interfering with “quality of life” but, as any man knows, that is and was diminished the moment the pain was introduced.
        Ultrasound looks basically normal, except for a possible “ball of nerves or veins.” Urologist has been dismissive ever since day 1. Reading this “disfigurement” comment, I now think I just need to go to see someone else – which is what I’ve been toying with and why I’m looking on line for similar stories and ways to help explain what I think might be at issue, to someone new and unfamiliar with my case. I suspect the doctor who performed the procedure is being defensive for his own sake, and might not ever shoot straight with me.
        I’d love to hear from more with the same experience, and to know what you’ve discovered if you’ve tried to remedy things. One other thing that I’ve noticed and will mention, in case it helps reinforce some similarities: Either the Vas or some other vein or tendon is very taught most of the time, on the side with pain. Like a guitar string. Grabbing my scrotum in front of and below this area and pulling slowly and firmly forward seems to give me some temporary relief. Almost like it stretches and releases tension at an anchor point on the testicle – until something slowly and elastically returns to it’s normal, taught state.
        The last thing I should say, for Christine, is “don’t feel guilty.” Your husband most certainly does not blame you or regret the decision you made. Really. I promise. Hope you figure it out though!

  23. Hi doctor Turek, I had a vasectomy 13 days ago and had a hematoma, now that the swelling had gone down I could feel the blood that has clotted from that which the doctor told me it would resolve but my question is my vas deferens feel really hard and sore, well this resolve on its own and soften up, thank you.

  24. Hi doctor Turek, it’s been 13 days since my vasectomy I had a hematoma and now that the swelling has gone I could feel the clotted blood which the doctor says will go away my question is now my vas deferan feels hard and it hurts to touch, will this resolve on its own and feel normal again? Thank you.

  25. Posting on behalf of my husband he’s had the vaceptamy for 3 half years now with on and off pain but now he is experiencing pain in his left testical and groin area more so after walking far distances how ever I must point out that he has one testical concisely larger then the other but the smallest is the most painful /sensitive his vas tubes you can feel it normal then lump bend in both which I’m guessing is the clip /clamp as he had the no scalpel vaceptamy what relisticaly should he do go drs I know but in regards to revesal will he benefit more from that then go on like this for years on end cause I feel sorry for him having these episodes

    1. Dear Stacey, you write like James Joyce: one big, long complex sentence. Refreshing. Sounds like its either inflammation (granuloma, vasitis) or congestion. He should certainly get checked out you can usually find inflammation on exam whereas congestion is usually a feeling associated with a perfectly normal exam.

  26. Hi i had a vasectomy last year. 3 months ago i started having pain in my groin left side radiates to my thigh and also have back pain with it. Some days it is fine and other days its rather painfully and painfull to walk. The doctor told me you may have a hernia so of to a specialist for that. That was a no no hernia. Then the doctor sent me to another specialist and he says with physio on the left leg will fix it. Where the vas was cut it hurts to touch. What could it be as getting sent from one to another is rather enoying. Any response would be great thanks.

    1. Dear Mark, left groin, thigh and back pain suggests a BACK issue and not a vasectomy related issue. A vasectomy should not cause leg pain or back pain, but the reverse could happen.

        1. Dear Satyanarayana, GREAT question! I haven’t had my vasectomy yet…the question really is WHO will do it?

  27. Hi I had a vasectomy 5 days ago. The one slit with cauterize. It seemed to go ok I see very little black and blue. The entry point seem to be healing fine. I do have pain still. The one thing I’m worried about is for 2 days after I would get woozy and have constant gas. It seemed to get better but now I feel I’m very bloated and still have the constant gas. Is that normal?

    1. Dear Mike, Could be normal to have GI disturbances early on after vasectomy, depending on what kinds of pills were prescribed with the procedure. Opiate based pain pills typically cause nausea and constipation whereas ibuprofen (NSAID) based pills can cause GI upset and heartburn. Give it some time!

      1. Thank you for the reply! Its now day 8 and still have some gas. I decided not to take the prescribed pain pills. I did start ibuprofen a few days ago. The pain is calming down now so I will stop that soon. I’m wondering if it was the antibiotic. I’m sure all will be well again, until I start the gym again and have the usual gas from the protein shakes :). I will say from my experience though for others, I would say the first 3 days I felt like my manhood was taking away. Up until day 6 I felt like I’d never be back to normal. I did manage yard work on day 7 with little issue but today after picking up my toddler the pain came back for an hour or so. I’m going to start back in the gym in a few days feel it out and see how it goes. I still haven’t tried intercourse yet and have been nervous to try. Lucky it was PMS week so it was out of the question anyways :). I should be able to try that also in a few days. The whole you’ll be back to normal in 3 to 5 days was not the case for me but I think I’m seeing the light at the end of the tunnel now.

  28. Dr. Paul, I had a vasectomy almost two years ago and about a week after I had it done the pain was almost unbearable. I went back to have to checked and they said I had a blood clot in the area that was hurting. They gave me some Medes and sent me on my way. Just recently I had extreme pain in my left testicle and swelling to go with it. It was about 2x the size it normally is. I have been waiting about a week now and the swelling went down some but not all but the pain is still there. Do you have any recommendations on what it might be or what could be causing it?

    1. Dear Justin, You should really call ur doctor on this one! Sounds a lot like a “blow out” due to epididymal obstruction which is not an infection, and usually responded to non steroidal antiinflammatories…

  29. Hello Dr. Turek,
    Had a vasectomy done about 8 days ago. I underwent no scapel treatment with a jet injector used to freeze the area for surgery. The surgery went well. I followed the direction with icing, light activities no sports and no heavy lifting, basically did much of nothing for the past week.
    However I am now experiencing a pain in my left testicle (very tender to the touch), I do feel a small pea size ball on the vas deferens leading to left testicle. It is uncomfortable to walk at times and running is out of the question as of right now. I’m currently taking Advil extra strength (400mg ibuprofen). When will this go away ? A I also play sports, coach hockey and soccer and work out with exercise and weight lifting regularly. When can I get back to this routine? Can please let me know, thx.

    1. Dear Marlon, You really should speak to your vasectomist or his/her staff about whether this is typical for his/her procedures. Sounds like a granuloma or swelling around the vasectomy site but a good physical exam can help out a lot.

  30. Hi Dr Turek. I had my vasectomy 10 days ago. I was told that I should be able to get back to normal activities within 2 to 3 days.
    Unfortunately I am experiencing alot of discomfort on my right side. All the way from my right testical up into my abdomen. It is extremely sensitive to touch the right hand side of my scrotum. If I use my index finger and thumb there is a hard line running from my testicle into my body. It fells like a doweling rod. I am experiencing burning pain almost like a stitch all the way up to under my ribs and to my back. This comes and goes but worsens when I lie down. I have also noticed a change to the base of my penis. A swelling like soft tissue that wraps around the right side and onto the top when I have an erection. It’s also quite painful when I have an erection on the right side. Any information you can give me I would be grateful. Thank you

    1. Dear Paul (nice name!) At 10 days after vasectomy this could represent a small hematoma (blood), inflammation or infection. Please see your vasectomist about this!

  31. I had a vasectomy about 3-4 months ago. About 6 weeks after the procedure I noticed, upon ejaculating, a slight itch in my groin about 3/4 of an inch up from my scrotum, maybe 1/2 inches to the right of my penis. Over time the itch has gotten more intense and now has evolved into pain. Only on ejaculation, then wears off in about 2 min never to return again until I ejaculate again. Is this a nerve thing? I waited the proper time before resuming activities, sex and otherwise, and it didnt happen right away.
    Also of note. i had bilateral inguinal hernia repair surgery about 6 years ago, and previously, the nerves in that area did seem seem to lose some sensitivity. There is a possibility that I am getting some feeling back in that area I guess although that seems awfully long for that to happen.
    Either way, any thoughts? Is this going to continue to get worse? Is it treatable? Any idea which surgery this is likely tied to?

    1. Dear Jay, it is very uncommon that vasectomy causes groin pain unless the entire vas is inflamed (vasitis). It is more common to have spermatic cord pain after mesh hernia repair, however. You may be associating new hernia-related groin with the newer event of vasectomy. Hard to know. Please talk with your vasectomist and consider contacting Dr. Shirin Towfigh of Beverly Hills Hernia Center who specializes in hernia related pain.

  32. My husband had gotten his vasectomy almost 2 years ago. He was very uncomfortable during the procedure and said there was a lot of pulling. His recovery was “normal”. It didn’t keep him down long. Sex started again and we were going as usual. Over the course of these last 2 years he would on occasion loose his erection. This had never happened before. We also know that this can happen to men so we didn’t think much of it. Since this past summer it started happening more. In addition to this he started having a pain on his right side in the upper groan area when he gets an erection. He want to see the Urologist. He said everything looked/felt fine. The pain has been getting more intense and now he is experience ED. He went to see the Urologist again and his primary doctor. Both said that he is healthy and it looks/feels fine. His primary doctor gave him some Viagra and said the pain is causing him to mentally not be able to preform. The Urologist suggested checking into pain management. He went to see an anesthesiologist for pain management who said he could get an injection to deaden some nerves to relieve the pain. This may or may not work and might only give him 6 months of relief all for only $2000K (insurance is crapy). That was put on the back burner due to cost. In the meantime the Viagra gets everything up and going but the pain is increasing. The pain starts as soon as he starts to get an erection. Once the erection is gone he still feels residual pain (he says it’s kind of like being racked but not so much in the stomach). We have noticed that if we try 2 or 3 days in a row the pain is not as bad. Its as if something inside of him is stretching out easing the pain because its not as tight. But when we wait several days or a week in between erections the pain is bad, it’s like starting the stretch all over again. I called the urologist today to set up an appointment. I talked with his nurse who then relayed the info to the doctor. With out seeing my husband again, the doctor prescribed a steroid RX for him to take. I don’t understand what this will help. There has not been any swelling. My husband is also going to get his testosterone checked. I have read many articles and blogs talking about how a vasectomy can lower testosterone and lead to ED. There is a lot happening here but I really think it is because of the vasectomy. What are your thoughts? Will the steroid work for this? Is deadening the nerve the right answer? Is this “disfigurement”? Will it go away on its own? Will a reversal fix all of this? My husband is 35 years old and healthy. This has been very difficult for us. I wish I would have NEVER asked him to get a vasectomy. I hate to see him in pain and not get full enjoyment from sex (when it happens). Thank You

    1. Dear Victoria, I agree. It would be nice to have someone give a list of what is causing this groin pain. Does he have a granuloma from the vasectomy? Vasitis? A hernia? Is this post vasectomy pain syndrome due to congestion on one side? Be happy to help but I really need to see him.

  33. Dr. Turek,
    Let me start by saying I have never once experienced any of the symptoms mentioned below until I had a vasectomy. I had my vasectomy on November 22nd, 2016. I am two months in. I have been on somewhat of a roller coaster of symptoms. I knew something was not quite right when I had some “dribbling” a couple of minutes after urination on day 4 or 5 post op. I had some abdominal pain as well that felt similar to bladder pain (I have had an appendectomy so I was familiar because my appendix had been resting on my bladder). I went back to doc the next week after days of dribbling, frequent urination, feeling of not completing urination, etc. They shoved Levo and Rapaflo at me with really no explanation. I took three days of the levo and stopped because it was giving my massive headaches. All of their tests came back negative on infection. Rapaflo did not seem to help completely. I visited my PT to do some muscle release on my groin and abdomen. That seemed to help (especially with some constipation i was having). I then had shoulder surgery on December 13th where things kind of died down for a couple of weeks. Maybe it was paid diversion……..or the fact I was taking pain killers and ibuprofen………I dunno. It never completely went away during that time, but was on the back burner. Things ramped back up early this month with dull ache very low abdomen, pressure dull ache feeling at the base of penis, and I have definitely had a pea sized nodule on the scrotum along what looks to be the vas. It seems to vary in size depending on the day. I went into my primary doc for my prostate concerns because my urologist who did the vasectomy not once bothered to check it (he also checked my pea size lump, and said it was most likely scar tissue that would go away……….come back in three months). It had recently felt like I was sitting on a tennis ball when I was sitting down. He checked my prostate…………….said it felt like mashed potatoes which was indicative on an infection (did urine sample after he massaged prostate). Test came back negative although they say I could still have infection. My two week dose of Bactrim ends this Thursday. I have been up and down. I still feel like I am sitting on a ping pong ball at times….even today. So I am not sure if the antibiotic is working. It is hard to tell. I forgot to mention I went for a run on a treadmill a couple of weeks post op, and it made things worse…………..hip flexors and muscles were super tight (that led to that PT visit). I did go for a run outside (3 miles) yesterday, and I was anxious about it. It was awesome. I felt great. However today my prostate is still bothering me. I am trying to get an appt at Duke Urology to talk to someone who won’t dismiss the thought immediately that these are connected. The doc who did my vasectomy actually had the nerve to tell me that maybe I was destined for prostate issues………….and it just happened to be at this time. I wanted to break his [email protected]##ing nose right there.
    Here is a full list of everything I have felt
    Enlarged prostate
    Constipation
    Dull abdominal pain
    Pressure/Congestion/dull ache feeling behind penis
    Tender Pea sized spot on scrotum at vas site
    Urinary frequency and post dribble with warm sensation
    Raw type feeling in urethral track near end of penis
    Groin tightness
    Blue Balls type feeling
    No pain with erection on command, but sometimes wake up with mild painful morning wood
    Tangled, tight, pinching, pulling sensation near that pea sized lump when I move a certain way as if a wire is caught up and being pinched or pulled (hard to describe). When I feel this it usually coincides with a rough day of symptoms.
    So I wonder constantly if this will just go away on its own. The prostate part is what really drives me crazy. Will I forever have prostate issues now because I got a vasectomy that was not really needed? Have you had patients with prostate symptoms that alleviated on their own?

