Post Vasectomy Pain Forum

Pain from Granuloma? And other sperm granuloma questions

#41

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.

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#42

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

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#43

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.

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#44

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.

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#45

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.

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#46

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.

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#47

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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#48

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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#49

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

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#50

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.

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#51

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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#52

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.

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#53

Hi @Ian, have you considered trying papaya seeds? Won’t cause any harm giving it a go

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#54

Hey guys-

I know this thread hasn’t been responded to in a while, but I was searching for some granuloma removal experiences and thankful I found this!

So, long story (hopefully) short, I had my vas in Jan '18 and was done (absolutely the worst in some many ways) with the original urologist by the spring. Was having definitive discomfort that I knew wasn’t normal. Based off a reco from a friend, started seeing a second urologist in the summer of 2018 and after 4 visits (at my second visit he gave me a cord block that if anything made my pain worse) ending in late November, went with his reco to excise the original vas location, remove any scar and recap*

*This was what he thought was causing the issue

Had surgery on Jan 17th, 2019.

So… its exactly a week after my ‘excise’ and what he ended telling me (a couple days after the procedure) was I actually had a granuloma and he removed it completely and he’s ‘confident’ that will solve my discomfort. What I’m dealing with a week later is just a very rough recovery.

1st, Can someone put me at ease and let give me ballpark as to when by left nut (the side giving me all the discomfort) will stop looking double the size of my right??? My consolation has been I’m not worse over the past 3 days or so, but I vary between a dull ache, to a constant soreness to just full on discomfort. Sorry to be graphic, but by the end of the day, my left testicle doesn’t even comfortably fit within the constraints of the jock strap…I have to tuck it in. again, sorry for the graphic visual…

For the swelling, was first on Hydocodone with Acetaminophen, but that made me loopy and constipated so I called and they recommended a NSAID called Sprix. It’s nose spray version of Toradol. Anyone ever been prescribed it? Its relatively new.

I’ve been using it in conjunction with Tylenol so between switching off between the two of them I suppose I’m getting some temporary relief.

Sorry…rambling, but trying just to grind thru this 1st wave of recovery and am getting inpatient. Would just love to know how much longer I need to endure.

2nd- Will the removal of the granuloma result in most of if not all my discomfort to go away? Can anyone give me their verdict? I’m encouraged by the post I attached in this thread. My urologist said in addition to the granuloma there really was minimal scar tissue so hopefully that won’t be an issue moving forward…actually sounds like it never really was.

To end this rant, just want to be realistic about the recovery and am really just hoping I know the surgery was a success within 4-6 weeks…hoping that’s a realistic time frame…

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#55

Hi Jdubb64321,

Well, I’ve still got pain that comes and goes. Removal of the granuloma didn’t fix everything for me, but I do believe part of my issue is a muscle imbalance, that I am dealing with and things have been better. Also I have been using Papaya seed powder over the past few weeks and that also has seemed to help. So I still do have minor pain in the groin and inner thigh sometimes, but not anywhere like it was prior to the redo.

After the initial redo, I would say that the surgical site caused me pain for probably a good 4-6 weeks. It was tender to the touch and the felt like you would feel if you had an open wound and put pressure on it. This diminished over the timeframe I gave above. But my doctor also said that he had to cut more of the spermatic cord open, to get to the granuloma and such, so it made sense it was more painful and took longer to go away.

I didn’t have the second nut scenario that you are describing above, but that is probably just inflammation from the surgery. I would say that you should limit your activities (which I’m sure you already are), stay on the anti-inflammatories, and know that over time it should get better. The more you stress, I believe the more those muscles in the pelvic region are going to tighten, which will probably put some additional pressure on the spermatic cord and cause some of the pain you experience.

I’m no doctor, so the above information is all just a best guess and some suggestions from someone that has been there in the past.

The question I would ask, is what was your discomfort before? Was it pain in the testicle or an achy feeling? Mine was mainly nerve pain in the inner thigh and groin area, whenever I exerted myself and some at the vas cut site. I had very minimal if any discomfort in the testicle itself.

Feel free to send me a private message if you want.

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#56

Hey Uncomfortable-

Thanks for the quick response, very helpful.

Additional questions/answers/comments:

Is your muscle imbalance in any way related to the vas??

Far as papaya seed, I have been hearing good things? Do you think it will alleviate my discomfort as I’m going through the recovery period of later (the ~4-6 period you mentioned) if I’m still uncomfortable?

Thx for letting me know about the 4-6 week benchmark. As much as I didn’t want to read that, I really think that is what I’m facing.

I’m thinking that my dr had to cut more of the cord open as well cause he mentioned he ‘really needed to get in there and remove the granuloma up to the skin line’ so that’s main reason I think the 4-6 weeks seems right.

Thx for putting me as ease about the ‘nut’ scenario. Totally makes sense that its inflammation and I’m definitely limiting my activities. Might have overdid it a bit today though…yes, going to stay on some sort of anti-inflammatories and thank you for the advice about stressing… honestly, it’s been hard not to, but I try and stay distracted at work…

So, as far as my discomfort, pain was def in the testicle AND it was kind of an achy feeling that came and went (there were weeks where I had almost no discomfort and then it would just come back) and really was isolated to that area and didn’t radiate to the thigh. Everytime I went to the ‘new’ dr he felt something, but never mentioned granuloma… so…it sounds like were experiencing different types discomfort, but both had the granuloma removed…

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#57

Is my muscle imbalance related to the vas? I would have to say, yes. Was it due to the surgery itself, probably not, but due to the way I walked for the weeks/months/years after the surgery. I can definitely tell that I walk different now, than I did before the vasectomy. I tend to apply less weight to my left leg, almost like you would do if you were trying to walk without making any noise. So over the last few weeks/month or so, I have been making a conscious effort to walk with my weight distributed evenly. It seems to have helped.

