Post Vasectomy Pain Forum

Pain from Granuloma? And other sperm granuloma questions


Has anyone had pain from a sperm granuloma? I had a vasectomy about 5 weeks ago and have been in pain since about day 4 or 5. There have been ups and downs and sometimes I feel fine and then other times I get a pain in the left groin near my testicle. I have also had pain that went all across my lower abdominal area and groin. At day 7 I went to the urologist that performed my vasectomy and he felt around down there and said I probably just had some inflammation in the spermatic cord and sometimes things get compressed causing issues. So he gave me Ibuprofen and sent me home. Day 9 I was feeling a lot better than I had been, but I was still having pain. So I felt down where the vas site was and I felt something like a small bundle of wires in a knot, so I freaked out. Called the urologist on call where I had my vas done and they said to continue with the high does of Ibuprofen and take some warm baths as they thought it could possibly be a sperm granuloma. Continued to take the medicine and then in a few days I still was anxious about the discomfort/pain (not as bad), but still enough that I felt I should call back. The nurse told me I just need to give it time and wait for my 6 week check-up.

I didn’t want to wait, so I decided to seek a second opinion. I went to a different urologist and had him examine me. He said that he felt a small granuloma, but he said that it should absorb over time, or not. He thought that the pain I was feeling was due to the granuloma rubbing against a nerve and compressing it. He also thought that the pain should go away over the next 4-6 weeks post vas. I am almost at the 6 week timeframe.

Has anyone else had any type of experience like this, with a granuloma causing pain? And if so, what was the pain like and did it get better.



Also, does anyone know if granulomas are hard or what they feel like compared to scar tissue. Also, does anyone know if they come back or get bigger if they reduce in size from anti-inflammatories?



I have a sperm granuloma. On my right side bottom of testicle. It changes in size. It always hurts but when it increases in size the pain is out of this world. Had it ultra sounded recently. Yes they are a hard mass. Not perfectly round. When they get really inflamed they can also have a fluid around it like a hydrocele. These are horrible and they shrink and then keep coming back. Of course they occur right in the epididymis which is the most sensitive place in a males body. Doctors down play these. They have no idea how much they hurt if they have never had one. I don’t know what proper treatment is for these. You have sperm leakage and body attacks it causing lump and inflammation. The cycle:After vas your epididymis pressures up then you have a blow out leaking sperm out then get granuloma (in your case it’s right from the operation)granuloma does its thing and then ma y shink down , pain going down a bit with it. Epididymis pressures up again and cycle continues. Pisses me off cause when you finally get to a urologist normally your at low point in this cycle and they just see a tiny lump and pay no attention then in 3days it gets to 3cm x3cm. With the worst pain on the planet. Hopefully yours disappears and never comes back. Cross those fingers. If you run into a Dr that treats yours properly let me know what he gives you. I have found (sounds weird) but antibiotics (Bactrim specifically ) does have a anti inflammatory effect on these. Ibuprofen also. I’m getting denervation done in 10 days. Can’t get both sides done at same time but plan to. Denervation should theoretically help with the pain. Vasectomy is a savage procedure. 18 years of pain now and counting .



Oh Ya. You asked what the pain is like. It hurts as if you have an infection.(the sperm are the foreign body) A very deep ache on the side it’s located. When mine was at its worst If I touched it it sent extra pain to inner and front thigh and also through inguinal canal to my right hip area.Couldnt sit as that put pressure on it. Very nasty. Got ultrasound done. Getting urologist to remove it or at least biopsy the thing when I get denervation done. That sums up what it feels like. If I didn’t know about PVP Id be positive it was Cancer.



Mine is pretty small, it seems to be about the size of a bb, but it is really hard and I think it is pushing up against the nerves. I feel it the most on the inside of my thigh though and sometimes in my testicle. It’s at the vas surgery site on mine. It’s never gotten much bigger than that, maybe a little bigger. I’m just hoping that mine didn’t get any nerves entrapped in it. I’m also wondering if it could be a hemoclip, rather than a granuloma, and the urologist put it on incorrectly. My wife was in the room for the procedure and she passed out while he was working on the side that is bothering me…I think I’m going to have an ultrasound done to see what exactly is going on, to be sure.