    1. Dear Frank, In my 2000 vasectomy cases, I have not seen urination issues worsen due solely to vasectomy. What could be happening is that your attention is now focused on this system and as you age, urination changes. Post void dribbling is very common in 30+ year old and tends not to progress.

      1. I developed horrific problems with frequency and burning pain in my left groin at my incision site after my vasectomy. All of my prostatitis like symptoms went away after my reversal. The pain I developed after vasectomy was so bad I could not sit to watch my kid in a play, take a long care trip, watch a movie. I would wake up with erections and it felt like a red hot needle was stabbing me in groin where I was accessed for my vasectomy. My symptoms were not that bad right after vasectomy but like a frog in a pot of boiling water got worse and worse over 5 years until my reversal. At year three after vasectomy the back of my left testicle swelled up to about 5 or 6 times it’s usual size and was extremely painful. That’s when I knew my vasectomy was the cause of all my problems. My reversal removed all the damaged tissue that was the source of my nerve pain. Full patency was restored and I could sleep through the night again without waking up with my chest pounding from the pain due to erections in my sleep that men have no control over. Getting your vasectomy reversed can fix prostate issues in my experience. It happened to me. I had a doctor that fed me the line that 1 in a 1000 men have problems then he changed it to 1 in 3000 then said he’d never seen it and if it happened it could be fixed. By coincidence in an online support forum I have run into two other men that go to doctors in his same practice/group. Because of this I think he is wrong. Doctors can say they have not had any bad outcomes if they don’t accept they have had any bad outcomes

      2. I Have somewhat the same symptoms, I had my vasectomy in Dec-17 and was pretty much ok until march-18 and all of a sudden started with constant urge to urinate as well as constant bladder pain/pressure and sharp pain after ejaculation. At first I went to the doctors who queried my problem as prostate related despite everything showing fine. I also received a ridge camera some months later to look inside my bladder but all seemed fine, its now may-19 and my problem has not eased in the slightest. urology has been useless and once discharged me informing me It will get better, to which I have now been referred back, this problem has destroyed my life and I see no relief to my pain and embarrassment, I sometimes wish I wasnt here at all. I had always been fine down there, and now I cant help but point my finger at the procedure I now wish I never had done.

        1. Dear Matt, We tend to associate symptoms we have with an event (like vasectomy). Although pain after ejaculation could be related to having a vasectomy (depending on where it is), the constant sense of bladder pressure and urgency may very well not be. Find a urologist who listens to your symptoms. They first have to BELIEVE in you.

    2. Frank,
      Did you ever figure this out? I’m having a lot of the exact same symptoms. Had my vasectomy only 10 days ago but feeling the need to urinate and a burning sensation in the tip of my urethra have been there since 24 hours after. I’m currently on an antibiotic for 5 days because my incision site appears infected-pus, little blood, and discharge but the Dr. called the rx in, no eyes on. The resident that closed my stitch picked up gauze that had fallen on the floor and used it to stop the bleeding post-op so it makes me wonder if that perhaps was the cause. Pain was bad but is getting better. I have had a varicocele for years and it always seemed to make any type of testicle pain (e.g., getting hit in the balls etc) linger much longer, so I wonder if that is part of the reason for still having pain at 10 days. Mostly though, I’m upset about not intervening when the Dr. retrieved the gauze from the floor and I’m wondering if I have a deeper infection that is maybe somehow causing the urinary and prostate symptoms. I’d love to hear anyone’s advice. I’m trying to be rational but this is really starting to affect me. I’m 33 if that’s important.

  34. Is it normal to have a small, slightly painful lump on the vas years after the procedure is done? Reading through the comments, it sounds like it could be a granuloma. My GP did not think pain or inflammation would be likely years after a vasectomy, but I clearly feel a small pea-like lump on the tube itself and the area is slightly swollen and tender. Thank you.

    1. Dear Sean, it absolutely could be a granuloma. I recently felt one on a patient who wanted a vasectomy reversal 28 years after his original vasectomy. As long as it is not painful, there is no concern.

  35. I had the old tried and “true” done 6 years ago. Epiditimus or whatever you call it is awful. Blue balls 24-7. Awful. Want it un done!

  36. Hi Dr. Turek,
    I had my vasectomy done April 2016 and during the procedure the doctor touched a nerve while doing my left testi. The pain was so sharp that i had to sit up from a laying down position. The pain went away quickly and the doctor said he must have touched a nerve. That night the pain on my left testi came back and was there throughout the night. Needless to say i had very little sleep even after taking the meds. The next morning was a saturday but i called the doctor office anyways hoping i could speak to someone one. I got through to a doctor by an doctor exchange agent. I told him about the pain and he told me it was to early to say if something went wrong. he told me to put ice on it and if it did not go away after 5 days then come in and see my doctor.
    The recovery was rough but I got better and started going back to work and resumed normal activities. then a few months later i started to notice pain in my left testi after ejaculation. it was not unbearable but it would go away after a few hrs or overnight.
    Then last thursday (Feb 9 2017 10 months after the vasectomy) my left testi started to hurt out of nowhere after having lunch at home (no ejaculation). The pain was getting worse at night. I took 2 500mg Motrin and they only brought the pain down a little. i thought it would go away just like other times. But the pain remained all day Friday. Still I had hope that it would go away the next day. Saturday it got worse so I called my urologist. He told me to come in Monday so he could take a look and in the meantime keep taking motrin.
    I suffered Sat and Sun and was upset that i had to cancel my weekend plans with my family. The pain was so bad i had to lay in bed most of the time. And sometimes i felt my left leg was numb or weakened by the pain.
    Monday I saw my urologist first thing in the morning. When he started looking at my testicles he asked me if my left thigh had any pain. I told him i felt a little numbness but i could still stand and walk and he stopped examining my testicles right away and said that I had a pinched nerve in my back causing the pain in my left testicle. He looked up at my face and must have seen the shock and disbelief in my eyes so he said: “I know you don’t believe me but I guarantee you that it has nothing to do with the vasectomy. I know the cause of this pain because I myself have similar pain where a pinched nerve in my back is causing severe pain in my buttock. I know you are not convinced and I know I cannot convince you. But you can get a 2nd opinion and a third opinion. They will tell you the same.” While I was still in total shock to hear such a far fetched cause. My doctor went on and said he ruled out epididymitis and granuloma because the testicle looked fine with no swelling, hardness, or redness. He also ruled out infection because I did give an urine sample. I asked him what should I do. He said I needed to go see pain management doctor or a chiropractor.
    I left the doctor’s office and while in the parking lot I called my friend a chiropractor and he said though it is possible it is very rare to have a pinched nerve in the back causing pain in the testicle. He said I would need an MRI to identify the cause.
    I went home feeling depressed, regrets, and angry. Depressed because it looked like I would have a long battle with this pain, regrets because of the bad decision to get the vasectomy in the first place, and angry and shocked at the doctor because he seemed uncaring and showed little compassion, and how quickly he turned the blame on something else other than the vasectomy or anything his doing.
    When I got home I went online to do research on pain after vasectomy. After spending hours reading many forums and websites I literally broke down and cried because there seemed to be no treatment, no solution to this pain. Many men reported the same pain I have: left testicle radiating to left thigh and it happened months after vasectomy. So did they too have a pinched nerve in their back? It sounded more to me my doctor had a well rehearsed answer to all his patients coming in complaining about similar pain after vasectomy. And from what I read, men have tried almost everything from reversal to smoking cannabis and all with little success of getting rid of the pain. a few stated that life was stolen from them. it is the best description of what I am going thru. I can’t play with my kids like I used to. the pain consumes my thoughts. I can’t contribute around the house in anyway. I can’t work. my emotions are racing back and forth from anger to frustrations to regrets. my mental state is weak. my body is weak because the pain is draining my energy.
    Sorry for the long post. So could a pinched nerve be the cause? and is there treatment? thank you!

    1. Dear Tony, this is quite complicated. Several things can mimic post vasectomy pain: infections (ruled out), inguinal hernia (with trapped genital branch of genitofemoral or ilioinguinal nerves), neurogenic vasectomy pain. Most are inflammatory however. A good long course of antiinflammatories (6-8 weeks) is a great place to start. A visit to a urologist, maybe other than the vasectomist, might work. There are nerve blocks and things that can help you figure this out. Good idea to seek out good care though.

  37. I am having some sharp pains 3 weeks after my vasectomy on the right side in my groin. It’s not my testicle, but to the right of my penis above my scrotum. When sitting, it is not a problem, but when I stand up, the sharpness of the pain almost brings me to my knees. It’s only there for a second and then I have to adjust to walk without it happening over and over again. I have called my urologist and still waiting for a return call. It’s been a couple hours. Any ideas?

    1. Dear Adam, Gees, I am really a poor substitute for a ER visit!! Talk to your urologist or go to an ER or urgent care center if you are concerned. Twinges of pain 3 weeks after a vasectomy are quite common. They should resolve though.

  38. Is it just me or does there seem to be a lot of guys posting on here with problems after vasectomy from a procedure that is deemed simple and safe?

    1. Dear Peter. Here, here! I, like you, am amazed to see all of these postings!! Clearly, surgeon skill has something to do with patient outcomes here!~

  39. Had vasectomy on Tuesday was put under because first doctor couldn’t locate has on one side yo do office procedure. It’s Sunday and testicals are feeling very heavy. Like still tender.
    I now have lower back pain and some Pain on one side in my groin.
    Also a few episodes of cloudy urine.
    When I walk they ache. I feel like something else is wrong am I just over reacting. I thought I would be better in 3-5 days.
    Thoughts

    1. Dear Mark, everyone recovers differently from vasectomy. Although my patients typically take 2 or fewer pain pills after the procedure, they worry a lot for about 5-7 days. Gives things some more time.

  40. Question for Dr. Turek,
    I have experienced Post-Vasectomy pain (very debilitating) for nearly 4 years. 2 months ago, I had a vasectomy reversal, and the same pain (from before the reversal) is still there. How long should it take before I expect to see improvement in my symptoms? I understand it can take several months for sperm to return, so I’m assuming i should give it a few more months before I hope to see improvement? Is that accurate in your experience?
    Thanks

    1. Dear JP, post vasectomy pain is complicated. I find that if the pain is low level, “congestive,” achy discomfort after a vasectomy, then reversal tends to work relatively quickly. Of course, you would only expect the pain to be relieved if the sperm returned to the ejaculate. Taking testosterone replacement therapy for 6 mos or more can also relieve post-vasectomy congestion in my limited experience by “turning off” sperm production.

      1. Thank you for taking the time to respond, Dr. Turek. I’m grateful. I haven’t had an analysis yet. I was going to wait for 3 months post-reversal. I’ve been informed that it can take 3-6 months for sperm to “return” (I had bilateral vasovasostomy). I’m still holding on to hope that the reversal was successful and that the pain will start to abate after 3 months or more (I’ve heard some men say they found relief at the 9 month mark). As I said, it’s been a 4 year struggle, but I did have a “window” of at least 9 months were I was entirely pain free. This last “round” lasted a solid year, and was so unbearable that my urologist felt surgical intervention was clinically indicated. Again…I’m hopeful that in a few months I’ll start to see relief. I’m going to ask for a requisition for an analysis next week (2.5 months post-reversal).
        My Sincere Thanks,
        JP

  41. First, thanks for this forum, it is greatly appreciated. I had my vasectomy about 7 months ago now (non-scalpel). It took me about 5 weeks before going back to my normal activities, which is longer than usual. After I was probably 95% back to normal for 3 weeks until I got some pain (almost like a seizure every 30-40 seconds) on the left side. I went to the ER and they told me I had an infection related to a granuloma and some scarred tissues (mostly left side to my understanding at the time). It was confirmed through an ultrasound. They gave me some antibiotics. I saw my urologist/vasectomist about a week after for a check up. At the time, he told me about the granuloma, but was surprised it took almost 2 months to declare. He said to give it some time and to see him in 3 month time. With some ups and downs, things generally improved, but with the right side (pea size lump, probably growing sometime on the right side while the left side almost disappeared ). It’s like it will become inflamed for a couple days/weeks at the time During those periods, it’s is sometime painful just to walk and make any effort. During those 3 months I was able to go back very slowly to stationary biking, but not else much. I’m practising karate (or used too…), and I haven’t returned since the ER event. After the 3 months, my specialist told me by a physical exam that he wasn’t finding anything anormal, by pressing the zone where the vasectomy was done. On my side, it was a pretty good day that day and I felt like when you go with your car to the garage and everything seems normal as soon as your there… He told me that it should improve with time and use a scrotum support more often. Things were getting a bit better for the next 2 weeks and until it seems that I pushed a bit too hard on the stationary bike. Since that episode, it seems that I went back where I was a few months ago, with problems to walk or just standing, with this pain around where the vasectomy was done. It’s mostly on the inflamed right side, but also a bit on the left. Ibuprofens don’t to help much. Sometime, the pain is also felt in the inner thigh and the abdomen (spermatic cords?). I’m seeing my specialist in July, but I’m afraid he will tell me just to wait another 3 months. My quality of life has suffered a lot since the beginning of this unfortunate adventure. I have two young kids (1 and 4) and it is difficult to play with them, put them in the car and changing diapers because of the pain. Right now, I cannot do any sports except painfully walking. I’m getting a bit desperate that I’m going to be stuck with that for the rest of my life. Is there another alternative then time at this point? I forgot to mention that during the vasectomy, my specialist was training a student (she did one side). It seemed they were having some difficulties during the surgery. I will never know if my problem are related to that. Sorry for the long message and thanks in advance for your advice. Stephane

    1. Dear Stephane, I am sorry about all of the pain and hassle that you have been through after a vasectomy. It appears that you may have had inflammatory granulomas form afterwards which can cause waxing and waning pain. This appears to have resolved but the pain hasn’t. This could represent post-vasectomy congestive pain. I agree that you should see your specialist but make sure you mention the significant quality of impact this issue is having on your life.