I think that after my original vasectomy I really guarded myself and my muscles really tightened up on the left side. I know this happened for a fact, because I went to a sports chiropractor for it (about a month and a half after my surgery) and he said my hip flexor and psoas was really tight. My biggest problem is that I rush everything. After my first few visits to the guy I was seeing, I was feeling a lot better and started to try and get back into things like normal. This caused things to retighten. I saw him maybe another 10 times over the next couple months and I would do better, then try and do too much and go back to where I was. Nothing in moderation for me…I was either on or off, not good to do in this situation.

I then had the second surgery. After about the 6 week mark I was only have twinges every now and again, and I saw the urologist that did my surgery. He said to go ahead and go back into working out and see how things go. So I went full steam ahead…not smart. After a few days I had some of the pain again and got all stressed out and anxiety riddled. Stopped working out and over the next couple months was doing better again. So I decided to go at it again only this time I vowed I would go slow. Went about 4-6 weeks of very mild workouts and was doing better, just minimal discomfort in the groin/inner thigh, so I pushed myself again pretty hard, just wanting to get back to what I was doing before I had the surgeries. Guess what…I started to have the nerve pain again. This has been a common route, because I want to do things ahead of schedule.

About 6 months ago I noticed my adductor muscle on my left leg was noticeably smaller than my right and I could see an indention. Then about a month ago I noticed my left calf muscle was noticeably smaller than my right calf muscle. Since then I have really been focusing on my calf muscle and my adductors and thigh muscles on my left side, making sure I’m not ignoring my right, but just giving my left additional attention. I have also been focusing on walking evenly as mentioned above. Things have actually felt a lot better since I have started to do those things.

So, here is my thoughts on the whole situation. After the initial surgery, my left side tightened up (because I felt a lot of what they did on that side, I don’t think they numbed it enough) and I became really guarded with how I walked and such. Things got loosened up with the chiropractor, but when I went back to the same regiment I was doing, I still was guarding that side, probably walking/running differently which caused pain/anxiety/tightening of muscles.

After all of the time that I have spent guarding my left side and walking differently, I believe a muscle imbalance developed, which I am trying to get back into alignment, but I know it will take a lot of time and will have to be patient. I also know there will still be some pain involved, during this process because the muscles are out of whack. Now, the question is, will this fix the remaining pain I tend to get? I don’t know the answer, just yet, but I’m hoping that it will. Time will tell. But I do know that I can jump on the elliptical or bike and also lift weights without much if any pain recourse. Running is still a work in progress.

As to your question about papaya seed. I would take it if I were you. I’ve read some articles on it and not only does it work as a spermicide over time, but it also has some anti-inflammatory properties as well. That’s why most people take it, so it would probably be a benefit. I wouldn’t think it would hurt, but again, I’m not a doctor. Your pain may have been more congestion related, rather than the granuloma rubbing on the nerve, which would mean the papaya seed would probably even help you more, based on posts by others on the board.

Sorry for the long winded response. That’s my story and thoughts. Hopefully you can get some information from that.

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#58

I’m glad we can be long winded on this forum cause I think it truly helps…

So…everything you are saying about the imbalance I will certainly try and be conscious of and look out for.

I’m also glad you said my pain seemed like it was congestion vs. the granuloma cause I always thought the same, but my dr didn’t think so. If it ends up that the granuloma removal doesn’t solve the prob then I will need to bring that up again…not sure what can be done surgically for that hence maybe just time and the papaya seed powder to help with the inflammation

We are very similar in the all or nothing mentality… If I’m going to the gym (which I tried again back in Oct when I was feeling better…but the pain came back) don’t want to be limited. I too, really just want to do the elliptical and do some light weights… If I can get back to that within 3-4 months with out much discomfort I will be very happy…

Thank you again for your perspective…truly appreciate it…going to order the papaya seed powder and then try to explain to my wife what the heck it is :smile:

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#59

Yeah. I left a lot out of my story too. See past posts and some of my replies to others. I also did a lot of stretching and did pelvic floor therapy for a while too. They both helped me, in my situation. I think it’s a combination of time, going slow, relaxing, and stretching that has gotten me to this point. Hopefully I continue my positive trend. I just have to constantly tell myself that its a marathon, not a sprint. That’s been one of the hardest parts so far…

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#60

Hey guys-

Just a quick update here and hoping for a little perspective. 4.5 weeks post my granuloma removal and the last 5 or so days have been very discouraging. Was truly feeling better just around the 3 week mark and then some pretty drastically changes mid last week. It pretty much feels like when I had periodic flare ups in the first year following the original procedure. (for a quick reminder- had initial vas in Jan '18 and the granuloma removal and recap in Jan '19) I know I’ve been reading (thx guys) 4-6 weeks till some real relief (I’m pretty much as that mark) but what is so frustrating is that I felt the relief and then the discomfort just comes back like a bitch!. Maybe I aggravated it (have had sex only twice since the removal…once in the middle of this most recent discomfort period…which is hindsight probably wasn’t the best idea…)

I’m going back to Dr (scheduled appt) on Friday so hopefully there is a logical explanation for this. I’m just going crazy in my head… did the granuloma grow back so fast? (doubtful, but I just want to rule that out) The other thought it what I thought I had from the beginning which is/was congestion. From what I read here you just need to be patient with the nerves calming down and it could take a couple years. I’m basically switching between Aleve or Advil thru the evening and its works ‘ok’… don’t have anything stronger anyway… Also have been back to wearing a jock strap the past couple days just to keep the boys immobile as possible.

Any perspective could be greatly appreciated gents…

J Dubbs

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