Post Vasectomy Pain Forum

Pain from Granuloma? And other sperm granuloma questions

You know it’s hard to scale. If you were a guy who had no pain there ever and woke up with it . The guy would freak out and go to hospital lol.
Can be at a very negligible one moment and then after some walking, sitting(putting pressure) , anything that stimulates nervous system negatively…stress, it I guess can get to a 8-9. It just does whatever it wants. Nerves are messed up. Hard to explain. When it’s fired up the pain radiates down inner thigh, front etc.
I had a blow out with sperm Granuloma on right which is still there but shrunk way down now. The pain from that was just plain scarey. Radiated into hip, down inner thigh etc. Wanted to vomit. Should’ve went to hospital. That was a 9.5.Have to save .5 for passing out lol. Was on hand and knees. Wall punching type pain.

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Has it always been like that, since the beginning?

It’s a cycle for the right granuloma. I just never realized what was going on. Pain there would calm down then get worse when things pressured up and then blow out. Then pain calmed down and so on. Very messed up.
The left knot is there to stay and just causes continuous nerve irritation. When left is hurting and I try to see where it’s coming from its coming from knot,(granuloma).

What is your pain level from the knot and has it gotten worse over time?

Hey, guys. I’m thankful I stumbled across this forum. After reading several of these posts, I don’t feel like I’m one in a million with my vasectomy issues.

I had my vasectomy performed in July of 2015. The procedure went smooth and didn’t have any immediate concerns. The Dr. said I can resume my normal workout routine on the 3rd day so I went for a short run. That was a mistake as my boys swelled up for a couple of days. I always noticed a routine deep pressure and dull pain in my right groin area. The pain would come and go and I just thought it would have to be something I’d learn to deal with.

About 6 months after my procedure, I noticed my knot at the vasectomy site. The knot was very tough and can be tender to the touch. My right testicle began to be very sensitive to the touch. My Dr. sent me a 1 year follow up survey asking about my experience. I answered them honestly and he responded right away and requested that I make a follow up appointment with him.

In September of 2016 I went to see my original Dr for an exam. During the exam he mentioned that I am likely dealing with a granuloma. He suggest I give it some time to see how I feel and if the symptoms get better. My situation did not get better so I had the same Dr. remove the ganuloma in October of 2016. The Dr did this free of charge as he does not want any of his patients in pain. After the removal, I was essentially back at square one. The pain was about the same as the initial vasectomy and I had to take it easy for a few days.

About 2 weeks after the procedure I noticed another hard lump at the same site. I notified the Dr and he suggested that we give it about 6 months and see what happens. 6 months later the lump is still present and so is the pain. I went back for another exam and he said I have yet another granuloma. He suggested we give it time and that another treatment would be a steroid injection.

I decided to seek a second opinion. During the exam the Dr agreed that it was likely a granuloma but he wanted to make sure there was not anything else going on. The Dr. mentioned that he couldn’t remember the last time he had to remove a granuloma from a patient and agreed that my discomfort and pain was rare. I had a ultrasound performed and I am going back to see the Dr on Monday. I dread this appointment as I will likely ask for another procedure to remove this granuloma. This weekend the pain has become worse and prompted me to join this site.

I attached a pic of the granuloma that was removed. You can see the titanium clip that was in the middle of the mass.

Has anybody’s granuloma shrunk or symptoms become better? Thanks for letting me vent and tell my experience.

Ian,

I too had a granuloma and pain associated with it and the rubbing of the nerves. I had my vasectomy in December 2015 and started having what can be categorized as granuloma/nerve pain starting about 3 days after the procedure. The first couple days was pain, but seemed to just be surgical.

You can see my story and such above. Fast forward to July of 2016 and I actually had the granuloma removed, because it did not go away. While it had decreased in size it wasn’t getting any smaller. The urologist I saw, thought that with removal the pain would subside and hopefully go away entirely, because he felt it was rubbing against a nerve. However, since I waited 7 months to take care of the issue, he didn’t know if the pain would entirely go away. I saw Dr. Nangia out of KU Medical Center for the recommendation and removal. He performed the removal under full anesthesia (which I am glad to have done it that way). When he completed the new procedure though, he did not use any clips. He just cauterized I believe and then used some dissolvable stiches. He didn’t want anything that could cause additional rubbing.