  42. Dear Dr. Turek,
    I have an unusual situation. My husband had a vasectomy 13 years ago with no problems and no pain. He has had two episodes in the last 2 years with one happening as I type. It starts out with a dull ache and comes on sudden. His left testicle is tender and it hurts more while sitting. This episode as we speak has been going on for a week. He went to an urgent care tonight and they did an ultrasound to find nothing wrong. They mentioned epididymis and gave him an antibiotic levaquin. Warm soaks help a little bit it comes back. He has been living on Advil for the past week and he never takes medicine. What could be going on after all this time since his vasectomy in 2004? Thanks.

    1. Dear Melissa, this sounds like a classic epididymal “blowout” in which sperm escape under pressure from vasectomy from the epididymis and is “seen” by the immune system, which reacts violently to seeing it. Typically, it is self limited and resolves with time. Ibuprofen 600 mg 2 to 3x daily can be a big help. I do not find that antibiotics help at all. It typically does not happen twice on the same side.

  43. Hi there!
    I had a vasectomy over a year and a half ago and I have had various levels of pains ever since. I have now seen two specialists including one that is trained to do microsurgical denervation. I have had a local lidocaine 2% 5cc injection but I don’t feel it did much to help.
    I have been on amitriptyline 25mg hs for about 6 months and it seems to have brought my pain from a 6-8/10 to a 2-4/10. I have been trying gabapentin 300mg BID for a couple weeks now but it hasn’t really done much for my pain but I’m not ready to quit that just yet as I am slowly titrating my dose up.
    My pain seems to be a rarer type of PVPS whereas my pain is initiated by testicular manipulation but projects mostly to the lower abdomen with a prominence on the left side.
    I have tried NSAIDS during the first year or so of my condition but it didnt really help. I tried a 1 month course of ciprofloxacin 500mg BID but that didn’t help either.
    I use a custom pain cream with bupivacaine, amitriptyline, gabapentin and diclofenac and it does help as a PRN pain relief method. I apply it to the scrotum along the spermatic cord usually and the bupivacaine “burning” sensation feels like relief. It however does not last more than an hour or two and takes 15-30 min to kick in.
    My pain is triggered by sex where the scrotum gets physical contacts but not by ejaculation or erection. Exercise will trigger the pain also which has caused me to gain weight and lose physical health. It has decreased my libido significantly. Having intercourse a couple days in a row is about the best it gets when the pain is at its lowest.
    The specialists i have seen are not really giving me any more help and they let me know there’s nothing else they can do to help beside prescribing neuropathic pain meds.
    I’ve seen some stuff on microsurgical denervation for pelvic pain but I’m not sure this is appropriate.
    I’m not depressed and I’m a young healthy successful guy.
    I’m a pharmacist by trade and I’m not quite ready to accept that I will have chronic pain for the rest of my life.
    I’m trying to find a doctor who has some experience with a case like mine.

    1. Forgot to say.
      ultrasound showed nothing
      no palpable granulomas
      left cord feels a little thick.
      urinalysis showed nothing… unsure what they actually checked though
      Initial post vasectomy recovery was a few weeks long and I heavily iced and took it easy. NSAIDS were used too.
      During surgery, the left side took longer to do. I believe the vasectomy was cauterized.
      I have had hematospermia a few times off and on (4 times) and it is characterized usually by a bit of a different pain in scrotum which feels like a pinch inside.
      I’m researching studies but I’m stumped.

      1. Dear Matt, In my algorithm of care for post vasectomy pain, this sounds like congestion, in the absence of palpable inflammation. You might ask your doctors whether a reversal could help with the pain, as you have tried pretty much EVERYTHING else.

  44. Hello Dr. Turek,
    I am currently 10 months post vasectomy. In the last 4 months I have had 3 separate incidents of testicular
    pain, always near my left testicle. The first incident, my urologist prescribed antibiotics. The second incident, resolved itself with NSAIDs. Right now, I am having the same pain/problem and I have begun NSAID treatment.
    When these incidents happen, they usually start as a dull ache and progressively hurt more day by day. They especially hurt when I have an erection and are the most painful when nearing ejaculation. Is a reversal the best option to end these disruptive bouts of pain and discomfort? Thank you for your reply.

    1. Dear Omar, intermittent pain after vasectomy could be any number of things, many of which are not related to the vasectomy. Left sided pain could be a varicocele, hernia, hip issues, adductor muscle problems, ejaculatory duct obstruction or prostatitis. There could also be intermittent inflammation from the vasectomy which should pass. Although I love doing vasectomy reversals, it may not solve the problem. Reversals work best for “congestive” pain after vasectomy which is typically low grade, “pressure-like” and not exacerbated by much.

  45. Hey doctor 3 years ago I had my vasectomy and about a week ago after intercourse I started feeling pain on the right side in the back of my testicle and it’s very sensitive and I’m not sure if it’ll go away on its own or what to do thanks any advice will help

    1. Dear Brandan, Peritesticular pain 3 years after a vasectomy could be epididymitis from blowout, inflammatory granuloma or something more serious. I would see your vasectomist for a good exam and ultrasound if necessary.

  46. My husband had a vasectomy 7 weeks ago and has suffered from groin issues every since, especially with physical exertion. Now he has to see a PVPS specialist because he has nerve issues high up in his groin. Two ultrasounds have been done and have found nothing relating to hernias or other ailments.
    How can there be nerve issues so far up in his groin when the incision wasn’t anywhere near here? I think its related to his spermatic cord.

    1. Dear Concerned, goin pain after vasectomy can be due to hematoma (blood) in the cord, a granuloma of the vas (inflammation) and even inflammation of the entire vas (vasitis). Nerve damage during the procedure is possible too. Pain in the testis area can “refer” north to the groin.

      1. What if there is no testicular pain? There is no issue with pain in his testicles or penis. No issues with congestion or swelling of epis. Is it still possible to have nerve related issues in the groin without those ailments?
        We are getting no help from anyone we have seen.

  47. Dr.
    Cautery and clipped testicle end 9 days ago.
    Felt fine at 7 days and had sex without pain. Sex again at 9 days post op. Now with achey left scrotum. Feels achy from epididymis through vas. I have a desk job and couldn’t have worked today. I’m going to talk with my doc but I’m feeling really stupid for not waiting two weeks to have sex as I was instructed. Right now I’m back to ice and using Motrin around the clock and slowly getting more comfortable. I’m just worried that I made a big mistake. Is there anything u can tell me that is reassuring?

    1. Dear Bradallen, Don’t rush to any long term conclusions about the vasectomy…you just had it. I typically recommend sex as soon as men are comfortable again, typically 4-7 days after the procedure. Agree with letting your doctor know and ice and motrin. Should clear up.

  48. Dr. Turek,
    I have a question for you! I had a vasectomy sept 21st. I ended up with a hematoma on the right testicle. And after about 2 weeks all healed and I have been fine mid oct all through nov and 1st week of dec. last week around the 8th of dec I am having a aching pain in my right testicle and really feels like a dull full ache feeling. I don’t feel anything when examining and no pain in peeing or ejaculating! The pain doesn’t seem to get worse or better just an all day ache like ( blue balls feeling ). No swelling !!! What could I be experiencing??
    Pain level is 4/10 maybe 5/10

    1. Dear Ben, Sounds like a resolved hematoma on the right with new pain after 2 mos or so. This could be inflammation or congestion. Antiinflammatories will treat inflammation but not congestion but its a little early on in the process for congestive type discomfort.

  49. I’m glad to come accross this post, since I’m wondering something. I had a scalpel vasectomy by my urologist about 3 weeks ago. Did everything I was told to for the aftercare. Now I have a really swollen left testicle, its hard like a baseball and very tender. I went to my doctor twice. He checked it and says I’m oke….the swollen testicle (inflammation he says) will go back to normal in 3 months, and pain will subside in 6 weeks. He told me not to apply ice anymore, and to take acetaminophen for the pain. However, the skin is kinda itchy since it seems stretched and wearing supportive underwear make it feel like something is burning. The scrotal skin (on the left side) is very sensitive. I have to lie down on bed all day, unable to work. What is something I can do, and how can I make the swelling go away faster since I usually apply ice to everything that is swollen? I also read somewhere that potassium citrate helps reducing the pain. Any suggestion?

    1. Dear Lionel, Having a painful swollen testicle after vasectomy could be due to either sperm spillage/inflammation or blood/hematoma. It could also be an infection brewing under the skin. Given that you are in enough pain that you are bedridden, your doctor really needs to know about this!! OR your primary care doctor. A scrotal ultrasound is not unheard of in this situation and may help hone the diagnosis. No advice about pain management here without a in office visit!!

  50. Dr t,
    I had my vasectomy 5-6 weeks ago. It wasn’t “no scalpel” and lower vas was clipped. I felt great for first five days and required no pain meds. I had sex with wife on day 6-7 and then again on day 8. Folllowing that I had bad pain (mostly left sided) and resumed wearing a jock, icing, max dose ibuprofen and Tylenol and abstinence. I saw my urologist and he didn’t think the exam was abnormal and didn’t think I had granuloma. I am following up next week but since that episode I have cycled to feeling better but not back to normal followed by recurrent left Scrotal pain. I resumed sex and running at about three week point and had a sharp left sided pain. My pain was exacerbated again and ebbed over ensuing week with rest ice and meds. Then I had sex and the same thing happened again. The pain seems near epididymis with caveat that it is hard to localize. I am back to being abstinent.
    1. Assuming I had epididymis blow out, how long do u tell your patients to abstain?
    2. Does blowout sometimes require steroids?
    3. If I end up requiring reversal vs epididymectomy are those better done at a referral center vs community urologist?
    I like and trust my doc and am seeing him again next week. I just want to have appropriate questions as I’m starting to worry that I will end up with chronic pain which has so har had a significant effect on my life. I can’t take max dose pain meds forever and need to stay active as avid runner etc

    1. Dear Ben, you are a precise in your description of your history. It is likely a story of inflammation and healing and not a “blowout” or “granuloma” or “congestion.” Blowout pain is like surgical pain, it comes and goes away. Congestion is a low level discomfort thats sort of always there. To help with inflammation, steroidal antiinflammatories can be considered at this point but certainly NSAIDs are encouraged. This should pass.

    1. Dear Krunal. If this pain you’re having has occurred after a vasectomy, please call your vasectomist and review with them! I would be happy to see you as a patient if you need it.

  51. Thank you, this article was very informative and easily explained. I had my vasectomy a few years ago with no issues. However, every now and then I experience slight pain and swelling. Common sense has always had me wondering of a “backing up of the plumbing” theory. I think the section on ‘congestive pain’ explains it. I don’t know if it is a low or high snip but the pain does subside within a week or so. The high snip makes good sense but I’m not sure if my doctor subscribed to this. Too late now but if I was doing it all over I would have asked these specific questions. Funny how it is hard to get good answers before you sign up… :/

  52. Dr. Turek,
    First of all this site is amazing and a great resource.
    I had a traditional scalpel vasectomy 1.5 months ago. No sutures, left open. Had the normal aching, but was good to go after 2-3 days. However I noticed both incision points were heavily dimpled in and seem connected to the spermatic cord. I called the general surgeon who performed the vasectomy and he told me to massage the incision area to try and free it from the scrotum. I did this but it only cause the incisions to open and bleed. Now 1.5 months later, I feel 100% but the incision points are still dimpled and obviously anchored to the cord inside. If I lightly pull up at the incision the testicle rises as well. Should I be concerned about this?

    1. Dear Jason, it might be that the vasal ends are “tethered” to the skin. This will likely continue and is of no consequence as long as it is comfortable. It can be “taken” down under local anesthesia and restored to native position if needed.

  53. Hello, I have a no scalpel vasectomy coming up on feb 1. After reading posts on this forum, I am wondering if it a good idea since I already experience discomfort and pain in my testicules after 3 – 4 days without ejaculation. It has always been that way. Would cutting and blocking my vas cause eternal congestion and pain?

    1. Dear Indostic, I tend to shy away from doing vasectomies on men with genital pain of any cause. I try to treat the pain that exists first before doing the vasectomy. You should definitely talk with your vasectomist about this!

      1. I talked to him, he says it’s congestive epididymitis. He says that the body usually has a surprising way to adapt itself and in most men, after a few months there is a balance between what the testicules produce and what the epididymes remove. He also said I could do an open end with sheath interposition with one of his collegue but that this méthod tends to leave less mobility in the sheath and some discomfort. This leaves me even more confused.
        Also what is male disfigurement? Is it a figure of speech meaning that the pain is in the head or is it a real physical condition?
        Lastly, are there nervs and muscles in the vas? Does cutting those tubes leave us with pain and reduced orgasm sensation or is it a myth?
        Thank you!

        1. Dear Indostic, Congestive epididymitis is a rare event longterm after vasectomy but is more common immediately after for the reasons your surgeon explained to you. I use “disfigurement” in a theoretical way to suggest “bother” from a condition. Typically, the sensation of orgasm/climax is generated in the brain and not in the genitals.

