Post-Vasectomy Pain Syndrome
Post-vasectomy pain syndrome (PVS) is an umbrella term for persistent pain over time after a vasectomy that is not directly related to the surgical wounds. The pain can be of varying quality and localization, mostly it is pressing pain in the testicles or epididymis. There may also be pulling pain in the groin area.
The cause has not been fully clarified to date, as PVS occurs in only a small fraction of the men treated. A possible cause is, for example, the backflow of seminal fluid after the vas deferens have been severed in the epididymis. This can result in the formation of nodules of undegraded sperm (so-called sperm granulomas).
Sperm granulomas also occur in other men after vasectomy without causing pain, so they are not certain to be the cause of PVS. The pain partially disappears on its own, occurs only occasionally in some patients, but in others it has a significant impact on the quality of life. There are several treatment approaches, but in many cases revascularization – i.e. the bringing together of the separated spermatic duct ends and thus the restoration of fertility – causes a reduction in pain. Also a severing of the nerve tracts supplying the epididymis can lead to success against the pain.
Longer lasting pain
Post-vasectomy pain syndrome can still occur years later. Adhesions around the spermatic cord and nerve tracts can be the cause. If the pain persists, these adhesions can be surgically removed.
However, PVS occurring after years is rather untypical. Pain in the testicles therefore often has other causes and is rarely related to vasectomy. A more frequent clinical picture, especially in men over 50, which can cause pain in the groin and testicular area, is the inguinal hernia, in which organ tissue can protrude from the abdominal cavity through a hernial orifice through the inguinal canal into the testicles.
Somewhat less frequent is varicocele, a vascular sacking of the veins supplying the testicle. It also causes pain in the testicles. A vasectomy does not increase the risk of developing other diseases, contrary to what has been widely believed in the past.
However, in rare cases a testicular tumor may be behind the pain. All in all, pain or swelling of the testicles over a longer period of time needs to be clarified. These topics may also be of interest to you:
- Diseases of the testicles
- Inguinal hernia – these are the symptoms