After the operation I had another knot form and some swelling of the spermatic cord, but that was all temporary for me. That has all gone away. My pain is almost gone now, but I do still have minor discomfort at times, so I am not fully healed. I also don’t think I will be able to run anymore without causing flare ups. But, I can lift heavy weights again, which I wasn’t able to do and I can do the elliptical and ride a bike. I think the impact of running causes some issues.

I’ve heard that some of that pain can go away as the nerves heal and could take up to a year to 2 years for damaged nerves to heal. So I’m still hopeful that it will slowly diminish and possibly fully go away. Time will tell. But I can tell you that I am 100% confident that I made the right choice with the removal of the granuloma. I may have just gotten lucky on another one not forming so far or it may have just healed properly this time.

Here’s knocking on wood that things don’t turn south.

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That picture is fascinating. Thanks for sharing. Is the granuloma on the testicular end of the vas or the vesicle side? Why clips are still used is beyond me. They dont seem necessary and there are plenty of complaints on this site about them.

Granulomsa are a necessary evil and your body’s response to the new anatomy. If the granuloma is on the testicular side, there’s a high likelihood it’s there in response to the sperm. (The opposite side is probably the titanium clip)

I speak teeth. When a nerve dies in a tooth, granulomas form at the ends of the roots in response to the toxins that are now leaking from the dead nerve. A root canal sterilizes the inside of the tooth and within days the granuloma shrinks and after a few months it’s completely gone.

Remove the irritant and the granuloma should go away on its own.

The key is the figure out the irritant. It could be bacterial but I doubt it. Perhaps it’s the clip but I think you’ve fixed that. It very well could be sperm and considering the fact that your immune system is now targeting that stuff, I’d pint my finger at that.

Just a guess but I feel like if you can shut that off it should help. I’d try T replacement therapy if you’re even marginally low in testosterone. If those numbers are good, try papaya seed therapy as mentioned on this site. That’s my advice

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@Ian

Was the procedure covered by insurance, including the anesthesia? I’m curious. I have a pea sized granuloma on my left side. I’m getting a reversal in a couple weeks, which will include having the granuloma removed. Of course insurance says no to covering the reversal. However I’ve been arguing that removal of the granuloma is something covered and that the insurance company should at least cover the cost of anesthesia. No answer back yet but my urologist thinks they’re going to reject it.

I had bilateral granuloma pain after my vas. Excruciating pain. Had them removed as well. Totally resolved granuloma pain however I developed painful scar tissue in response to surgery which I had removed when I got a reversal. I actually thought I developed granulomas again but turned out it was simply scar tissue. That was supposed to be my cure but unfortunately I’m dealing with scar tissue pain again after the reversal.

I’m with you on this choo, and @Ian, I too appreciate you sharing this picture. Yikes!

The granuloma pictured above was removed from the right side and grew around the titanium clip on what I believe to be the testicle side of the vas. When the granuloma was removed, the area was cauterized and the doctor used dissolving sutures. The granuloma was removed with local anesthetic and I was conscious. It was very similar to my original procedure. The initial granuloma removal was done free of charge by the doc that preformed my vasectomy.

These past few days I’ve noticed that I am favoring my right groin area. When I squat or bend over, I subconsciously try to keep my right leg straight. Sitting, squatting or bending definitely creates more pressure and pain in the area.

I met with my second opinion doctor today and he received my ultasound results. The ultrsound looked good with exception for the expected granuloma. The doctor did not recommend a second surgery to remove the granuloma. He was hesitant as he believes that this can be a reoccurring issue. If he did perform the removal of the 2nd granuloma, he would remove more including a gland and the entire portion of the vas where the granuloma is. He also mentioned that the steroid injection was essentially an anti-inflammatory and would be very painful and have short term results. Instead, the doctor has referred me to a pain clinic and said they will likely recommend an injection in the back to numb the area. This is obviously not ideal and a little frightening. I have an open mind though and will meet with the doc at the pain clinic and get his professional opinion of what is needed.