  54. Hello Dr. Turek,
    I had a traditional vasectomy with bilateral incisions. my vas-deferens was pulled out through those incisions and an air-gap was created and it involved cautery and lot’s of sutures (my reversal surgeon said the amount was overkill as sometimes the vas can die and break off with the level I had). I developed excruciating pain on the left and still have pain to this day. The reversal I had at least was able to help with the level 8-9 pain I would get at night with nocturnal erections. On the left the incision was high up and close to the base of my penis. That’s where I sill have a lot of pain. It’s neurogenic/neuropathic pain. Stinging, burning, stabbing etc.. I wish I had an inline procedure but there is nothing I can do about it now. I am 10 years post vasectomy and 5 years post reversal. I was wondering if you had any recommendations on what I might try to “fix” the remaining issue I have.
    Thanks,
    Mike

    1. Dear Mike O, I would suggest an office visit to evaluate this chronic pain. Maybe its unrelated tot he vasectomy! Sports or inguinal hernia, varicoceles, epididymitis can act just like this.

  55. Dr. Turek,
    First off I have read a ton of this thread and want to thank you for alleviating most of my concerns with the “Big V’ procedure. I had a smooth go of it (yesterday)until the clinic grew nervous about A-fib that they detected. I spent the rest of the day in the ER of U of M getting checked out. Horrible day of recovery…at least today my wife made me chillax. Anyway I feel fairly well in the scrot, but I have slight pain in a “V pattern” in the lower ab region. Possibly like a hernia feeling. I never had one, but its what I imagine a very small one may feel like. Is the unheard of? It has been 32 hours post op. Thank you, Doc.

    1. Dear T.J. Sounds like a ROUGH day after your procedure. Also sounds like you might be having typically post-procedure discomfort. Give yourself a chance to heal!!

  56. Hello Dr. Turek. I had a no scalpel vasectomy in August 2017. No recovery issues and everything had been fine up until 3 weeks ago. I had pre ejaculation and sudden pain out of no where. Next week, pre ejaculation again and the pain during ejaculation came again though not as intense. Since then my wife and I have had sex a few other times and while I haven’t had any more pre ejaculation issues, the pain is still there. It slowly intensifies as I near ejaculation and then it seems to go away. It seems to be occurring on the left side where I had the procedure done. I haven’t noticed any lumps or swelling. I’ve started taking 600 mg of ibuprofen, but I’m not sure what could be causing the pain. It is making me not want to have sex anymore which defeats the purpose of a vasectomy. Of note, the weekend before the first event I had been moving flagstone in my yard. I didn’t feel as though pulled or strained anything though.

    1. Dear Pem, I would advise that you get checked out by the vasectomist who did the procedure as your issue may not be related to the vasectomy at all!

  57. I had a vasectomy 10 days ago, and on the right side I have what feels like a “tube” (sitting behind the right testicle) swollen and sensitive to the touch. No increased pain with ejaculations or exercise (occasionally when I sit up or pick up the kids I can feel it). The pain is bearable as long as no contact is being made with that area. Is this normal, will it resolve itself, and what does a timeline look like?

    1. Dear Steven, having discomfort within several weeks of a vasectomy procedure is relatively normal and not generally a cause of concern. If it persists however, a visit with your vasectomist may be in order. Inflammation and congestion can do this.

    2. Hi. I’m having this exact same thing 7 days after vas. I have an appt a few days from now, but I’m wondering how this turned out for you. Thank you.

  58. Hey Dr. I had a vasectomy 4 yrs ago and was told during the procedure that it was a difficult one because of lack of room in my scrotum. I had a very tough time recovering from it, and still have issues to this day. During sex I have pain in my testicles if they get touched at the slightest and sometimes ejaculation feels like a razor blade coming out. I am currently laying in bed because of the excruciating pain in my groin region. I have had this pain atleast 3 times a year since vasectomy. I have spent almost a whole yr on antibiotics that I feel did nothing but the 2 Drs I saw were sure I had an infection. I have had prostate checked various times thinking it was the cause and nothing ever shows up there either. I am not sure what to do now, just seems like the pain is very extreme for 3 or 4 days and it slowly goes away but never completely. Any suggestions you may have are greatly appreciated!!!!!

    1. Dear Brian, I am sorry that you are having pain with sex after the vasectomy. The episodic nature of the pain reminds me more of inflammatory than congestive pain. Antibiotics don’t really help with inflammation unless there is an infection (i.e. bacteria) present which is highly unlikely after a vasectomy. Antiinflammatories may be a better choice but this recommendation depends on the findings on physical exam and a thorough evaluation.

  59. Dr Turek,
    I’m reaching out because it appears that you are generous with your knowledge and like to help people find some relief. I have my vasectomy 2 weeks ago today. I am currently feeling a pain In the left side that is hard to describe. At times it seems to shoot up into my abdomen but for the most part stays in my groin area near my inner hip. It is not really tender to touch but it is notice. Also I get a pulling feeling in the left testicle if I move my penis to the right side. All other pain has seemed to subside and this pain is usually worse later in the day. Could it be nerve related or just slow healing. The person who did the op was a general surgeon not a urologist. I didn’t know this until after but he has years of experience, he did my father’s before I was born. Please help give me some direction.

    1. Dear Josh, having residual pain in the scrotum two weeks after a vasectomy could be within the range of normal. Please talk with your vasectomist to see what he thinks. Often this is inflammation. Since its on the left side, do you know whether you also have a varicocele?

  60. Hi Dr. Turek,
    I think it is great you trying to help so many like this.
    I had my vasectomy a little over 2 years ago. Recovery was more or less ok with no issues. However, 10 days ago I developed an ache in my left testicle that radiated pain into my lower pelvic region. There seems to be a hard area just behind the testicle.
    Now, the ache in the testicle has mostly gone, but the pelvic ache remains. The pain does not intensify with ejaculation or urination, etc.
    Could this be a blowout or granuloma? Should I just keep taking ibuprofen and be patient?

    1. Dear Gary, I would definitely consider a visit with your vasectomist on this one as it sounds like inflammatory pain either granuloma or epididymitis.

      1. Hi, follow up to this. I saw the urologist in April and he found nothing on physical exam. I left and pain was more or less gone for a while. About 3 or 4 days ago, it has come back, but only in my pelvic region. On the left side about 3-5 cm up and left from the base of the penis. No testicular pain, swelling, lumps, etc. Walking seems to agitate it a little, but not much else does, really. Could this be congestive pain or something else entirely? I have a another appointment, but it is a month away.

  61. I had a vasectomy about 4 months ago. Things have been fine up to about 2 weeks ago. I have pretty bad pain, only when having sex in the left test. It’s bad enough at tunes that I need to stop, but only happens during sex. I can actually feel a pee sized bump right where the pain is located. It’s really starting to take a toll on my sex life.

    1. Dear Mark, Great observations here: pain with sex only, bump near pain. This could be either inflammation due to granuloma or congestion. The physical exam by your vasectomist can distinguish these two in a flash.

  62. I am 5 weeks post-vasectomy and have mild congestive pain originating in the epididymis. Some days it’s on the right, other days the left. Sometime both sides. Should I expect this to go away on it own? What type of time frame is reasonable for it to resolve itself? I’m beginning to worry because I still cannot go to the gym or do physical activity.

    1. Dear George, At 5 weeks after the procedure, scrotal pain after vasectomy can be either congestive or inflammatory, and possibly even surgical. Time helps. An examination by your vasectomist could help even more.

      1. Let me thank you ahead of time for reading my post. Like George, I am approximately 5 weeks post op. I have very subtle tenderness along my right testicle and it feels like neuralgia all the way up to my bladder. No visible bruising, redness, swelling, or discharge. I called and spoke with the nurse at the office where I had my Vasectomy and based on my description, she said this is most likely due to the titanium clips used on the vas deferen and that it should resolve itself in 6-8 weeks post op. Is this legit?
        I am grateful that I am not in near as much pain as some on this thread, but needed your opinion. So at the top of the scrotum where it attaches beneath urethra, it feels like 2 small, virtually identical pea sized lumps. What would I be feeling there. No pain at all when I touch these “nodules”. Pain can range from a 1-3 out of 10 and it’s more tender after I run or after sex…then it alleviates itself. So is time what I need to give to this situation or is there anything legitimately better that can bring resolution? Based on what I’m reading it seems that most people have some kind of pain or discomfort of some kind for about 2 months post op? THANK YOU KINDLY FOR YOUR RESPONSE SIR.

        1. Dear Matt, I really don’t think that many (if any!) of my vasectomy patients have pain at 5 weeks~ And, I use surgical clips routinely but have never ascribed postoperative pain to them. Based on my blog it is either post-surgical pain or inflammatory pain. Consider contacting your vasectomist again and asking what they might suggest that you do for either of these types of discomfort.

          1. Thank you Dr. Turek! I will have to check with my vasectomist as you stated… in the meantime (just to be proactive) what would you do if your patient had what you mentioned “post surgical pain or inflammatory pain?” It’s mild/barely even qualifies as pain, but I’m fairly certain that most men are not content feeling any undesirable setbacks post vasectomy!
            Should this resolve itself? Thank you so much for your response.

          2. Please forgive the rating I clicked on accident. It show’s -1 I don’t know what that means?? Nothing you have posted is “negative” anything just for the record

  63. I think your patience is amazing in answering all the questions. I had a vasectomy 2 months ago -the recovery went well – but about 3 days ago, i sat on a chair and I felt a tasing sudden pain from my testicle surging through my lower right abdomen. The pain is constant, and gets really worse if i try to walk. It fel like a pinch nerve – what i need to do to alleviate these symptoms ?

    1. Dear Jamy, this sounds like a post-traumatic pain.. maybe when you sat your testicle changed position a bit. Typically minor testis injuries resolve pretty quickly. See you doctor if it doesn’t resolve.

  64. Dr. Turek,
    Hi, I had a vasectomy (no-scalpel, open ended) almost 2 years ago and had been doing great with no issues. My issues began about a month ago when I noticed soreness in my left testicle during sex.  The past couple weeks I now feel soreness and burning/tingling in my left testicle all the time. Doctor examined me and diagnosed Epididymitis, it was painful to touch.  He prescribed a course of antibiotics, but I am near the end of the course and no change.  It feels like constant aching pressure on that side, kind of like ‘blue balls’,  and tingling going down my leg.
    He said if it doesn’t get better to get an ultrasound. 
    If this is due to congestion of sperm, I am concerned about my Epididymis bursting.  The side with the problem is the higher and smaller testicle, so perhaps the other side just has more space.  
    Although I had an open ended vasectomy, I read that the vas tubes may close on their own after the vasectomy.  
    Should I be concerned about my Epididymis bursting? And if so take some sort of preventative action? Or will these issues generally go away on their own?
    Thanks, Andrew

    1. Dear Andrew, Hard to give care over the intranet, but getting care for this is a good idea. Consider that it may also be inflammation and not infection and ask the doctor about antiinflammatories instead of antibiotics.

  65. My husband is scheduled for a vasectomy on Friday, and after reading these comments I’m absolutely terrified that I’m encouraging him to do something that will permanently have a negative impact on his life!!! Are these issues rare? Because they don’t seem like it!!! What questions should we be asking? We had the consultation today and I didn’t realize this was a possibility until now!!

    1. Dear Scared (for the family jewels). I tried to list the rates of the different kinds of pain in the blog. Most are <1%. But that's in my practice. Now that you are more educated about what's possible, it might be a good time to circle back and talk with the vasectomist about their procedure's particular side effect profile.

  66. Dear Dr. Turek
    Hoping you can shine show wisdom my confusing and worrisome issue. Been 3 months since vasectomy, no issues during recovery. Roughly a month post vasectomy started to feel a dull pain in my left testicle, feels like the pain in behind the testicle or along the left side, looks like left testie is hanging lower than right but it isn’t swollen. Pain is constant like a 2/3 out of 10 all day and more so feel it in the morning when waking up, also pain hasn’t gotten worse or better overtime nor is it worse during intercourse. I did 1st ultrasound when i started feeling the pain and showed nothing: epdididymis was normal left and right testis roughly same size and no variococele. I left it and decided to give it some time hoping the pain will go away. Decided to see Urologist around 3 months mark and he did physical examine and stated a granuloma and watchful time and advil is course of action. I decided to do a 2nd ultrasound and this time it stated left epididiymis is enlarged suggesting epididymitis. Trying a course of antibiotics, scrotal support, advils, warm baths regiment but pain persists. Am confused because urologist says granuloma, 1st ultrasound showed nothing 2nd ultrasound says enlarged epididymis (wouldn’t of it shown the granuloma as well?) and current treatment isn’t helping. Hoping you could shed some wisdom on my situation and what can i do to help with the pain. Could this be a case of congestive pain instead of epididymitis? or is it indeed a granuloma casing the pain? How much time should i give this before i look at surgical intervention? and is a vastecomy reversal my best option here?
    Looking forward to your response
    Nick

    1. Dear Nick. I like the way you are thinking this through. The time frame for inflammation (epididymitis or granuloma) is typically the first several months after the procedure. Congestive pain may coexist but would be little early to call. Antiinflammatory treatment is the treatment of choice, often for 1-2 months. After about 6 months, congestive pain is more likely.

      1. Thanks Dr. Turek for the feedback, i just started my 1st week of meloxicam hoping this will help… fingers crossed. Should i consider a 1 – 2 month course of this? What do you typically suggest to your patients. Also what are you thoughts on daily dose of papaya seed powder? Started to take that as well in conjuction to mobicox. Wonder if i should stick to just the mobicox for now in hope that it’s just inflammation. Appreciate the insight.
        Thanks
        Nick

  67. Dr. Turek – Thank you for this great resource. I had a vasectomy on March 13th, 2018, and about 7 days later developed a walnut sized hard mass on both sides at the vasectomy site. The incisions were near the base of my penis so I assume it was a high vasectomy. These shrunk over the next month to acorn size, and then pea size, but have intermittently grown back to acorn size, and on one occasion walnut size. I’m not more than 2 months post vasectomy and they continue to remain present. I have also been having inguinal nerve pain accompanying this. It comes and goes, but it usually there. Two ultrasounds have shown nothing but bilateral varicocele. Surgeon says he thought they were hematoma when I first saw him after the procedure. Could these be hematoma or granuloma that are simply not showing up on ultrasound? My best guess from your post is granulmoa but wonder what you thoughts are. I’m hoping it is not PVPS. Thank you for any help you can provide

    1. Dear Mark, good investigative work. Hematomas typically occur early on after vasectomy and resolve and do not return. Varicoceles can become engorged at the end of a long day standing but are not “masses” as you describe. Granulomas are a likely diagnosis here and should resolve with time and the use of nonsteroidal antiinflammatories.