Should have read your post better. What I think your talking about is your typical vas knot. Yes that is what commonly causes pvp. It is the source of pain on my left. Size of a bb or a bit larger. I don’t think its a granuloma as all vasectomized guys have this but Ya the knot can be very painfull . Getting denervation done to try to deal with that pain. Unfortunately it can stay constantly painful. No fix for that. Get used to taking ibuprofen or your going to end up on gabapenten,Lyrica, cymbalta etc(nerve pain meds) I hope it settles down for you and you don’t have to go down that rough road. If it gets horrible Get on something as constant pain there will mess you up. Depression, tightening of the pelvic muscles etc will set in then . I’m there right now.



I have one as well.
And of course my urologist said that that was the issue as to why i have pain.
no it hasn’t gone away-pain or the granuloma.
And no, that isn’t the reason for the pain.

I have had numerous people look at the knot. Which yes, it feels like a knot. or lump. it hurts when i touch it or it’s messed with. And from what others say, they don’t go away Mine hasn’t and Im in year 2. So unless something magically happens, it’s there to stay.

Doctors don’t know what to really say is the problem. I am finding out they just don’t know what to say or do. Hence all the people who’ve had reversals with no success of pain relief. I think the major point of everything is is don’t go messing around with your junk!!!

I’ve had mine since the begining.



Can they get rid of the knot? Like cut it out? Is that not a possibility? I was on Amitriptyline, which I think was helping, but I wasn’t sure of the side effects of that.



Do they have any idea what causes the knot?



i was on amitryptaline too. there are some side effects to that stuff. i was wired for the three days i took it, didn’t sleep at all. although its supposed to make you sleepy. it didn’t help with pain either.

i have been told the knots will just go away. mine is the size of a marble and hasn’t gone down.

they say its a build up of sperm in the tubes that were cut. it can be due to pressure or due to the sperm not having anywhere to go. do they really know, who knows. given they don’t even admit to pvps, i highly doubt they even know. or in my case, even care.



It’s where that terminate the vas. It’s there for good unless you get a reversal. not claiming to know exactly what’s happening but I do have the knot on left (painful ) and have spermatocele on right (painful). Pretty similar.



Like I mentioned before. The (what I call it) knot is like you said where they terminated your vas. If you see a urologist and you don’t tell him you had a vas and they examine you he will say "so you had a vasectomy ". Because all vasectomized guys have it. Some have bad pain from it and some don’t. Haven’t talked to any guys that had a vasectomy that don’t get some kind of pain from there. Minor as it may be.
No way to get rid of it. Except reversal. “It’s part of the deal with the devil we made.” You can get a granuloma there as anywhere some semen has leaked out. The confirmed granuloma and the knot feel exactly the same texture wise. Without cutting my sack open and looking for myself this is what I know from my wonderful experience lol. Ibuprofen with be your friend for a long time if your feeling pain from it now. I hope it settles for you. Makes me sick seeing another guy starting this horrible journey.



Has your pain gotten progressively worse over the years or stayed pretty much the same? And when did it start? Right after your vasectomy, or did you have a period of time that you had no pain? My pain comes and goes, but right now it is a discomfort most of the time. I can’t imagine how you have dealt with pain in this area for 18 years. Did it limit your activities, such as moving heavy things or any physical activities?



I think now that my inflammation has gone down considerably my horn as I call it because it protrudes forward, I was thinking it was the upper vas but I believe it is the bottom part going into the epy(?) I guess which connects to the testie. @Rss your saying that the vas knot is where the clipped you even if it was cauterized? And that it’s entrapped sperm like in a bubble or scar tissue? Which has caused the knot, or is it scar tissues that is the knot?

