AboutArthur Goldstein, M.D. Expertise Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations American Medical Association, American Urological Association, American College of Surgeons
Question I'm 40 years old and had a vasectomy about a year ago. I am currently experiencing a good amount of soreness in my left testicle only. The sac feels completely fine as does the right testicle. It feels as if the left testicle is swollen some and there is something soft surrounding the testicle, unlike the right testicle which feels like it always normally does. I can't recall anything that provided a reason for the soreness, i.e. getting hit, etc. The soreness is constant and I have never experienced this before, either pre or post vasectomy. What could be the cause?
Answer Mike, this is a fairly common long-term occurrence after vasectomy with a frequency of around 10%. Since sperm are still produced by the testicle but cannot escape the tubules (epididymitis), pressure can build up and some of the microscopic tubules can rupture. The leakage of sperm into the surrounding tissues sets up an inflammatory response noted clinically as swelling and discomfort in the area. The treatment is warm baths or compresses, a scrotal supporter, and anti-inflammatory agents such as ibuprofen. The process typically lasts 3-7 days and clears completely.
Another similar condition is the development of a spermatic granuloma characterized by the appearance of a small, tender nodule at the end of the severed vas. These usually can be left alone but if they cause persistent discomfort, surgical excision will cure the problem. Spermatic granulomas do not disappear whereas the the inflamed epididymis will. If the process does not resolve, contact your urologist for re-evaluation to make sure nothing more is going on. Good luck.