  68. I have had pain for 13 years despite converting to open ended 11 years ago and a reversal 9 years ago. Is there hope for relief?

    1. Dear Buz, I have NO idea whether your 13 years of pain is curable! Chronic pain is a different beast than acute pain. I could tell you more with a full history and physical exam though. If its congestive pain after vasectomy, then yes it can be relieved. In fact if it is almost any kind of anatomical pain (hernia, varicocele, inflammatory, congestive) then we can usually help. It’s time to treat this!!

  69. Dr. Turek,
    I had my vasectomy back in dec. 2017, it has been close to 9 months now, and I have been in pain ever since. It is a dull, achy pain that is bilateral, and rides up to the groin/abdominal area, but more severe on the right side. Dr. said I had a sperm granuloma on the right side, there is a squishy mass right on the right testicle, and is painful when touched or have pressure applied. So not too sure if this is a granuloma, or inflamed epididymis. Pain when having sex, depending on the position, once again a pressure feeling. I went back to the urologist, and he said to just “chew on some ibuprofens”. Not the typical response I was looking for. Went to see another urologists, and they said sperm granuloma as well. It definitely is a pressure sensation/pain, and am seriously considering a vas-reversal. One Dr. talked about performing a spermatic chord block, and if that worked we would consider spermatic chord removal. I do have a history of pelvic floor dysfunction, and that flared up ever since the vas. So any new surgery completely scares me, and makes me wonder if a reversal will either give help to this pain, or cause new issues for me. Just looking to pick your brain, and see what you would recommend. Considering vas reversals are not covered by insurances, sucks, because they are quite expensive, and don’t want to waste the money if they are not gonna fix the problem.

    1. Dear Mike, with pain and a mass, an inflammatory granuloma sounds like a distinct possibility. Nonsteroidal or even steroidal anti-inflammatories are a reasonable first choice. Reversal is also possible.

  70. Dear Dr Turek,
    Pain behind (posterior to) right testicle (only), commencing 1 full week after vasectomy, and distinctly different from any post-surgical discomfort/healing. No sexual activity attempted, nor any exercise post-op. Pain is constant, ‘nasty’ (not sharp/cut-like) in nature – and can be made especially acute by pressing the testicle inward. (No pain sensation at all on left side.) Same or worse over last few days. Am now slightly less than 2wks post-op. Symptomatically, is seemingly most consistent with epididymis pain, of the kind that many report chronically (i.e., ‘congestive epididymitis’). Localized to this posterior of testicle (i.e., presumably the epididymis). Not intermittent. No obvious swelling or abnormal morphology or systemic symptoms. Motrin, supportive underwear (slightly worsens, given mild inward pressure it applies), as prescribed upon disclosure of the foregoing, is without effect. Concerned, as anyone would be with prognosis of a chronic pain condition and its effects. So – can congestive epididymitis occur so soon (if so, can/should anything be done rather promptly to improve long-term outcome)? And, if not, what could reasonably explain the onset of the above specific symptom, with that timing – and is there a surgical remedy if it is not resolved (that has a very high likelihood of success in this ambiguous setting)?? I used to be, but am no longer, local (other coast). Mid-30s. Many thanks for your consideration.

    1. Dear Mike, your concern is palpable! I cannot provide medical care over the world wide web, but this seems more like inflammation so so after the procedure, rather than congestion.

  71. Hi there,
    I don’t know if you’re still responding to these comments, but I’ve found these posts really helpful in identifying what’s going on with my boys.
    I had a no-scalpel vasectomy 3 and a half weeks ago. After 2 weeks, the pain was starting to go away, and I started to get back to normality. Now a week later, I have a dull pain (more of a discomfort) in my lower abdomen, and groin. The testicles themselves don’t hurt much aside from some increased pain on the left side, above the testicle (I assume at the site of the cut vas deferens). There is slight, but not major swelling around this area, but no hard lump.
    Is there any significance to it seeming to always be worse on the left side? Anecdotally, every time I read something similar to my experience, it tends to be the left side.
    Can I expect this to subside? It’s not debilitating, but I couldn’t go for a run, or play too rough with my kids.

    1. Dear James, at 3 weeks out from a vasectomy, you are still in the operative time period so swelling and inflammation may play a role. Consult with your doctor whether you should take antiinflammatories or not. Blips of discomfort can be common at this point, but they should be tapering off to unnoticeable.

      1. Hi there,
        I wanted to update this to give people some reassurance of a positive outcome. It’s now a couple of months on and I have no pain whatsoever. I get extremely mild and infrequent “twinges” on the left side, enough that I know something’s different, but truthfully not painful at all.
        I was pretty down and anxious about this when all I seemed to find online were horror stories of life long pain so I wanted to say that although mine took a few months to sort itself out, I’m pain free and 100% happy with my decision.
        Thanks
        James

  72. Thank you for all of this information! It is surprisingly difficult to find information about the possible complications of vasectomies online. I am in a slightly different situation – my husband had a vasectomy reversal in April of 2018. He had the typical recovery pain, that slowly subsided. However, he has still been in pain for months, the best he can describe it is as “the worst blue balls I’ve ever had.” He said that often times it is due to being aroused and not being able to finish, so the traditional idea of blue balls, but that sometimes it seems to happen for no reason. He said the pain gets so bad that it affects his decision making. One time recently we went out to dinner and he talked about how he could feel it in his abdomen as well, almost like bad constipation, couple with the testicular pain. The pain is intermittent, not constant, so we don’t think it is an infection of any kind. What could this possibly be? My initial thoughts were that it might be something where his body is now producing way more sperm because the flood gates have been opened, and his body is still trying to figure out how to regulate how much to produce, and there is a backup which is causing the pain. He is trying to get an appointment to see a urologist, but with Kaiser, it becomes increasingly difficult to get an appointment with a specialist. I will do anything to help him relieve his pain, I feel terrible that he is in constant pain because of something I insisted that he do.

    1. Dear Courtney, Post vasectomy reversal pain in the absence of pain after the vasectomy is very unusual. It could represent ongoing inflammation or leaking. What is his sperm count? If it is zero then he has an ongoing blockage. I agree with seeing a urologist to make a better diagnosis. Be happy to see him if you can’t get in in a reasonable time!

      1. Dear Dr. Turek,
        He had his sperm count checked about 5 weeks after the procedure, and I don’t know the exact number, but we were told they were within normal limits.

  73. Hi Dr. Turek,
    I am 3 weeks post-vasectomy. It’s actually my second vasectomy as I first had it done in 2012 and then had a reversal in 2017. The expected swelling, bruising and general discomfort pretty much disappeared about 10 days after this most recent procedure. There were no issues with sexual activity the first 2-3 times. However, last night i in the context of sexual activity there was a sense of “pulling” in my right groin area and within a few seconds a relatively intense pressure in the area of my pubic bone (radiating from the right groin area across the pubic bone area from right to left). It made me flinch so I took a breather. After getting started again it happened again. It dissipated rather quickly but left behind a lingering dull aching sensation in my right groin area (in between the middle of the public bone and my right groin). There is absolutely no pain or weird sensations in the scrotum or in relation to the testicles themselves. I should note that during the vasectomy (at the very beginning) I felt a similar type of sharp pressure+pain in the area of the pubic bone; but last night’s experience was not as intense.
    I appreciate your feedback.
    Thanks.

    1. Dear Dennis, that sounds intense and the kind of pain that you don’t want at that time. Could be anything or nothing, consider contacting your vasectomist if it continues however.

  74. Hello and thank you for your website! I had a vasectomy 3.5 weeks ago. I have lost feeling during ejaculation and my left testicle and surrounding area feels slightly numb. If I touch my scrotum with cold fingers it don’t really feel it much like on my right side. Is it possible to have nerve damage from the procedure? Is anything connected to the Vas that could have been damaged and resulted in numbness and loss of feeling during orgasm?

    1. Dear Jordi, This HIGHLY unusual after vasectomy. I would give it some time. Maybe its discomfort that’s driving things.

    2. Hi Jordi: Welcome aboard. I had the exact same symptoms when I had my vasectomy 1.5 years ago. The condition is permanent. You are going to be told by every doctor you see: (1) it will go away, (2) it is all in your head, (3) it is medically impossible, (4) I have never heard of this before. However, if you google orgasm and vasectomy and ignore the websites that are sponsored by urologists, then you will find the truth. I am going to have a reversal in the next few months. Hopefully, that will work. Ben.

  75. Dr Turek,
    First off, I’m sure on behave of everyone, thank you for providing this forum.
    As I understand it, sperm is produced in the testes and migrate to the epididymides for storage and maturation. Sexual arousal produces a contraction of the epididymis pushing sperm into the vas. Would decreasing sperm production via hot baths, hot tubs, heating pads, TRT, anabolic steroids etc. help to decrease the likelihood of epididymitis and granulomas?

    1. Dear Matt, Nice thought process! Yes, by decreasing sperm production and “pressure” in the system, it might relief both congestive discomfort as well as granulomas and epididymitis. I have used testosterone supplementation for precisely this purpose and it has served me and patients well as a way to reduce pain but keep the vasectomy.

  76. Hi Dr Turek,
    Thanks for this resource and for taking the time to answer all of these questions! I had a vasectomy (transect vas deferens, tie both ends, cauterise both ends and tissue placed in between) seven weeks ago. The first few days post surgery things seemed to be going well, but after a week I started to experience a persistent dull aching pain in the testes that radiates into the groin, accompanied by swelling of the epididymis which feels thick and hard. This condition has persisted for the last seven weeks, varying in degree, but always there, and is interfering with work, sleep, and sex – there is sometimes additional pain with erection and ejaculation.
    I have been on pregabalin (75mg mornings and 150mg nights) but still top this up with other painkillers, and despite all this experience pain pretty constantly.
    Do you think there is a chance that this condition will still resolve itself naturally over time? I am considering a reversal as I can’t keep going indefinitely in this pain and discomfort.
    Thanks for any advice you can give!

    1. Dear Luke, pain and swelling 6 weeks after a vasectomy is either bleeding (gets black and blue, unusual), infection (gets red and usually there’s a fever) or simply inflammation. You might consider adding an antiinflammatory to your regimen.

  77. Hi Dr,
    I am at 2.5 weeks post op.
    As of now i feel a small knot on both sides. about 1/4 inch on both sides of penis and above testies. The left knot is sensative to touch and seems to feel larger when i lay down. If i move my penis to the right with an erection it hurts maybe 4 out of 10 and also my left testicle gets tighter then my right. Do you think this is granuloma or the Vas knot?
    Also i have some minor abdominal pain that is pretty constant,mostly left side as well.
    Appreciate your thoughts and opinion.
    Thanks,
    Mike

    1. Dear Mike, being only 2.5 weeks after your procedure,it could be any of the above and it could also change dramatically and resolve quickly. If you are concerned, please see your vasectomist!

  78. Hi Dr Turek – I am almost 7 months post vasectomy. Around month 5 I experienced a large swelling of both epididymis, and new onset pain. The first wave of this subsided over about 10 days and I was left with a dull ache in the testicles that varied in intensity. Then a few weeks later the epi swelled again, and the same cycle occurred. Now I’m on my third bout of swelling. I am hopeful that the epididymitis will eventually stop happening as you note above, but I worry about the deep ache. That sounds like the congestion you describe, for which you made it sound like reversal is the only hope. Is there little chance that this will resolve on its own? I have the ache on both sides. My vasectomy was relatively low because I have a tight scrotum.

    1. Dear JC, “Bouts”of pain and swelling in the scrotum occurring months after a vasectomy sound a lot like epididymitis and not simply congestive pain (no swelling, low level waxing and waning pain). Aggressive antiinflammatory treatment may be needed. Testosterone replacement to “shut down” the system may also be effective. Love to help.

  79. Thank you in advance for the time to review these questions. I am 6 weeks post vasectomy and I have an issue that I can’t seem to find any one has had. I had sex with my wife 3 to 4 days after the surgery and my penis seemed to ( its difficult to describe ) have a musle twitch going between hard to extra hard before ejaculating. Eversince this happened when I am at full erection I have a pain in the tip of the penis like have strained something. I called the office where I had the procedure and the nurse said she had never heard of this and if it contnues to come back in. Any thoughts as to what I have done to myself?

  80. Thank you for answering our questions here! I had a vasectomy back in January. The healing process seemed pretty normal for the most part, but I’m still experiencing intermittent pain in the testicles. It kind of comes and goes, but seems to possibly be triggered by ejaculation. It doesn’t hurt during ejaculation, but the testicles get tender several hours later, which is quite annoying. I’ve been taking 600mg of ibuprofen fairly regularly and it helps some. Any advice?

    1. Dear Eric, this could still be normal, since your vasectomy is < 3 mos old. Given that much of early discomfort after vasectomy is inflammatory, I like the idea of antiinflammatories.

  81. Hello,
    I had a vasectomy about eight years ago (no scalpel) and occasionally experience some pain in my vas. Usually only one in particular and on the left side. Upon self examination I usually find (like today) that at a certain point in my vas (i believe its where the disconnection was made) there is a little sore ball of swollen tissue. Even very light touching hurts and I usually have to be careful while this pain persists walking, sitting, or leaning into anything. I notice this time that I did have intercourse just last night. I’m wondering if this could be one of the conditions you laid out? Any ideas?