I’m still trying to figure out what mine is. This horn now I feel protrudes out thru the chord I believe. It just doesn’t feel like they put it back in the right spot, because its in the front while my other one is sensitive too and is in the back.

@Uncomfortable small bundle of wires at least what I was told after my ultrasound is a Varocasele vein or veins ( I think I mentioned this to you in another post also I had one prior to my vas not a real bad one per say). My knot feels separate from the small bundle of wires as you put, or it is maybe pushing thru the chord and or viens. And has gone down in sensitivity but still can be really painful to touch and even light brushing.Is yours similar to this maybe or at least where your knot is? The red parts actually push forward enough to make my penis angle to the right.

Also @Rss does back up begin immediately from what you have been told or experienced? Like when you are first ejac trying to get number 15 or whatever. Is your epy still trying to make swimmers go and shoots them upward and onward towards the newly formed roadblock? Or does the body say WE have lots in the tube still lets use that first before we call upon the epy? So you had blockage actually in your epy. I’ve read if you have them on the outside it can be from your epy releasing them which is a blowout?



I’ll try to answer best I can. The knot on left same location as your drawing. Hurts like a bitch. It’s where they cauterized. Mine would be larger if it was clipped. Urologist I talked to says scar tissue.
Testes keep producing semen and pressures up vas and yes a blow out. Experienced this on my right side. I normally just complained about left sided pain. I started noticing pain increasing on right. Noticed epididymis on right to be swollen and tender to touch. The pain came and dissipated for quite some time. The left knot always hurts that doesn’t go away. On the right the pain got bad like really bad. That’s when I noticed sperm granuloma. Epididymis wasn’t so swollen but the lump grew to 3x3 cm in a week. Pain was like nothing I have experienced so far.Wanted to barf. Got ultrasound done. Good thing because it slowly got smaller and is now not nearly as painful but it is still there. You need proof because the Doctors don’t believe this shit is happening.Pains a 7 not a 10. In ultrasound they spoke of swollen and inflamed epididymis still. Granuloma was noted also with hydrocele. They shoulda seen it before blowout.
In reply to uncomfortable . This has affected every aspect of my life . Hard working guy doing well in life but couldnt work with pain anymore.Dont know how I did it for as long as I did.By end of day it was just to much. Off work and going for denervation in a week. My Dr is trying to talk urologist into doing both sides.
Hope that explained a little bit. Oh Ya. Varicocele. have a couple of those but they say they don’t cause this kind of pain. Sperm granuloma proved that to me.



Forgot. Yes it has gotten worse over the years. I think it’s more like the pain may have been this bad and then got a bit better then bad again. This condition just wears you down. So wanting help and nothing but road blocks and denial. They want to give you unlimited drugs but not admit what’s going on. I like getting proof (ultrasound when things are at its worst). It kinda piss’s them of but they realize something has to be done.



My knot is at the vas site I believe. It doesn’t seem very big, but it is similar to what you said. I think my testicle is twisted different then the one that doesn’t have a problem. I twisted it a little bit yesterday and it moved the stuff around and made it more comfortable for a time, but then it went back to how it was. I go back to my urologist on Wednesday though, so I will see at that time what he says. Have you been back to the urologist since your surgery? If so, have they given you any thoughts/ideas?



Are you saying that if you got the knot removed then it would come back bigger? Also, how do they do an ultrasound? Do they do it at the time of the doctor appointment? How does that work?



No my doctors is an ass hawai doc stuck in Ohio. Lol. Problem is everyone (Urologists at least the “good ones”) is in the same practice. I’m looking for someone who is separate from the Urology Group, because my Doc now will be like “OH that guy” you know? So my new doc will already have an idea in his head of what kind of patient I am.

I can kind of feel the knot on the right and yes like I think we discuss before, it’s set in the back while left sits in the front to the side. I am going to get a second opinion…



Order a book that explains a lot about these issues and how the testies produced sperm get a better understanding I’ll share if I find anything

1 Like