My wife and I have a set of 22 month old triplets, so a reversal is definitely not ideal, and today’s doc mentioned that I could easily end up with more scar tissue to irritate matters worse. I’m not looking forward to the pain clinic but I do hope to get back to normal. I must say that I have been extremely irritable recently too and I feel that my chronic pain has something to do with this.

Granulomas shouldn’t grow without an irritant. It’s seriously consider an option to halt sperm and see if that does the trick. Pain management will just get you high.

I’m curious, what are some options to halt the sperm? I do not think the injection in my would cause me to get high, would it? I will not take any opiates. Thanks for your thoughts.

Pain management is typically pain meds. Injections won’t get you high but it doesn’t last more than 5-6 hours. I hear a lot of talk about nerve blocks etc. this is really a temp fix or s diagnostic tool. It’s not going to help long term.

To stop production of sperm, that’s either papaya seed therapy or testosterone replacement therapy.

Listen to choo choo he’s dead on and I’d say me and him know more than 95% of the urologists out there now from an Anatomy and physiology standpoint. Urologist at Cleveland clinic said he recommends increasing T on all pvps sufferers if it looks like congestion or granuloma to stop the production of sperm. Makes way more sense than blocks if your not getting nerve pain.

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So I got a vasectomy and got a sperm granuloma. Doctor said it might go away. I was stubborn and went back and asked if it was going to go away which it probably was going to over time but the doctor then said we can cut it out no problem. It’s a minor surgery just like the vesectomy. You’ll be good in like 3 days. BS. It’s been like 2 months. Still have problems. Now I have a huge lumberjack of scar tissue or something on top of my right testicle and it is very annoying. Wondering if it will go away at all. Don’t want a third surgery. Just super pissed at my doctor. He said it would be fine. Never mentioned the risks of more issues after the surgery. Not sure what to do. Maybe it just takes a ton of time to heal?? Not sure. Trying to seek answers. Feel like I was needlessly put through surgery. Also the doctor didn’t tell me they were going to cut into my testicle!!! Crazy. Definitely would have said no. Also they put me under for the surgery. And he seemed nervous like he’d never done the surgery before… should have listened to my gut…

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I’m right there with you , been almost 4 weeks. Day 6 started getting a lot of pain and swelling above left testicle. Went to the er twice and got 2 ultrasounds . They keep telling me it’s normal but I can hardly walk. The lump is bigger then my testicle’s . They put me on doxacyline in case of infection but all the ibuprofen Tylenol and oxy, still doesn’t subdue the pain

Mine was painful too. HAd it cut out as part of my reversal. I still get pain at the site from the granuloma - it was wrapped in the cord and nerves.

Most of these “knots” are oversize scar tissue. I’m no doctor, but they may form due to many reasons. One is sperm leaking out of the vas. Another is a reaction to any foreign body, sutures and whatnot. And obviously a reaction to many layers of skin and muscle after being cut open. Some people heal easier than others, but in many cases scar tissue formation is unpredictable and may lead to great discomfort, especially if they adhere to other internal tissues.

Doctors don’t really care much about adhesion down there because it’s not like having one in your shoulder or knee, which is also quite painful. Also because the only way to remove bad scar tissue is by making a second incision, and the adhesion may form again - only thicker and to a greater extent. This is possibly why doctors don’t take them out right away. But maybe they just don’t have a clue.

I have a lump on the left side. Fortunately, it doesn’t hurt. But it took quite a while to heal and the skin is all glued together at incision site.

Sterilization through surgery is not a “contraception method”. It is genital mutilation. Plain and simple.

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I still have pain and discomfort after the granuloma was removed. I have not had the 2nd granuloma removed. My Dr sent me to a surgeon to get his opinion. The guy was very upfront and honest saying he doesn’t know if removing it again would do anything. He thinks its a combination of the granuloma and scar tissue. If he were to do anything, he would remove the granuloma and wrap the end of the vas with “pig bladder.” Pigs have phenomenal healing qualities and the bladder is used to assist with healing and keeping swelling down. I was shocked by what he said and decided to give it some time to heal. Due to reoccurring pain and discomfort I will begin exploring all options.