    1. Dear Scott, Good observation and self detection! soreness in combination with a “little sore ball” is typically inflammation due to granuloma. It generally responds to antiinflammatory medication. Kind of suggests that the vasectomy is leaky…

  82. Hi, doctor. I got unlucky. Double hematoma. Both small (less than a centimeter each) but painful. Ultrasound was “as good as can be expected,” my urologist says. It’s been almost a month since the snip and I’m still in constant pain and getting extremely depressed. I’m taking advil/aleve, wearing super supportive underwear, working from bed and using a heating pad and sometimes ice.

    Is there anything — any activity, any supplement, literally anything — I can do to make this issue resolve faster or provide more relief? Even if merely anecdotally helpful? (Was considering using my red light therapy board, which is purportedly good for wound healing unsure if that would help or hurt in this case). Thanks in advance for considering my question

    1. Dear PrivateJ Not sure whether this is hematoma or granuloma. Hematomas should resolve pretty quickly with pain subsiding. Granulomas can take longer, especially if things are still “leaking.” Steroidal antiinflammatories, much stronger than NSAIDs is a reasonable next step. I have been toying with the idea of using hyperbaric oxygen treatments to help the pain and healing in cases of granuloma.

  83. Hi Doctor,
    I’m only 5 days removed from my vasectomy,but I am very worried. Not only are my testicles very bruised (which I assume is normal) I also have noticed bruising on and slightly above the shaft of my penis. There is also a pretty prominent pain in that area….nowhere near my incision site. I don’t feel any bumps at this time. But the pain is definitely noticeable, especially when walking or seated in certain positions. Any ideas/advice?

    1. Dear Justin, Perfect issues to raise with your vasectomies! Send a picture to them and ask if things are OK.

  84. Hi Doc,
    I’m 9 years out from my vasectomy. About four weeks ago, I started to get an uncomfortable feeling, resembling the need to urinate/defecate, that was not going away. I was worried about my prostate, so I visited the doctor and had xrays and labs to verify my bowels, urine, and blood (PSA) were all good (all was normal). The pain persists, though, and is getting a little worse. It is a light throb about every 20-30 seconds right at the base of my penis, between the testicles and anus. It’s also just slightly uncomfortable urinating, as if there is a small blockage. Erections are similarly uncomfortable, but I have no issues ejaculating. I have no other symptoms – no fever, no blood, no other discomfort. I’ve inspected my testicles and felt no tender spots or any knots of hard tissue around the testes. Also, pressing into the base of the penis does not seem to trigger any pain.

    I’m curious to know if you think this might be related to my vasectomy or something else.

  85. Can anyone provide insight? My husband is 8 days post-vasectomy. He followed doctors orders regarding ice and rest to a T. Visually, everything appears to be healing well, no swelling, bruising getting better. However,
    last night he got a sudden sharp pain in his scrotum that he said came on and then left quickly. More rest and ice, and he was feeling better this morning – until the same thing happened again. He describes the sensation as being low or “underneath” his scrotum, though the incision site is place high. Help? We are both very worried.

    1. Dear Jane, please contact his vasectomist if possible. This is likely not permanent but part of the healing process.

  86. Doc, I’d love your thoughts on my issue. Vasectomy 1/24/19 (urologist said he cauterized and used clips) and I had no pain for the first day. Severe pain (10/10) only on right side beginning the morning after the procedure. Pain has improved somewhat (most improvement was slowly over the first four weeks) but it is still present today. No swelling and totally normal ultrasound. Urologist does not feel any granuloma and says epi feels normal. Two courses of antibiotics and still ongoing pain just on right side. Probably a constant 2-3/10. I’m beginning to feel hopeless. Any ideas? Could a clip be rubbing a nerve?

    1. I should add, the left (non painful) side was cut up high, almost in the center. The painful said was cut down low on right side. Also, ejaculation has no impact on my pain level.

    2. Dear Andy, pain within 1-3 mos after vasectomy is typically not surgical but more likely to be either inflammatory (granuloma or sperm spillage), epididymitis, or possibly congestion. Please say in touch with your vasectomist or give us a shout.

      1. Dr. Turek, I want your opinion (as a follow up from my post in June) if possible. I have some good weeks with pain on right side (low vasectomy side) at 1/10. But then I have intermittent periods (weeks at a time) of aching, significant pain at about 4-5/10. This pain began the day post-vasectomy and while the periods of minimal pain have increased, I am 10 months post-procedure and still having significant discomfort 50% of the time. The other side has always been great.
        Does this sound like congestion to you? My ultasound and physical exams have always been totally normal.

  87. Dr. Turek,
    I have read in the posts above alot of different situations regarding results of a vasectomy. Here is my problem which is two fold: Its been two months since my procedure and my left testicle is slowly but surely getting larger. I mean it now hangs down a full inch below the right one within the scrotum. That is odd to me. What is going on? They were virtually twins in size before the procedure.
    Secondly, (And this makes my wife happy,me, not so much) It takes between 15 and 20 minutes of action before I ejaculate and when I do, instead of feeling “Zowee, WHOOPEE!!!!”, I feel, “yay, go me.” Its like I have Orajel on my nerves that feel those sensations. Honestly, I’ve gotten so tired, I just stopped during sex. And that is both depressing and humiliating. Any help is greatly appreciated.

    1. Dear David, absolutely LOVE the description you give regarding the change! Sorry, I digress. A larger testicle could mean the development of a hydrocele after a vasectomy. A scrotal ultrasound can make this diagnosis. Not sure about the delayed ejaculation issue… contact your vasectomist or give us a shout.

  88. Hi Doctor,
    My husband had a V on a Monday. He masterbated on that Wednesday. He was doing ok on Saturday so we had sex. Now he is in a fair amount of pain. He was even told not to have sex for 2 weeks. Can you explain why it is not a good idea to ejaculate withing those 2 weeks, and why the pain is still there, because one has ejacuated, before he had time to heal? Thank you for you help in advance.

    1. Dear Rae, I usually recommend that men have sex (protected of course) as soon as they are comfortable. Usually they start at about 5-7 days. Please consult your vasectomist to see whether there is inflammation or swelling still going on. I’d be happy to see you too!

  89. HI Dr Turek,
    I have had a vasectomy with the scalpal method i.e. two cuts on either side, near the base of the shaft. When I got it done, it took around 2 weeks or so until I was about 70% back to normal.
    After two weeks, my living situation changed and once or twice a week, I would be required to walk up and down stairs a lot. I would notice that each time I exerted myself in this way, I would feel some pain or strain in the testes and in the area just above my groin (lower, lower abdomen).
    So for the next 2 – 3 months, I was continuing to be in mild pain but I was noticing that the pain was getting worse each time I needed to walk up and down the stairs. During the other times, I was pretty much resting but I noticed the pain building up.
    Now, 3 months after the surgery, I have decided to give myself a real resting period to try and get back to normal again. The pain in mostly centred around my lower abdomen and now, it is to the point where I can feel the pain just by standing up or if I sit down on a chair that is not so comfortable, I will also feel pain.
    I went to my urologist and he said that this was most likely muscle pain but Im not so sure. It definitely feels like its connected to the vasectomy region beacuse I can also feel referral pain (not the main pain) in my genital area as well.
    I am looking into acupuncture at the moment but I would appreciate any other help or advice.
    Many thanks
    Marty

    1. Dear Marty, This could represent vasectomy related inflammation or granuloma or congestion. Sounds like its definitely related to the procedure. If you want my help consider a visit. I can take it from here.

      1. Thanks very much for your response. I am planning on doing some natural therapies here in Malaysia for the next few months and then hopefully I can heal this area of my body 🙂 Thanks again for your quick response!

  90. Hi Dr. Turek,
    Thank you for taking the time to answer questions. I am two weeks out from a vasectomy. Things went well, but I have developed a dull, constant ache on both sides. No sharp pains. It feels like pressure. NSAIDs tend to help, but the ache comes back. I am concerned it may be due to congestion (even though this may be early). How effective are hot baths at reducing the congestion? What is the mechanism for the relief? I have read sperm production is reduced by heat, but is epididymis permeability also affected? I would like to keep the vas, but if it means dealing with long term aches then count me out.

    1. Dear Matt, typically discomfort 2 weeks out from a vasectomy is not reason to change your plan. Keep in touch with your vasectomist and hang in there!

  91. This is my second vasectomy. My first was a breeze until 5 1/2 years later and my wife became pregnant . Going into this one i thought i knew what to expect. Last friday 6/28 during my vasectomy while the dr was doing the left side if felt as if he tore something. Even with all the pain shots to the area it was enough for me to come off of the table with the sudden pain. He brushed it off and finished the process around 12pm. I came home and followed procedure with ice, naprox, and tylenon. I was hurting worse than the first time but it continued to get worse until about 5:30 pm i decided to go to the er. As i was trying to get off the couch there was a pop on the left side in the same area of where the majority of the pain was coming from. By the time i arrived about 20 minutes later i was in excruciating pain mainly on that left side. It was so bad i could not walk and felt as if i was going to be sick with the pain. There was swelling to the left at the base of my penis in the abdomen where it meets the ball sack and the left testicle. They did ultra sound and of course it showed bleeding but finally decided to send me home at 1am. I had bruising and swelling from my waist to my thighs and all the way back to my butthole. Now its been 9 days and almost all the that swelling is gone with the exception of that extremely sensitive knot at the left base of the penis in the abdomen area and my left testicle is swollen approximately 100mm long and 50 mm wide. What is wrong with me?

    1. Dear Kenny, probably NOTHING is wrong with you. Given that you did not similarly bleed after the first vasectomy, it is highly unlikely that you have a bleeding disorder. Sounds like you had 2 vasectomies with 2 complications: procedural failure after the first and bleeding and hematoma after the second!

  92. I am on day 11 of recovery of the no scalple method. Honesty, I had very little pain post op. The skin has healed, I am walking around no problem. I figured I am not completely healed yet because even with no pain have two things happening still. I feel like no matter what I wear or what position I am in I can’t get comfortable. It’s not painful but it’s hard to describe. The other symptom I am having is that between the scrotum and anus I feel like I pulled something. I have had a similar groin injury in the past from playing sports. That feeling has been pretty constant since the procedure. That might be normal but again, not alot of pain but discomfort.

    1. Dear Vincent, Gees, give your self a chance to recover!! Its been less than two weeks. Keep in touch with your vasectomist if this persists.

      1. OK, thank you. I just didn’t know if that pulled groin feeling was normal or not. My doctor said no restrictions after 7 days so maybe my expectations were out of whack. Will give an update later.

  93. Hello,My husband has had two vasectomies, one in February 2017 and the second in April 2018. He has suffered from testicular pain ever since April 2018 when he had the second one. The pain comes and goes with some days being worse than others, but the pain upon ejaculation is always present, and it is always pretty severe, approximately a seven or eight on a 1 to 10 scale. His surgeon/urologist does not appear to have any suggestions for us, other than ice and ibuprofen. At 17 months out, those just aren’t cutting it anymore. We are searching for a more permanent solution to being pain-free. This is severely impacting the quality of our sexual relationship for both of us. Any help would be appreciated.

    1. Dear Wendy, this is unfortunate that your hubby needed two vasectomies to get the job done (I assume). Given that he is over 1 year out from the procedure, it sounds like he may have either inflammatory pain or congestive pain. I have remedies for both. Give us a shout!

  94. Hi Doctor, I had the scalpel version of the vasectomy done two weeks ago. During the procedure the left side was incredibly painful whenever the Doctor cauterized the area – it felt like being shocked and happened maybe 10 times. I mentioned it to him during the procedure and he said this might be due to the nerves proximity to the vas, said they was no reason for alarm and proceeded to give me more local, which did nothing. The right side was pain free. The left side where I was getting nerve pain during the procedure is taking a lot longer to heal, but seems to be coming along. My partner and I have been having gentle sex one to two times a day for the past week, – including masturbation – and so far there is no pain besides just soreness that is subsiding each day and has been nonexistent the past few times, however I’ve noticed very profoundly that my penis sensitivity is less than before, and most noticeably my orgasms are nothing like what they used to be. My ejaculate seems about the same in volume, etc, but the climax itself is way off. The build up is same as before, but the climactic orgasm is barely there, maybe 10% of what it was before. Could there be some nerve damage that just needs to heal? If so, does it self-correct? After doing some searching online, I’ve found personal experiences talking about the same thing, which started to freak me out since many accounts cited a permanent. Any input would be greatly appreciated. Thank you for your time.

    1. Dear Geoff, Sounds like a very, very uncomfortable procedure! But since it is only 2 weeks out from the ordeal and that penis sensitivity is typically unrelated to a vasectomy, I would wait and see..

  95. My vasectomy was on June 28th (one center incision with a scalpel). The urologist struggled with some bleeding on my left side but otherwise the operation seemed to go smoothly. The first day was not too bad, but for the following week I was in a great deal of pain and was completely bedridden. During that entire time I noticed that the incision was dimpled in and tethered internally (more on that in a moment). After the initial swelling subsided I had an almost golf ball sized hard mass above my left testicle and everything was unbearably tender. On July 4th I was diagnosed with a hematoma by a second urologist. At that same visit I also pointed out that the incision site appeared to be tethered to a firm cord/tube of about 1.5-2 mm of seemingly uniform thickness extending from directly behind the incision site back around into the tissue directly adjacent to my pelvis, slightly right of center (the hematoma is on the left). The tethering pulled the incision upward and inward toward the shaft of my penis, so much so that an obvious amount of excess scrotal skin above the incision folded over it. The doctor clipped the suture, which he said was about to dissolve anyway, but the tethering remained. He acknowledged the tube/cord was unusual and said it was likely scar tissue (from “burrowing to find the vas”) and that it would likely disappear gradually along with the hematoma. He recommended supportive underwear, hot baths, Ibuprofen, and assured me things would gradually improve. I’m pleased to say the hematoma is indeed gradually improving. The hard mass is much smaller and causes only a little discomfort. The tethering, on the other hand, has not changed at all. The tube/cord is virtually identical to how it was more than a month ago. Walking for any length of time is very uncomfortable because the tethering pulls and everything on the right side feels aggravated (not to mention sharp pain at the incision point if my scrotum moves too far in any one direction). Sitting is also uncomfortable. In fact, the only thing that stops the constant discomfort is ice. Today I went in for a visit with another urologist (I’ve been travelling out of state), who called in yet another urologist, and they both were puzzled by the tube/cord/tethering situation. They said the tube/cord is not likely the vas, but that it could be, or that it may be scar tissue. They also hypothesized that perhaps the suture had inadvertently gone through some unintended tissue and that the incision and that tissue had healed together. They recommended either waiting a month or two to see if it’s scar tissue that will slowly improve, or they recommended an operation to explore and hopefully disconnect whatever is tethered. Needless to say I’m a bit anxious about either option. What is the best next step?

    1. Dear Justin, Gees, so sorry for all of this mess! The vas needs to be pulled up into the midline to be treated and sometimes (rarely actually) it doesn’t fall back into place. Consider a procedure under IV sedation where the tethering is “taken down” and the vas returned to its rightful place on either side of the scrotum.

  96. I think it’s important for men to realize that a vasectomy is an unnecessary elective surgery. I underwent the procedure at the encouragement of my wife and have become a statistic. Most guys dont want to talk about the pain of having your testicles swell due to an epididymal blowout or having pain months after having the surgery and doctors who make money performing a 9 minute procedure most certainly will not discourage the practice. I say to any man considering the operation to save themselves the trouble of being a statistic. There is statistically a better chance of you having long term testicular pain after a vasectomy than of you winning money at a casino. Let that sink in before allowing someone to convince you to maim yourself.

  97. Dr. Turek,
    2.5 weeks ago I had a scalpel vaesectomy. Pain went away rather quickly. On day 5 I masturbated with no pain. However, about 2.5 weeks after surgery, over the past 3 days a mild pain has developed. I feel I have swollen very tender testicles. My entire pelvis area has a dull ache and sometimes feel pain near my anus and tingling on my upper legs. I often waddle when I walk to prevent my legs from brushing testicles I wear tight fitting underwear. The pain is currently manageable. Does this sound like recovery pain, or something more serious I should talk to my doctor about?

    1. Dear Arlo, you should certainly contact your vasectomist if this continues. Sounds like inflammation. Usually resolves.

  98. Hi Dr. Turek,
    I appreciate how much you follow and respond to posts on this thread. I’m about 4 weeks out from an no-scalpel vasectomy and I am still experiencing bothersome pain. Not much pain at rest, but the testicles are very tender, especially on the left side. Any slight bump or jiggle causes sharp pain. No swelling or redness. Pain seems to be worse for 24 hours after sex (but no increase pain during ejaculation or immediately after sex). Wearing a jock helps me get through the day. I went back to the doctor who performed the vasectomy and he was not much help. He did a brief exam, said everything looked normal, and just said “if it doesn’t get better you might have to have a reversal”, then sent me on my way. I’m not inclined to go back to him. My question is, at this point do I just need to be patient and let my body do its thing, or is it time to take action and see a new doctor?

    I’m in Phoenix and would happily make the trip out to LA to see you, but not sure if maybe I’m jumping the gun a bit. I’m still hopeful this will resolve in time, just not sure how long that is realistic and when I need to come in.

    1. Dear Chris C, having persistent, bothersome pain down there 4 weeks after a vasectomy is likely inflammation but could be congestion. Be happy to take care of you, as I find that many vasectomists don’t want to deal with men who have pain afterwards. Maybe worth the traipse to LA…

  99. Respected Dr. Turek,
    I would be happy to pick your brain on my vasectomy. I had the procedure done about 5 weeks ago and everything went smootlhy, the procedure itself and recovery wise. Starting 5 days post vasectomy however, I noticed an increase in my epidymis and it has definitely further increased in size. Right after ejaculation the increase is noticable the most and I can even feel a big lump in that area (low in the epydomis located at the cauda approximately), that goes down a bit but still stays. Althoug I do not feel pain, I am worried that at some point my epydimis might burst? I had an open ended vasectomy though. Can I expect my epidymis to reduce back to a more normal size over time? I am a bit concerned that my epidymis might get seriously damaged and leave me with pain further down the road due to some micro damage or what not. I am even considering a reversal (would very much like to keep the vasectomy though) if the epiymis does not size down eventually. Is the swelling due to inflammation or congestion? What would you suggest? Wait for a few months for the body to possibly adjust and level sperm production with sperm reabsorption? Thank you so much for taking the time doc, I highly appreciate you <3

    1. Dear Mike, after a vasectomy, the system has to adapt to a new you. This sounds normal. Check with your open-ended vasectomist regarding whether he/she thinks its normal.

  100. Dear Dr Turek. I am thoroughly amazed and appreciative at your dedication on this blog post. I had my vasectomy on February 28 2019 and suffered a post operative hematoma on the left side. This, like my urologist told me, resolved with time. I am now about 7 months s/p vasectomy and at the 6 month mark started to experience pain and swelling in the left side. I was promptly seen by my urologist who diagnosed with a late post operative infection. I was placed on Levaquin 500 Qd and noticed my symptoms abate over the next 2 weeks. On follow up his physical exam confirmed his initial impression. He advised that I take NSAIDS for any further discomfort and sent me on my way. This was about 2-3 weeks ago. Since then I have been experiencing a dull ache in the left testicle and burning sensation in the skin around the penis and scrotum. It comes and goes throughout the day. It has been improving, albeit slowly. I have been taking naproxen bid and for sleep Xanax, clonidine and Benadryl as this has been weighing on my mind. He told me that the side with the hematoma would always remain a bit larger. Please explain. My left testicle is still a bit tender. Reports say that acute epididymitis can have symptoms for as long as 6-8 weeks. Do you find this to be the case and do they typically resolve completely? Also do I at this point need to be considering anything else in the differential and also does all of this at all predispose me to PVPS? Will this ever return to normal? Why did these symptoms come on so late? Should I seek a second opinion? My surgeon reassured me that in his 30 years he has never had a patient who developed a hematoma go on the develop PVP. But I ask… are they even connected? What are the real risks of developing an even later (like 2-5 years post op) complication? Is this truly a rarity or is it something I should be concerned about? Any answers would help.

    1. Dear sam, this sounds like epididymitis and not a hematoma. NSAIDs are best. Keep in touch with your vasectomies. This too shall pass. Stop thinking about PVPS.

  101. Dear Dr Tarek,

    If you have time please could you look at my post on September 13 2019 and reply as I would really appreciate your opinion, you don’t have to post this but please can you help me? You may help Ben, Mike and others too. Personally I am happy to take the risk of a reversal despite there being only a slight chance of it returning back to normal but what other options are there?
    Thanks so much, ten years without any satisfaction is a long time.
    My wife will not support the reversal as she thinks it won’t work and I may end up worse than I am already am, you cant fault her logoic medically however personally I think it’s my own body and I should decide what is best for me.
    I would like a second opinion though!
    KInd regards
    Geoff

      1. Hi Dr Tarek,
        Thank you for your reply.
        I wonder if you could reread my original post please as I have no issues with me being sterile at all, this is why a got a vascetomy in the first place and nothing has changed in this respect at all. I don’t want any more children, however despite my wife’s protestations I am considering a reversal purely on the off chance that it might give me some semblance of my old life back in terms of achieving a proper orgasm as opposed to a sympathetc response that I have had for ten years now, basically faking it…. I don’t know what else to try, i do know there are others with the exact same symptons, maybe the vascetomy has caused nerve damage and there is no signal telling my brain that I have just released sperm, or perhaps the slight drop in volume has had a large Impact on me, or of course it is just physiological….so a reversal might help here too. Even a 10% chance of returning to normal would be worth a shot.
        Could the brain actually knows whether a lot (or in my case any) of sperm is released? If you have already come recently the sensation of orgasm is reduced, is this simply volume based or somthing more complex, could we have evolved to be more in tune with the amount of sperm that is released possibly? It makes sense to me to increase the chances of pregnancy if this were the case. If so nerve damage might be affecting more people than you think right?
        Appreciate there is a lot of conjecture and speculation here, and don’t want to waste your time… but at the end of the day my life has been ruined by this vasectomy and I need some help, please! Could we be a little more complex down there than we give ourselves credit for? You areally the expert and I would value your opinion.

        1. Dear Geoff, I have reversed vasectomies for altered orgasm issues after the vasectomy. And men have improved. Some men are really sensitive to the emission phase of ejaculation and the fact that the tubes aren’t pumping sperm through before ejaculation because of the vasectomy matters to some. I get it.

  102. Dr. Turek,
    Two years post-vasectomy without any problems, but seems (per ultrasound) I have developed a “small right varicocele and focally prominent and heterogeneous right epididymal tail…suspicious for acute and/or chronic epididymitis.” Given the nature of epididimytis after vasectomy is likely noninfectious. Do you recommend abstaining from sex/ejaculating if there is a flair? In your experience is there a relationship between ejaculation frequency and epididymitis rates?

    1. Dear Joshua, the finding of a prominent epididymal tail after a vasectomy implies new onset of inflammation. I would treat this medically and NOT curtail sex..what kind of solution is curtailing sex?!!?

  103. Dear Dr. Turek,
    I had a no-scalpel vasectomy last year. The procedure was successful. I was back on my run of the mill after a month. With the occasional manifestation of a dull pain in my lower right abdomen, like some pulling. This went away after 3 months. After 3 months of my NSV I have done a sperm count twice and both resulted negative for sperm. So I am now shooting blanks. My concern was, last week our toddler was sleeping with us on the same bed. He has this habit of raising his left feet up in the air and slamming it down the bed, he is doing this unconsciously while sleeping and doing it for several times until we make him some milk or calm him up. Unfortunately, I was on his left side. The next morning I felt some pain in my right testicle and in my lower right abdomen. My guess was he might have hit me in my family jewel and I did not notice or woke up. My questions are, how strong are these stitches in the Vas? Once these stitches are healed are the Vas totally closed and can they withstand some impact from other force maybe let say, an accident from sports? Or if someone by mistake yanks you up down there. Will the Vas opens up and leak? Do I have to worry, it took 2 days for the pain to go away. Do I I have to undergo a sperm count just to check if the Vas got damaged or something? Any study on the impact of Vasectomy when one play contact sports and they get hit in the testicles? What are the side effects or implications? Thank you.

  104. Wow OK!
    I really don’t know what to say apart from thank you SO MUCH for your time, your reply and quite simply, your belief in that I am not just making this all up. I don’t know how to say thank you enough.
    I wonder, and appreciate that this is may be quite rare in the scheme of things but just thinking of others now, and how many men may be suffering in silence here….just like a couple of guys above for example, but given its such a private issue is there anyway we can make this side effect more widely known to health professionals so they can provide better advice when people go back for help as this really have been life changing, I cannot explain the frustration enough. At the moment I feel like a dog who’s lost his wag to say the very least, I been extraordinarily unhappy for ten years now and pretty much resigned myself to the fact that i woukd be like this forever so if there is any chance of any improvement at all I will go for a reversal for sure. I did read about one other patient who had a reversal that helped, not 100% back and one person only with no way to contact him to confirm this was true or not etc so I was a sceptic.
    Again, thank you so much, not expecting a full recovery but I will post how it goes for anybody else with the same issues who may be reading this thread.

  105. I had a vasectomy about 4 weeks ago. At the incision site there is a lump and it almost feels like the vas was stitched in with the incision. Is this possible? No pain or discomfort.

    1. Dear Jim, certainly something you should show to your vasectomist! IF the vas is not properly delivered back into the scrotal bag after the procedure, it can tether up at the skin surface.

  106. Hi Dr. Turek. I am 3 days post no scalpel vasectomy, and I dont feel any incision pain but feel major discomfort from what I can only describe as having a refractile testicle. It is causing serious pain and pressure and I cannot get it to stay in the scrotum. Is this normal? I haven’t found anything related to this subject.

    1. Dear Derek, It is true that many testicles ride high immediately after vasectomy. That’s likely to be the cremaster muscle being stimulated from the procedure and swelling. Talk to your vasectomist and give it little more time.

  107. seems to me you Dr’s should be honest with men before you mutilate them, reading this there are more complications after the procedure than before, I am a victim and I am totally against vasectomy and what it stands for. Vasectomy has been to date the worsted and biggest regret, that changed my life. I WOULD never recommend the procedure. the pain is unreal. and trust me it is not at all in my head. Its further down than that.

    1. here I am Paul from the above email. I am sorry about my bluntness however a bit of background, I had the vasectomy 27 years again and have suffered pain for that length of time. yes it did alter my sex drive and have to say I can see why my wife never got pregnant as I also suffered from ED, I still have pain, as I live in New Zealand I was quoted $11500.00 for a reversal, something that my wife would not agree to, she had never heard the theory that my body my rights pretty selfish but kept reminding me that her body and her right. She is gone now Divorced, so I had a reversal done and had some relief and more volume of ejaculate. My question is I am not concerned about becoming fertile as I am now in my 60’s but I need some advice as to the right testicle it is shrinking and down to the size of a marble, and still in heaps of pain, by the way this right could not be reversed as it was to mutilated for the urologist to touch. My own Dr says I should just learn to live with it, the story of my life, is there any advise Dr Turek.

      1. Dear Paul, My that is some complicated story. I have been unable to reverse a vasectomy only 5 times in 2500 cases due to scar tissue or insufficient length of tubing to reconnect. So, this is an extremely rare occurrence. The small size and chronic pain in the right testicle implies that it could have compromised blood supply. You should not “learn to live with it” in my view.

  108. Dear Dr. Turek,
    I am scheduled to have my procedure in a couple of weeks. Similar to a lot of other people I was under the original impression this was a fairly simple procedure and you are back on your feet within days and pain free in less than 2 weeks. After reading through this I may be too optimistic on the pain-free in less than two weeks portion of this. I am scheduled for work to travel to South America 15 days post surgery. This trip will entail a lot walking and at times dragging around a suitcase. When I first planned this trip I thought this would be plenty of time to recoup. Now I am second guessing the timing and am wondering if I should reschedule or is that an appropriate amount of time for recovery? Thanks!

    1. Dear Brian, I typically let my vasectomy patients do whatever they want at 2 weeks, including travel abroad. BUT, ask your vasectomist what they think.

  109. Dear Dr. Turek,
    I had a vasectomy approx. 30 years ago – I have always had scrotal pain on both sides, which I attribute to the metal clips. It has always been very painful if touched at the right angle, jostled, etc… I would like to have the clips removed. Should this be a big deal. I am now 65.

    1. Dear William, Gees you are a patient man!! 30 yrs! I have been putting surgical clips in men for 2500 cases over 25+ years and have no seen this. Maybe there’s something else—like congestion. Get thee some care!

  110. It’s been almost 2 years since I’ve had the vasectomy and I wish I would’ve listen to my gut or balls Which ever one was telling me NO fn way man don’t do it!! Never been the same down there just discomfort some sharp pains here and there. Just pissed at myself for listening to my wife cause she wanted me to get it cause we have 2 kids and wanted to make sure we wouldn’t have anymore. The whole thing just didn’t seem right now I’m paying for it big time ! We might be the minority here with pain afterwards but its honestly not worth the gamble in my opinion !

  111. Dr. Turek, I want your opinion (as a follow up from my post in June) if possible. I have some good weeks with pain on right side (low vasectomy side) at 1/10. But then I have intermittent periods (weeks at a time) of aching, significant pain at about 4-5/10. This pain began the day post-vasectomy and while the periods of minimal pain have increased, I am 10 months post-procedure and still having significant discomfort 50% of the time. The other side has always been great.
    Does this sound like congestion to you? My ultasound and physical exams have always been totally normal.

    1. Dear Andy, Given that you still have pain and there is no evidence of inflammation (normal exam and ultrasound), this sounds a lot like congestion.

  112. Hello, I had a no-scalpel vasectomy performed on Friday, Nov. 22. My recovery has been smooth and everything is feeling very good aside from anticipated and minor soreness. I have been taking it easy and icing on and off. This morning, I felt good enough that I masturbated very gently. I had no pain or other issues immediately following, nor have I had any issues in the hours since. Now I’m feeling paranoid that there could be increased likelihood of recanalization or other failure. Is failure or recanalization a concern from ejaculating too soon after the procedure, or is the concern mainly of aggravating the incision and testicles?

  113. Hi I had a Vesectomy done over 3 years thru them years I have developed serious pain it has come to the point we’re if I ejaculate I get all the feeling and nothing may come out. I have also had to start taking a form of viagra tardenifel to help with blood flow and I am on nerve blocker this pain is serious and I have been told I have 4mml sist on one side and strain in the other after reading all this I still don’t feel that it is explained correctly by the surgeon before it I am in excrusating pain which results in me not being able to do my job a chef or much physical sport this includes sexual imtercourse I have to take gabapentin 600mg to block the nerve as I know with the damage its connected from a nerve in my testicles which is connected to the T12 of the spine we’re you ejaculation feeling starts I think a Vesectomy is the worst operation I have had for my physical state and especially mental health

  114. Hey Doc.

    I had a vasectomy just under 3 months ago.

    I had no issues, never even had to take my pain meds.

    About a week ago, I had fairly bad pain in my right testicle and it was a it swollen. I had been rough housing with my son, so I just wrote it off as that.

    The pain went away in a few days.

    Now, around a week later, the pain is back, but no swelling this time.

    From the best I can tell, the pain/tenderness is coming from my epididymis and the part of my testicle that is attached to it.

    Is this something I should be worried about?

    I plan on getting this checked out by my urologist but, in the meantime, the internet has me scared about all kinds of potential causes Haha.

    Any advise would be much appreciated.

    Thank you!

    1. Dear Jim, I would check with your urologist. It may be epididymitis but its typically not infectious and will resolve.

  115. I’m 4 weeks post no scalpel vasectomy (with cauterised ends) and wondering at what point I need to go back to the doctors to raise my concerns. In spite of the feeling of a lightning bolt going up my rectum when the left side was cauterised I was feeling quite chipper afterwards even getting back to action with my wife the next day. That was right up until six days post op when I developed pain in my testicles akin to being kicked in them… and it hasn’t stopped or subsided since. After much gentle palpation and examination I have established the following: I have what feels like a garden pea sized granuloma around the surgical site, which is healing slowly and shrinking gradually. It weeps serum quite a bit and is sore, but nothing to write home about. There is a strange fibrous mass leading away from it, which I have a query about, but it doesn’t hurt. I saw something about the vas getting caught up in the surgical site in a comment above, so wonder if there’s something like that going there, or maybe it’s just blood vessels nourishing the site. I have what I presume to be a petit-pois size granuloma on the left vas and a lentil size one on the right, which I’m guessing indicates where the “cut” was made, though I’m not entirely sure because there is no gap in the vas as described to me pre-op. These are about 1 inch from the testicles, so I’m thinking this was quite a low vasectomy. Neither hurt, so I’m not greatly bothered. The vas on both sides is about several times its normal size on the testicular side of these granulomas. The pain that concerns me is in the epididymes mostly eminating from the cusp of each testicle where I think it meets the epididymes. Now, that point is extremely sore. Like someone stuck a pin in it. The pain varies throughout the day. Mildest when I first wake up. I know its still early days, but would I be right in being concerned? Maybe the vasectomy was too low and I’ve already got congestion going on.

    1. Dear William, this is THE most graphic and illustrative depiction of early postop healing after a vasectomy I think I have ever heard! Give things some time, as inflammation is common early on after vasectomy.

  116. Interesting forum here. Many different observations and experiences. I figure I might as well share my own. I had the no scalpel done 8 months ago. Procedure and recovery an absolute walk in the park. However, I immediately noticed a slight loss of penile sensitivity – with or without erection. This has been the case ever since the procedure so it can’t be attributed to some unrelated health issue or aging. I have found that the process of getting to orgasm is a little less enjoyable because, due to the decrease in sensation, more speed and determination, if you will, is required. The reward of the climax, once it occurs, is as pleasant as it always was. So with the end result being the same, getting there is less fun and more work. As another described in an earlier post, it’s like wearing a very thin condom. Don’t get it wrong – my only regret about vasectomy is that I didn’t decide to have it done a little sooner in life and I won’t hesitate to recommend it to anyone. But, I must say that there is something lacking in the quality of the overall sexual experience now. Is it a major big deal? No. Must I disagree with all the literature out there that says sex and orgasm afterwards is “exactly the same”? Yes and no. Thankful to not be dealing with the issues that some others have shared on here and wish all the best of luck.

  117. Dr. Turek,
    Thank you for your time and dedication here! I had a nightmare vasectomy 8 months ago in April where I had a significant hematoma bleed by my left testicle. Entire Scrotum swelled up to a purple sized grapefruit within a few hours of the procedure. Black and blue all down my legs to a few inches above the knees, bruised scrotum, waist etc. the pain was unbelievable and especially when standing it brought tears to my eyes.

    I was told to “take it easy” and let it resorb naturally. I have had several ultrasounds which show healthy testicles and blood flows but the initial hematoma mass was about 6x6x6 cm connected to my left testicle. I’ve been battling just to get through each day for months and the mass is down to 1.5×1.5×1.5 cm now after 8 months. The mass is hard to the touch and has been the whole time…I’m thinking it will be gone in 2-3 more months but the pain has not gotten better.

    The hematoma is still painful and tender and my legs are in a lot of pain when standing. The pain radiates down both legs from the hematoma clot when I stand and my legs are constantly sore and achey which makes it hard for me to do anything on my feet. I can’t be active or play with my kids. All I can do is sit or lay…it’s been life changing and no meds have helped the pain sensation I have in scrotum and legs!

    I’ve seen several urologists who have discussed surgery to remove the mass, denervation or just more time to recover but I’m worried it’s not improving and nervous of another surgery after what I’ve been through. Nobody can figure out my leg issues and just say it’s “referred pain” etc.

    Please advise! I’m desperate for relief. Thanks!

  118. 37yo, 8 months post op, and still experiencing discomfort, pain, and tenderness. I believe it is congestive in nature. Is there anything I can do besides reversal?

  119. Dr Turek,
    not sure if you still follow this and respond but I had a vasectomy about 5 months ago. It went well, no issues no pain. What i have noticed now tho on my right testicle upper side where things were pinched off, its much more sensitive. Even still a dull ache and the tubing feels bigger than the other side. Almost as if its backed up or swollen. Is this something that should go away or something i should go in for?

    1. Dear Danny, Pain 5 mos after a vasectomy could be either inflammation or congestion. The fact that you cannot feel a mass (granuloma) but find that the tube feels bigger suggests congestion rather than inflammation. Congestion responds to time, vasectomy reversal and a new approach I am taking involved testosterone replacement. Give us a shout!

  120. Hello I had a vasectomy five days ago. Feeling pain a lot like “blue balls” and it seems like there’s a swollen hose or tube for a lack of a better word. Also there is a red spot on the skin where the pain is not near the incision site not sure if that related

    1. Dear Peter, sounds about right for the first week after vasectomy. Check in with your provider if you are worried.

  121. Hi Dr,

    I had a vasectomy about 2 years ago and now I am experiencing not pain but a ache in my right testicle. Won’t go away and ejaculating seems to make it ache more. It’s really more uncomfortable than anything but it almost put me down for the count one day.

    1. Dear Ray, pain two years out from a vasectomy may or may not be related to the vasectomy. Inflammation, epididymitis are two things that can occur after an infection. See your vasectomist to be sure.

  122. good day I had a vasectomy done 5years ago suddenly my testiculars are paining and numb sometimes what could the reason be for this feels like if I want to vomit if the pain starts

    1. Dear Corrie, acute pain 5 years after vasectomy usually suggests inflammation such as epididymitis. It is typically treated with nonsteroidal antiinflammatorie and not antibiotics and should resolve with time.

  123. Dr. Turek,
    I got my vasectomy 4 days ago, recovery is ok so far. It was with scalpel with one incision high up the scrotum.
    My concern is that i am a grower, and the incision site is higher than the base of my penis when erected. Which means the incision site will go a little inside the vagina during sexual relations. Should i be concerned ? I definitely don’t see myself having sex one week after the surgery…
    Thanks a lot for all !
    Nicolas

  124. Dear Dr. Turek,

    My Husband has a Vasectomy December 2019….. he says his orgasms aren’t as strong as they were before and sometimes he can’t tell if it happened or not… is this normal? Will it improve ?

    Thank you,
    A concerned Wife

    1. Dear Bhoward, I have had only a single patient among 2500 who had a persistent change in orgasm after a vasectomy. That means that it is possible but highly unlikely to be related or persist. Lets see what happens.

  125. Dr. Turk
    I have read most of the post regarding PVPS and it has been since 2007 for me. I have now and continue to have discomfort with a present granuloma about the size of a pea and constant pain since the procedure. I am a Vet and had the surgery while on active duty. I am told that there is nothing that can be done and given antibiotics which I clearly know will not work. The urologist suggest possible surgery but not sure of outcome even working. Is there anything that can be done or can this discomfort pain support the ICD -10 G89.28 Post procedural Pain in which the VA is denying. I really need help to resolve my discomfort and regret for having a scalpel procedure done.

    1. Dear Raoul, I have seen this in many men from around the world in my practice. Luckily, I have been able to “cure” virtually all men. However, this really requires an office visit with an examination to know what’s going on. Consider a single visit with us!

  126. Hey dr.
    I had my vesectomy 3 1/2 weeks ago and had a relatively good recovery. I was off work for 2 weeks and stayed away from intercourse for the same amount of time. (I did materbate after about 8 days)After 3 weeks I felt great and about 90% recovered so i decided to go back to work and have some sex with my wife. 4 days later I had sudden pain on the underside of my left testicle…. worse pain then my post surgery pain. I’ve read lots about the pea size bump around the vesectomy site and I have that indeed. What’s concerned me is that now on top of that my testicle is in some serious pain and feels very weird to the touch. Almost as if there is either part of the tube(whatever it’s called ) wrapped around my nut or a very sensitive growth. I’ve never noticed it or had problems with it until now. What’s your thought?

    1. Dear Cody, Bouts and twinges of pain early on after a vasectomy is not uncommon. Finding a pea-sized tender bump could mean inflammation or a granuloma. Consider a Virtual Visit if you want me to pursue this with you.

  127. Dear Dr.Turek,
    I’ve had a scalpel-less vasectomy 7 weeks ago (both ends closed) and I’ve had discomfort since. It was slowly improving, however for the last few weeks it’s been a pretty consistent dull ache on one side (3/10) that sometimes radiates into my abdomen (5/10). Occasionally, I have no discomfort. I didn’t notice anything increase when I palpated my testicles. Is this a normal part of healing or is there an issue? What can I do about it?
    I really appreciate your insight.
    Anderson.

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